Nurture the Motives that Brought you to Medicine

Learning how to communicate effectively with patients is an important part of every physician's training. Physician educators are often challenged to decide how to teach "empathy" and great deal of research and study has gone into helping new physicians learn the proper techniques. After a recent and lengthy discussion thread on this topic on a medical education listserv, Ms. Barbara Packer cut through all the rhetoric to get to the heart of the matter. - Linda Rowe Barbara Packer's message to physicians. July 8, 2014: Before any of you learned or taught “med-speak,” you had another language which hopefully included how to respond to people around you who might have experienced joy or pain. I think if you can impress upon your students the fact that each patient is a unique human being and that they need to meet each one of us with their humanity, this might not be as complicated as it appears. You don’t need to prove you have been in my shoes in order for you to let me know you care that my walk is burdened, and that you want to help me relieve that burden. We patients know when physicians are authentic and when they are not. So a little more nurturing of the motives that brought students to medicine might be in order. Best, Barbara Barbara Packer Senior V.P./COO The Arnold P. Gold Foundation www.humanism-in-medicine.org Working to keep the CARE in healthcare!

HELP DRIVE AWAY CHILD ABUSE

Show your commitment to kids and child abuse victims by purchasing exclusive Stop Child Abuse Special Event License Plates. Display these blue ribbon license plates during March and April, and show your support with the Pediatric Resource Center in the fight against child abuse in Central Illinois. Each year professionals all over central Illinois help over 350 children obtain much needed specialized-medical exams and case-management services through the Pediatric Resource Center. These exams are often vital for the health of the child and to assist with criminal and juvenile court processes. All proceeds from these special plates will benefit the PRC. To purchase these temporary special license plates, simply complete a form http://p1cdn4static.sharpschool.com/UserFiles/Servers/Server_442934/File/Peoria/Departments%20and%20Programs/PRC/BlueRibbonLicensePlate/2014%20PRC%20License%20Plate%20Registration%20Form.pdf and return to PRC one of 3 easy ways: 1. Mail your completed form, a copy of your current vehicle registration and a $40 check to PRC, 530 NE Glen Oak Ave., Peoria, IL 61637 2. Fax your completed form and a copy of your current vehicle registration to 309-624-9694, and we will send you an invoice for the cost or let us know you will drop the check in the mail 3. Send an email to prcinfo@uicomp.uic.edu along with a scanned copy of the completed form and copy of your current vehicle registration, and we will send you an invoice for the cost or let us know you will drop the check in the mail Interested in the special license plates but have a question? Call Amanda Erwin at the PRC, 309-624-9595 or email prcinfo@uicomp.uic.edu The PRC is a program of the University of Illinois College of Medicine at Peoria

Giving Bad News Compassionately

It’s never easy telling someone’s family that their loved one might not make it. The ability to do so might set good physicians apart, but it also a skill that is difficult to teach in medical school. Most would say it falls under the “art” of medicine, and that it is something that one can only master with practice and the right perspective on life and death. I am grateful to have had the opportunity to learn second hand from “Dr. S” during my rotation on the neurology service this year. What I also learned from Dr. S is that giving bad news is even harder to do when that patient and her experiences resemble so much of your own life.

Our patient, “Jennifer”, was transferred to St. Francis Medical Center that day after suddenly becoming unconscious hours after running a marathon. Her loving husband, mother, father, and mother-in-law accompanied her. Her two young children were in the waiting room, not old enough to understand what was wrong. Her diagnosis was a massive stroke to her brainstem.

By the time she arrived, she was non-responsive on a mechanical ventilator and there was little that could be done in terms of immediate treatment. As a medical team, we decided the best thing we could do was to wait and see, day by day, how she would recover. We also set out to understand why such a debilitating injury could happen to a seemingly young, healthy individual who had no previous medical history. As it turned out, Jennifer had the misfortune of having a serious genetic clotting disorder that did not show itself until that one fateful day.

