One of the best parts of my work with youth is watching the impact that they have on learners, especially medical students.
On the day that they finish their rotation, many students will speak of how much they enjoyed their time. They will speak about what they learned, and I know that most of what they learned came from my young patients.
Each student who comes to work with me follows one or two patients only. The team, and especially the Residents, try to match students with patients with compelling stories. Imagine what it’s like to be 17 years old, with the low self-esteem of serious depression, or the disorganized thoughts of schizophrenia, or the impossibly rapid thoughts of bipolar mania. When someone with such difficulties tells their story, it helps a learner to understand how mental illness affects a person.
I always present my requests to patients as a favour: “Will you please allow this student to meet with you with me? They will do the interview but I’ll still be there to answer your questions and to make sure that your care is still progressing.”
My patients rarely refuse and it’s a toss-up sometimes whether it’s the medical student or the patient who takes their task more seriously. I’ve even had patients give me unsolicited evaluations of “their student”. Then there are the comments I hear:
“He took notes of everything I said.”
“You never ask me all those questions.”
“She worked on my self-compassion workbook with me.”
And my favourite comment of all, if I happen to ask one of my own questions during an interview:
“Dr. Beck, do you mind? I’m teaching here!”
The Histories of Presenting Illness in medicine are moving, personal stories – to most physicians, they are the most critical part of their assessment. These stories are touching, a reminder to all of us who practice medicine of the richness of the lives of our patients. They are a reminder that we are more than our illnesses. Every doctor I know remembers at least one patient they met in medical school. Every doctor remembers how much they learned while speaking with that patient every day, to learn their history, to complete their examination.
Students learn more from a housing insecure youth about social determinants of health than from any lecture. They learn more about psychomotor retardation from a 16 year old who cannot move from a chair in the lounge than from my description. They learn more about emotional pain and trauma from examining and bandaging sharp razor cuts on a 14 year old’s forearms than from the Emergency Room report.
They learn more from being with my young patients than I will ever teach them.