Me. A timid, white-coated kid with fake patients

No, no, I should use a deeper voice to sound more authoritative…

“Hello. My name is Ben, I’m a second year medical student. Today I’m going to ask you a few questions about your problem. I’ll also conduct a physical exam, and then I’ll consult with my attending physician. So, why did you come to see us today?”

Maybe that was a little too formal? And when should I ask the patient his name?

I was sitting in bumper-to-bumper traffic, practicing to myself. Today in school I had to see three “patients”. These patients are actors, and when the interaction is over with, the actors stop acting and offer us criticism on our communication skills. My number one criticism from all three patients?

Lack of confidence. An uncertain demeanor. A little timid.

Last year, when I did this same exercise, the patients said I performed swimmingly. The difference between one year ago and today is that for the past year, I’ve been constantly cramming knowledge into my head. Last year, I was full of self-confidence for one reason: no matter how much thinking I did, I just couldn’t think of any reason why I might be wrong. Now it’s entirely different. The more thinking I do, the more and more I doubt my initial impressions.

But patients don’t want a timid, uncertain doctor, and this kind of doctor won’t give patients the comfort they need when they’re ill. I may have an exquisite line of reasoning. I may be friendly, professional, and composed. But somehow, I need to convince the patient that I do, definitely, beyond any shadow of a doubt–know what I’m doing.

Of course, I won’t really know what I’m doing for another six years. Eventually, I’ll make accurate, lighting-fast diagnoses without even lifting a mental finger. Eventually, I’ll back up my confidence with competence. Until then, I guess I’ll just have to fake it.

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6 responses to “Me. A timid, white-coated kid with fake patients

  1. As someone who is faintly considering the possibility of med school, I stumbled upon your blog, and found it very honest. Unlike a lot of medical blogs I have come across, you do not possess an air of superiority nor have you lost sight of your goals and your spirituality. Your posts taught me a thing or two about love, hard work, and appreciation. Best of luck to you and your wife. You will be doing many good deeds in your lifetime.

    • Thanks! That was such a kind thing to say. It made my day. (No it really did–it’s not hard to do when I spend most of my day studying. 🙂 )

  2. Perhaps the key is in your previous post? Look back at why you started out, think of what happened to your friend, how he couldn’t get help for 9 hours. When I started out in sales I was nervous & jittery.
    It took years of practice, failure and success for the process to “click”. I try to give exemplary service to everyone, and frequently get positive feedback. If you’re sincere, have the right credentials (experience & patience) I am sure you’ll crack this problem.

    Stephen

    • Thanks for the encouraging word, Stephen. Yea, I’m pretty sure people in every profession go through the same thing. But practice makes perfect I suppose!

  3. As with any new experience, it takes some time to get settled in the role. This was your first foray into a -real life- situation. That is to day it involved a real patient. This new element, along with the presence of your preceptor and in a real clinical setting, adds to the different environment. I consider this a new/different experience from any we’ve had on campus. You knew for a fact that the patient you had before was standardized, despite all the wonderful efforts by the school to try to make it otherwise.
    Over time you’ll gain back that confidence when you realize all the months we’ve been cramming in more knowledge into our heads will make you a better clinician. That to at least some degree you know more than your patient, and this is why they’re coming to you.
    I remember over the summer when I was taking HPIs on real patients (cranky and slightly disturbed ones) I was stumbling over my words and felt like I couldn’t get anything. But I got the information, and after doing them on more patients, I felt comfortable. It took time, but focused exams and hpis got shorter and I got the information I needed.
    We’re all going through the same boat with you. You seem to hold yourself to a higher standard. I suspect you’ll be feeling similar feelings when starting residency – how the heck are we supposed to diagnose and treat? We feel inexperienced. Constantly. And then, one day, you’ll just randomly realize, “holy crap, I’m a doctor, and I’m treating these people without thinking about it.” Until then, it seems you’ve got the right idea – fake it until you make it. 🙂
    I think I rambled a bit there, but basically – you’ll get through it. With the weight of the world on your shoulders, what do you do? Plant your feet.

    • That’s alright Matt, I like your ramblings. I know we’ll all get better, and I feel like the standardized patients really are a valuable way to practice. I think I learned some pretty useful things from the feedback I got.

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