As the days went by, it became increasingly clear that Jennifer’s odds of meaningful recovery were getting slim. She displayed some primitive reflexes, but continued not to be able to breath on her own. It was time to have a more frank talk with the family about Jennifer’s situation.

Dr. S was the leader of the care team, and led the family meetings that ensued. She displayed poise and confidence, empathy and concern like she had so many other times. However, there was something about this particular situation that seemed to be affecting Dr. S more than in the past. It wasn’t until my last day on the neurology service when I learned why.

In a discussion at the bedside with Jennifer’s mother, Dr. S and I answered more questions while we were examining our patient. It was during this conversation that Dr. S started to break from her usual stoic, doctoring persona, and began to discuss with the family how this case had affected her personally. She let them know that Jennifer and her were the exact same age, and that their kids were the same ages as well. Even small details from Jennifer’s life had reminded Dr. S of her own.  That was why it was even more difficult for her to say that to the family that their loved will likely never recover. Her encounter with Jennifer seemed to bring the idea of her own life’s fragility into remarkable clarity. It was then that Jennifer’s mother broke down into tears and Dr. S followed suit. Not a word was said for a period of time, and the visit with Jennifer ended with Dr. S getting a hug from Jennifer’s parent as if it were her own mother. It was a moment of pure empathy. It meant more to the family then I could possibly put into words.

I still wonder if before that day Dr. S ever thought about how her family would deal with things if she were to one day unexpectedly go into a coma. Even if she had, I wonder if it could have captured the true gravity of the situation. Hearing our patient’s story would be difficult for anyone, but it is probably even harder when that story hits so close to home. I think this is what makes Dr. S’s actions even more impressive, and why she is a wonderful testament to compassionate, humanistic care in Peoria.


Brian Andonian
UICOMP Class of 2014

Time is Precious

Fictional anthropologist Dr. Temperance Brennan, a normally stoic woman who prizes logic over emotion and science over passion, is mystified when she cannot stop herself from worrying about her baby daughter after dropping her off for her first day of daycare.  She is faced with the fact that it is human to be unable to control certain feelings even where knowledge and trust abound.  Though Dr. Brennan is not real, the dilemma she faces is one that is very applicable to one that many patients face.  Whether the patient and their family has to see a physician for a benign problem or learns that there is a very serious issue, there is the potential for anxiety.

Recently,  during my time in clinic I met a patient whose condition required her to have a tracheostomy tube.  As the visit progressed she became increasingly distressed.  Though calm in the beginning of the appointment, her composure was lost as she described the problems she had with her tube.  Her fear of future pain and of the still unknown condition which had led to the multiple hospitalizations and procedures she'd endured was palpable.  Understanding that her trach tube was likely keeping her alive did not stop the worries she had.  However,  what also became clear during the course of the visit was that she did not necessarily want more information, but that she wanted to feel that the medical professionals entrusted with her care actually cared.  She said, more than once, "You [doctors] don't know,  you never have had one these [trach tubes]."  My attending's empathetic demeanor helped her to feel comfortable enough to share her concerns.  He acknowledge her feelings and made her feel validated,  even though his deeper understanding of her medical situation could have led him to devalue her worries in the face of the necessity for the tube.  At the same time he calmly advised the patient to take the logical steps to improve her situation.

Patients need conscientious care that is explained to them in a way they can understand.  However, what many want is to know that someone, in this case someone with a particular skill set they do not possess,  is in their corner.  For television's Dr. Brennan, it is a husband who encourages her to accept her feelings and a on-site daycare provider at work.   For patients like the one I described,  is someone with and empathetic ear who is willing to use their powers on his or her behalf.  

