In the first weeks of third year, I began clinicals with my surgery rotation. Alongside us juniors, there was a fourth-year student, who I’ll call Andy. He had graciously taken a couple of us on as his “project” for the month, demonstrating the appropriate behavior for a medical student on rotation and making sure we were set up for success. Andy was what some in the medical community might call a “gunner,” but not in a bad way. (A gunner is a person who knows all of the answers and never hesitates to answer quickly when the teacher asks a question to the entire group, putting the rest of the class to shame.) His energy level was always set to the maximum and he was loved by everyone on the team. I, on the other hand, was timid, unsure of myself, and struggling daily with imposter syndrome. In a state of perpetual uncertainty, I was trying to recall what I had said or done that had allowed me to pass our second-year course on the “foundations of patient care” in the first place.
One morning while Andy and I were pre-rounding together, I watched him pull up a patient’s chart on a computer in an ICU room, turn the screen toward the patient’s bed, and proceed to explain radiologic studies from the chart to a patient and his family. Shocked, I wondered if we as students had that authority. I wasn’t convinced that my friend was explaining the diagnosis entirely correctly, and I remember thinking it would be safer if we as students could stick to the gathering of information. I knew that our learning process would eventually involve integrating concepts and applying knowledge to synthesize care plans. However, I felt strongly that this would be best done behind closed doors. Even in the context of my background as a teacher, I could not yet see myself in the role of patient educator.
I had almost forgotten this experience and how appalled I had been at a senior student’s audacity and poise in explaining a diagnosis to a patient, until one day toward the end of my medicine rotation (month 10 of 12 into my third year). My patient on this particular week had been dealing with a multifactorial pulmonary illness, and after gathering a thorough history at her bedside one morning and empathizing with her woes, I found myself turning the computer screen as Andy had done, showing her the serial chest x-rays in her chart, and explaining to her the treatment course and prognosis of her illness. There was a slight depersonalization that occurred, as I heard myself explaining and teaching her the physiology at play. Somewhere along the course of the past 9 months, I had begun to grow into this role that I had been so unsure of at first glance. I have much left to learn, but I think this story represents a subtle yet significant personal shift. I may not have all of the answers and all of the knowledge perfectly memorized, but the truth is that I never will. My job is to simply share what information I do possess in a way that provides patients new insight into their illnesses and answers their questions in an honest and tactful way.