As I approach the end of my third year of medical school, I’ve found myself pondering a terrifying question, “Am I going to be a good doctor?”
At this point I’ve sat for dozens of exams, read hundreds of pages of text and memorized thousands of facts. And yet I worry I am not much more than a glorified Wikipedia page. To be a good doctor, I feel, one must also learn to communicate, to anticipate people’s needs and to know when to linger just long enough so that a person feels heard and understood.
Medical schools have recognized the need to teach these skills, and they are trying. I’ve even been lectured on “How to be Empathetic.” But I believe the place I have learned to communicate and provide empathetic care best has not been in the classroom or on the hospital wards. Rather, it has been in the numerous service industry jobs I’ve held on Martha’s Vineyard.
My first real job was as a cashier at Morning Glory Farm, where I stood for hours (much like the operating room I later came to find) ringing up groceries and restocking shelves. As a 17 year old, I learned to build rapport with customers of all ages and many walks of life. I learned to multitask without appearing flustered, to remember different customers’ particularities and to bag groceries with attention to detail — always keep the dripping head of lettuce far from the freshly baked bread. I admired and attempted to emulate a particularly vivacious and vibrant employee who remembered every customer’s name, asked questions about their lives and families, and in general made everyone around her feel special.
The next summer, as a hostess at the Seafood Shanty and a caterer at the Harbor View Hotel, I learned to welcome people with a sincere smile and strong eye contact. And I learned to deliver tough news. “Yes, the wait really is 45 minutes.”
I learned that listening rather than interjecting myself could turn a frustrating dining experience into a wonderful night out. I learned to keep my cool when a rude or inappropriate comment was made, and I learned the importance of treating everyone with respect, always, even if respect was not received in return.
As a camp counselor at the Felix Neck summer camp, families entrusted us to walk miles of forest trails and explore the seashore with their most precious commodities. Not only did I learn important medicine such as how to recognize poison ivy and differentiating a deer tick from a dog tick (deer ticks are the ones that carry Lyme disease), but I learned to gain trust from children, and to understand and speak their language.
These were the jobs I looked to for help when I finally began working with patients. For example, one day I was working a 24-hour shift on the very busy obstetrics floor at Boston Medical Center. This was during one of my first rotations in my third year of medical school. My patient was a young Muslim woman in her early 20s, delivering her first child in a foreign country. Her mother and husband were absent and she communicated with them in their home country through her iPhone’s FaceTime. It was 3 a.m., and she was nearing 10 hours of labor.
I had been working since 6 a.m. the day before. I was exhausted, but she was significantly more exhausted, and every contraction left her screaming in pain. Her only family member present was her father, but because it was Ramadan he had left to go home and prepare food that the family would eat before dawn. Around 4 a.m. he returned to the hospital to sit by his daughter’s side as she labored. He was pale and uncertain, looking to me for reassurance each time his daughter screamed in pain.
The caterer/hostess in me had trouble offering him only smiles and words of comfort, and I asked him if I could get him a cup of coffee.
“Yes, please,” he said. Good, this was something I could do, I thought.
“And three sugars please,” he added. “But not normal sugar, you know, the kind that comes in the blue packets. And cream as well. But make sure it’s not too light. I like my coffee the medium brown color.”
I felt my annoyance rise, but instead of rolling my eyes I left the room and made him his coffee, exactly as he wanted it. He drank the first cup, and asked for another.
Fourteen hours of labor and an emergency cesarean later, my patient delivered her baby. The child rested, healthy, in the recovery area of the maternity ward. On my next shift I went to visit my patient, and she put her hand on my arm.
“Thank you for bringing my father coffee yesterday,” she said.
She went on to explain that her father had tried to go home to eat, but had felt too anxious about leaving her alone at the hospital. He tried to go to the hospital cafeteria, but because he is partially blind he had been unable to read any of the signs. When he attempted to ask for help, he became embarrassed and quickly left. He hadn’t eaten anything for more than 10 hours, and the cup of coffee was his first nourishment since the morning before.
When I think about taking care of people, really good care of people, in an environment as intimidating and cold and confusing as a hospital can be, I think about that experience. Good doctoring is more than keeping the wet lettuce away from the bread, but the same ideas of patience and thoughtfulness apply. It is taking the time to explain to a mother of a child with a fever and a blistering rash exactly why we’re ordering the tests we’re ordering, why she needs to wait as long as she does, and what the next steps will be. It’s important to explain to a sweaty and dehydrated soccer player that he can’t have a sip of water because he fractured his ankle, may need surgery, and if he drinks water he will be at risk for aspiration during anesthesia.
In a year I will earn my MD, and while medical school has filled my head with knowledge, I believe it is my life experiences and the jobs I’ve held that will take me from a knowledgeable physician who can treat a disease to an empathetic doctor who takes care of a whole person.
Avital Fischer is a third-year medical student in Boston, and a summer resident of Edgartown.