By taking a little extra time with her,  my attending showed her that he cared.  And that made all the difference for our patient.  Knowledge is necessary,  but time,  especially in the medical field,  is precious.  Giving time and attention to our patients is a way in which we can care for them.
--
Abimbola Olayinka
UICOMP, Class of 2014

Start with the Patient's History

When you ask people why they went into medicine, quite often the answer is “because I wanted to help people.”  Sadly, sometimes this noble intent gets lost in the rigors of medical school and the demands of the profession.  And yet, I think it finds itself best in the little actions of compassion that happen every day.  Good medical care requires a solid foundation of medical knowledge coupled with the ability to communicate that information to others.  Much of the compassionate medical care I’ve witnessed is not about grand gestures—although those are nice—it is about the details:  taking a moment to ask about someone’s family, putting your hand on a patient’s shoulder, sitting down with a patient when you ask them if they have any questions.  I’ve seen all of these at work every day, and I’ve seen how they make a difference.  Physicians I respect and admire do these things with each and every interaction.  In this way, they establish relationships with patients and really can change lives.

I worked with an attending who wanted every presentation to start with something about the patient’s history.  Not their medical issues as is standard, but something about them personally.  I think that was his way of humanizing patient care and trying to teach compassion—not an easy task.  Throughout the tenure of my training I have had the privilege of working with physicians who go the extra mile for students.  These are the physicians that are always available for questions and guidance, and who themselves provide exemplary patient care—modeling the kind of physician I someday hope to be.  These physicians are also changing lives—they are changing the lives of people who will help other people.  I am grateful to have had so many of these role models throughout my education.

Lisa Fosnot,
UICOMP, Class of 2014

The Power of Truly Listening

Too often in the hospital we refer to people as their disease or their symptom: the heart failure patient in room 10, or the shortness of breath patient who was just admitted.  I am guilty of this every day, though I try to remind myself to focus my attention on the person instead of the illness.  My constant lack of really understanding my patients is displayed in my own little case histories that I write or present every day. Most of them begin something like this: “A 55 year old male with a history of such and such disease presents with the following symptoms for this length of time.” The only mention I make of the patient, the person whose suffering is in question, is that he is 55 years old and male, before proceeding to delve into symptoms, the illness or disease, and its characteristics.  The’ what’ part of my case histories are very detailed while the ‘who’ portion is surmised in “A 55 year old male.”  It is too rare an occasion when in the flurry that is the inpatient hospital experience or a 15 minute office visit that I ask patients how they are dealing with their circumstances.  I often forget to ask what aspects of my patients’ lives help or hinder their struggle with a particular illness.  I am, however, trying to spend more time thinking about the narrative of each person because while understanding the ‘what’ is important, ignoring the ‘who’ does not do our patients justice. 

What I understand humanism in medicine to be is very simple in concept but difficult in practice.  It is the ability to listen and show patients that their stories, their lives, are unique, and just as important as the symptoms of the illnesses they suffer from.  In the end, every patient just wants to tell their story and feel they have been heard.  For every time I have failed to ask and to listen, I think I can best describe humanism in medicine with a story of when I got it right.

His name was “Eric,” and he showed up at the emergency room one evening with vague complaints that made him appear delusional.  When the emergency room doctors determined there was no physical cause for his aliments, he was sent up to the psychotic unit for further evaluation where I found him the next morning.

Eric, like me, looked young for his age, and it was instantly clear that he was a very shy young man.  Initially his case appeared to be straight forward.  His family mentioned some ongoing drug use, and the team and I believed him to be psychotic secondary to whatever illicit substances he had been using.  We placed him on medication and encouraged him to participate in individual and group therapy in the hopes that things would turn around within 48 hours.

Several days later no progress had been made and Eric seemed distrustful of the entire treatment team.   Everyone was frustrated, so one afternoon when I had some free time I decided to spend it with my patient.  I sat down with Eric and didn’t ask him about his illness or his symptoms. I asked him about his family, his brothers and sisters, and his child.  I asked him his aspirations in life, what his neighborhood was like, and what he did for fun.  I quickly learned that Eric’s life was much more complex than I had initially thought.  I found out that he missed his child’s birthday while he was in the hospital, and that he was basically the sole caretaker of his grandma who suffered from complications of diabetes.  He told me about his prowess in sports and how he would have made the local high school team had he not dropped out to take care of his grandmother.  We talked about his neighborhood and how it was a rare week when he didn't hear gunshots.  Eric was clearly worried about his family, and I asked him if anything had ever happened to a loved one.  Reluctantly, and with tears welling up in his eyes, he told me about a brother, who got caught up in gang violence, and was now serving time in a penitentiary for murder.  Eric said he felt personally responsible for not keeping his brother out of gangs, and that his brother was still his closest friend.  I gave Eric a hug, thanked him for sharing this information, and reported what I had learned to the team. 

