On the last day of my hospital stay, I became an ‘interesting patient’. Three medical students stood in front of me and played doctor. I’m afraid I didn’t play along.
I was sitting on my bed waiting to be a discharged when a young woman came into the room. She completely ignored me and a couple of other patients in the room and addressed the doctor standing by a patient’s bed. The doctor immediately stopped the conversation with the patient and started talking to her. She asked him whether he had any ‘interesting patients’. It sounded like she was looking for interesting specimens. It was a bit too much for me, so I commented on it. She asked whether I was volunteering, I said I was not volunteering to be a specimen. She left.
A few minutes later she came back, approached me that asked me whether she could bring some medical students to speak to me. The conversation went like that:
- Doctor: Would you mind talking to some 5-year medical students.
- Me: Who are you?
- Dr: Oh, I’m a doctor.
- Me: Do you have a name?
- Dr: (clearly irritated): Yes, I do? I’m Dr X
- Me: And you don’t think you could introduce yourself first?
- Dr: Yes, I’m sorry, again, I’m Dr X, I’m helping students to talk to patients.
- Me: Hello, I’m Dr Galasinski.
- Dr: Oh, a fellow physician.
- Me: No, I’m a real doctor, with a doctorate.
- Dr (more irritated): so, what about the students.
- Me: Yes, but it’s not a good idea.
- Dr: ???
- Me: I’ll tell them what I think.
- Dr: Hahaha, no problem
A few minutes later, three students arrived. One was to conduct an interview. His first question was what I would like to be called. ‘Professor Galasinski’, I responded. Visibly shocked, he said, ‘Oh, I can do that….’. He never did, of course.
What was absolutely amazing about the ‘interview’ was that the student didn’t look at me even when he was asking a question. He was looking around, checking the walls and the windows. After a couple of minutes, I stopped and said: For pity’s sake, man, can you at least pretend that you’re interested? And I proceeded to tell him that looking at walls and windows is not the way to talk to a patient.
The student denied, of course, that he was uninterested, to which I said he was being disrespectful, that most patients would not react, but because of my symbolic capital, I was able to tell him off. The student was taken aback (as the other two were), I was probably the first patient ever to challenge him so openly. But I was livid. I pointed out that very quickly I stopped talking to him, orienting myself toward one of the other students. She was continually seeking eye contact with me, nodding in acknowledgement of what I was saying.
At that time, I think, the doctor who sought interesting specimens started regretting she had brought the students. I told her I had warned her.
Now it was time for the acknowledging student. She asked me to take my top off, I obliged and she started palpating and listening to my chest. I asked her why she was doing it in complete silence and if I could not be only a specimen. The doctor-trainer responded that this was the drill and that in real life she would be telling me what she was finding.
But that’s just stupid, I said. You’re asking the student to behave in a way she would not be expected to behave in real life. You’re asking her to do things wrong and then you expect her to change what she learnt. That’s just bonkers. I mean – surely, medical students are capable of double-tasking. Palpating and telling me about it not too much, is it?
That was enough for the pursuer of interesting patients. She said they were done and just walked off. The three students followed, only the second student thanked me for my time. I acknowledged it with gratitude. My brief contribution to training British medics ended abruptly. Yet, I still think it was quite successful. I thought that at least one student stopped to think about what I did. Full success.
But this brief glimpse into how medical students are trained offered me much insight. Now, I understand why I am ignored by doctors, why I am not listened to so often, let alone why I feel like a Foucauldian object of medical gaze. This is how those doctors are trained! The interviewing student should have been interrupted immediately for disrespecting me. The palpating student should not be taught to do things wrong, for pity’s sake!
If this is how you train medical students, no wonder, you continue despairing about clinical communication and about doctors’ empathy. But, admittedly, judging by anecdotal evidence, they just do what they’re taught. And before you do raise the issue of the small sample, consider that it is unlikely those students and the trainer behaved differently just in front of me, isn’t it?
What do we do? Oh, I don’t know. I am fairly certain that as you will continue despairing, you will continue to seek ‘interesting patients’ and teach your students how to disrespect us. Abandon hope all ye who meet a medic. They do as they were taught.