What the treatment team decided was that Eric may not be psychotic, but instead he was under an inordinate amount of stress and was likely depressed.  His symptoms could stem from this depression, and he needed anti-depressant medication as well as outpatient follow up at a drug rehabilitation center.  With the new plan in action, Eric became well enough to leave with his family about two days later, much to his delight, as well as mine.

I hope those few minutes I spent getting to know and understand my patient helped him, but what I don’t think Eric realized was that our conversation helped me even more.  Through our interactions I came to understand the power of truly listening to a patient, and I came to believe that in our patients’ stories lies humanism in medicine.    

(Anonymous)    

Student Provides Comfort to Pediatric Patient

I was working on a consult service and was asked to see a Pediatrics patient. She was a young girl, just under 7 years old, and had initially presented with fever, rash, and pain. After an extensive work-up, including evaluation for autoimmune diseases, she was diagnosed with pediatric lupus. 

Just as I was about to enter the patient's room to evaluate her, the third year medical student on the Pediatrics team who was caring for this patient, met me outside the room. He shared with me our patient's story and his understanding of her hospital course up until that point. He shared with me many of the details of our patient's history, which could only have been acquired by someone who had spent significant time at the bedside. 

I asked him if he had any concerns about our patient, to which he shared that he was concerned about the patient's emotional well-being. He revealed that the patient's parents were rarely present, and that the patient appeared scared and lonely. I later found out that this medical student had been taking the patient to the playroom, giving her company and ephemeral retreat from the confines of a hospital room. He had gone above and beyond the expectations of a medical student in order  to address the patient's social and emotional needs. 

I was impressed with this student's insight into the global needs of our patients, and humbled that he did not feel it was outside of his scope to care for her in this way. In the end, I am certain that our patient's hospital stay was not defined by the nature of her diagnosis, but rather by the exemplary medical student who went out of his way to make her feel at home. 

Meghna Motiani
UICOMP, Class of 2014

No Task Too Small to Help a Patient

With how busy many physicians and residents are, it seems that even the most simple and important aspects of the physician-patient relationship are overlooked. However, one medical student that I worked with for a month never found any task too small. Even as the attending would breeze in the room, get the information he needed, and quickly walk out with the rest of the team, this student always remained in the room. She would stay there to ask what questions the patient had, what she could do or get for the patient, and if the patient would like the door closed or not after she left. No matter how busy she or the team was, how complicated or simple the patient's problems were, or how friendly the patient was, she always did her part to make the patient feel important. She always made listening to the patient important. Her consistent actions made the patient feel important. And her actions inspired me to do the same.

Charlie Jain
UICOMP Class of 2014

Perception

THIS POEM RECEIVED HONORABLE MENTION IN THE FIRST ANNUAL EXPRESSIONS IN HUMANISM CONTEST, SPONSORED BY THE UICOMP CHAPTER OF GHHS

___

Perception

by Brittany Price, Class of 2015

Copyright Brittany Price, 2013.  All rights reserved.

It could have been the most miniscule part of your day
But through the eyes of another, their life could change.
Whether it is talking with a lonely person, or sitting with someone who is sad,
You never really know the impact you will have.
So, maintain an awareness of others
While fumbling throughout your day,

Because in some cases, you may never be able to take your influence away.
Five minutes with a piece of your heart shining through.
What could five minutes mean to you?

A Measure of Performance

THIS ESSAY WON THE FIRST ANNUAL EXPRESSIONS IN HUMANISM CONTEST, SPONSORED BY THE UICOMP CHAPTER OF GHHS
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A Measure of Performance

by Matthew Chia, Class of 2015

Copyright Matthew Chia, 2013  All rights reserved.

If there is a common axiom to modern medicine, it is that performance is discretely measurable. Throughout our premed and medical school curricula, we are judged on exam performance, letters of recommendation, or research accomplishments, each of which represent milestones that are meant to quantify our abilities and our hard work. In medical practice, there seems to be an ever-increasing number of external forces that evaluate, score, and count. Hospital administrators deliver policies and performance metrics, while Associations, Societies, or Groups deliver countless publications and guidelines. The insurance companies deliver miles of red tape, living by the rule “deny, delay, and refuse to pay.” While a physician might praise or curse any one of these, you might think that above all, a physician’s performance has been anatomically dissected into its vital components.

And so, a patient presents with poorly-controlled diabetes mellitus and depression. A physician can take his or her vast experience and apply it thoughtfully, balancing each and every one of the external forces that would test a physician’s competence.

But here’s the trick. Today, this patient didn’t present at all. She existed, and was well known to my preceptor, but I still don’t even know her name. Today, we saw her family, who came to us frustrated, tired, but most importantly, near the edge of despair. Our patient, who I will call Mrs. D, had fallen into depression and was refusing to take her 500 daily units of insulin. Her condition declined, blood glucose rising so high that her glucometer failed to even produce a number. Even as her mental status deteriorated, she refused to seek care, refused to allow her daughter to call 911, and refused to allow her husband to take her to her primary care physician, who she knows and likes.

In my mind, I was starting to quantify our inability to care for Mrs. D. I wondered about the legal ramifications of DNR, about reimbursements for hospice care, and about why we still didn’t have her chart in the room. But my preceptor didn’t balk at any of these things. He first recognized the pain the family was in, and the hardships they tackled each and every day. He carefully asked about Mrs. D’s symptoms and behaviors, and what her family had tried to do. After further dialogue, he told them that Mrs. D should get to the hospital, by the husband’s legal consent, or when she fell into a coma. But what stunned me was what he said to them last;

“Make sure to bring her here. If the ambulance takes you to another hospital, I can’t be there to take care of her.”

If that seems underwhelming, consider how anybody would measure this visit. Mrs. D received no care, and thus fails to meet policies and performance metrics that a hospital might set for diabetes patients. Her quality of care is certainly outside what the American Diabetes Association guidelines recommend. In fact, because there was no proper patient encounter, my preceptor spent more than half an hour in a way that insurance would not pay for. Ultimately, I realized that he cared deeply about his patient, whether or not his patient cared about him, or about herself. Mrs. D’s family knew that he was there to support them through this critical moment, and that Mrs. D had a real advocate. She was a case that could have been punted to another hospital, given up on, or forgotten about. In fact, I am embarrassed to say that our jam-packed schedule for the rest of that day was already on my mind. But my preceptor was properly focused on giving Mrs. D the best care he could give her.

I should now spend the rest of tonight studying about the sequelae of prolonged ketoacidosis, and the inpatient management of severely hyperglycemic diabetes mellitus. But today I saw a performance that showed me medicine beyond the rubric, medicine that exceeded measurement. It is a lesson that I will carry not on another scribbled notecard, but in my head, and in my heart.

Expression in Humanism Winners Announced

The Peoria Chapter of the Gold Humanism Honor Society is pleased to announce the outcome of its first annual "Expressions in Humanism" contest.  The winner is Matthew Chia, class of 2015, for his essay, "A Measure of Performance."  Honorable mention goes to Brittany Price, class of 2015, for her poem, "Perception.

Their entries will be presented in subsequent posts on this blog.

Linda P. Rowe, EdD
Advisor, UICOMP GHHS Chapter

"He even had her smiling"

In a recent comment on an OSF St. Francis "DAISY Award" card, it was said that student doctor Matthew Fischer (Class of 2014) "was very calm, compassionate and caring while examining [a patient]. He even had her smiling by the end of his visit."

Humanism Every Day

Just an obvious reminder—humanism and compassionate care should be there 100%, 365 days a year.

L. Whittaker, Jr MD, FACS

Families of Patients Appreciate Compassion in Care

One of our senior medical students shared this inspiring story about an Emergency Medicine physician's expression of how he was touched by a dying patient http://m.cbsatlanta.com/w/main/story/85029303/

In turn, his revelation of an emotional connection provided some measure of comfort to the patient's family.

Although this story did not happen in Peoria, I think it could have.  Over the years I have read letters in the newspaper and heard comments from families who deeply appreciated the compassion and caring shown by our local emergency room physicians and nurses during some the darkest moments in their lives.  I am grateful that our students are able to train with such inspiring role models.

Linda Rowe, EdD
GHHS Chapter Advisor
University of Illinois College of Medicine at Peoria

Pediatric Surgeon Goes Above and Beyond

My daughter had numerous admissions to the children’s hospital between the months of November 2011 until December 2012. This included too many surgeries to keep track of.  We had the utmost privilege of having Dr. Mark Holterman involved in her care from day one. Not only was he relentless in finding the cause of her pain, he was also relentless in keeping her happy and safe.

After a major surgery, Steph asked why he left his starbucks in the hall.  He stated that it wouldn’t have been polite to drink in front of her since she was NPO. He then offered to bring her one when she could drink again and asked her favorite kind. The next day, he asked his PA to get Steph what she wanted.  Around noon, Dr. Holterman himself showed up in our room with the Starbucks she had ordered, that he personally had went and purchased.  Talk about making a kid’s day and a good doctor/patient relationship scaled to the next level.

It is just the little things in life that keep it human in the medical world. 

We are forever grateful for those little things that mean so much to a teenager trapped in pain and in the hospital

M.L.

OSF St. Francis Medical Center

More than a Doctor

For the last few weeks of my internal medicine rotation, I traveled more than an hour away from Peoria to work with Dr. Mark Fernandez in his outpatient office. As I prepared to see my first few patients, I pored over their medical records, gathering every detail, lab result, diagnosis, and other relevant historical information. After interviewing the patient and gathering my thoughts, I would locate my preceptor to present my findings. Before each of my presentations, without fail, rather than delving into the intricacies of their illnesses, Dr. Fernandez preferred to tell me about his patients - not in reference to their medical conditions, but rather with respect to their lives. He would say something like, "Oh, Don is here today? He's been my patient for a long time. He's a really great guy! I see him at the gym and our kids are in scouts together." Time and again, it impressed me how well Dr. Fernandez knew his patients. No matter how many appointments he had scheduled on any given day, he would always take some time to update me on how amazing his patients were as indviduals, then would turn the ensuing clinical interview into a conversation between friends.

The most remarkable enounter I witnessed was with an elderly patient with multiple problems. The patient's son was a fairly close acquaintance of Dr. Fernandez. It quickly became apparent to me that the patient's health was deteriorating rapidly. The gentleness, care, respect, and compassion that Dr. Fernandez showed this patient was more than a doctor-patient relationship; it was something akin to how a son would treat his ailing parent. Through it all, I could see in the patient's eyes that Dr. Fernandez was more than a doctor; he was part of the family.

As my time in the office came to a close, Dr. Fernandez left me with this final thought: "My patients don't come to this office to see the doctor. They come to see me." the most brilliant and intuitve doctors can effectively treat diseases, but true success and satisfaction come from treating patients. In the end, that's what it's all about.

Christian Nunez
Class of 2013
(some details in this story have been altered to protect privacy)

I will Fix You

A Human Connection in the Trauma Room

"Excuse me," I shouted, barely avoiding running into two nurses as I jogged down the long, dimly lit hallway. The trauma pager had beeped at 2:15 AM, waking me from a light sleep in one of the call rooms on the opposite side of the hospital. As I continued my half run, my brain was still waking up. Injured people from a motor vehicle accident involving a semi-truck and a SUV had  been transported to our hospital. My imagination was kicking into full gear. Entering the trauma room, I found the charge nurse and scribbled the information I needed on my pad of paper. The doors burst open as the driver of the SUV was rushed in with the emergency transport team. The whole room erupted into chaos as I did my best to stay out of everyone's way.

After thirty minutes of tubes, fluids and continuous CPR, the patient was no longer breathing. There was no pulse on the monitor and most of the staff had stopped running around frantically. Suddenly, the doctor applying chest compressions yelled out, "Where's the medical student? Medical student?"  I rushed over with my paper and pen in hand, ready to transcribe. To my surprise, he handed me a pair of gloves, stepped down from his stool and instructed me to continue with the chest compressions. I frantically pulled on the latex gloves, tripping up the one-step stool, unprepared for what was about to occur. As I began compressions, I looked down into a face whose eyes stared into mine with no feeling and no warmth, but what appeared to me to be a pleading not to stop, not to give up. "1...2...3...4...5," I counted in my head as I pushed with all my might, wishing I could somehow push the life back into his eyes. This individual whose life was unknown to me had become in that moment everything that I cared about.

This one memory has taught me many things about medicine and the value of people. What was it about this man that drove me so much, emotionally and physically, to bring him back from death? Previously, I would have said this was due to the altruistic nature that resides within most medical professionals, the reason we claim to be in this career from the beginning. While this is still true, I believe there is something deeper that drove me and pushes others to give everything they have to save a complete stranger: the human connection. As people, we are blessed with the capability to comprehend that there is more to a person than what we simply perceive with our senses. We are a collection of our parents, friends, and family. We embody our achievements and failures, our hopes and dreams. These are things most everyone can share and appreciate with one another. The human connection allows us to look past the exterior and see a little of ourselves in everyone we meet. For me, I looked into this stranger's dying eyes and wanted to not only rescue this man, but myself as well.

"Didn't you hear me?" the doctor shouted while grabbing my shoulder. He had been speaking, trying to tell me the time of death had been announced and all efforts for resuscittion were to be stopped, including chest compressions. I backed away from the table, filled with questions that were impossible to answer. What did I do wrong? Why didn't he live? Why did they let him die? While my mind understood there was nothing more that could have been done, especially by me, my emotions overruled the logic of the situation. At the end of that clerkship, I left with an understanding of the human connection, the bond we as practitioners have with patients that drives us to be physicians. During a few short hours, I learned a lesson that I will continue to reflect upon and use to enrich not only the lives of my patients but mine as well.

Samuel Abebe
Class of 2013

The Power of Bedside Manner

Most medical students have more time to spend with patients than do higher-level providers. This encourages me to take the time I have with each of my patients to truly get to know them and how their lives affect their abilities to take care of themselves. Something I came to learn throughout my third year clerkships (and that I did not value as much before) was the power bedside manner has on the outcome of a patient's care. I have seen a direct correlation between good bedside manner and patient cooperation and health outcome. Observing this correlation has not only made me aware of how I should and should not approach my patients, but has also encouraged me to ask for feedback from residents and attending about my bedside manner - not just about my clinical knowledge and presentation skills.

Oluchi Ukaegbu
Class of 2013

GHHS Member Oluchi Ukaegbu

Oluchi Ukaegbu is a highly respected leader among her peers. She helped develop the aforementioned GUIDES program - just one of many community service projects for which she volunteers. Oluchi serves as an officer for several student organizations including Student Government, the Student National Medical Association and the Christian Medical and Dental Association. As such, she is a strong and effect advocate for students.  She is also a strong and effective advocate for patients. Reflecting on Oluchi’s rotation through the Heartland Community Health Clinic, one of its physicians said, “[she] has an enhanced ability to combine confidence, humility, and knowledge with graciousness to all those around her that results in a sense of being at ease with her – as if she has been a friend for a long time. I noted that our staff enjoyed her and patients are willing to share their concerns with Oluchi, no matter their backgrounds.” Oluchi’s family came to the U.S. from Nigeria. During many of her formative years, they lived in the state of Wyoming. She is a graduate of the Communication Sciences and Disorders program of Northwestern University.

Linda P. Rowe, EdD

GHHS Advisor