By Megan Masten

I recently had the opportunity to spend a month at a free health-care clinic in Flint, Michigan as part of my third year Internal Medicine clerkship.

I am in an underserved medicine program and I have a deep interest in working with people who have characteristically been left out of healthcare.  I loved working with the population who receive their healthcare services at the free clinic – I have mostly been impressed with patient’s willingness to feel vulnerable.  I have spent my third year of medical school in a variety of medical settings, and my favorite type of patient interactions are the ones where patients are willing to be completely honest with me and share things about their life that they might be ashamed of or have complicated feelings about.  I feel like I am doing what I’m called to do when I get to have difficult discussions with people about medical and non-medical issues that affect their lives, and my ability to have these discussions has been strengthened by my time at the clinic.

I spent time with a patient at the Free Clinic who opened up to me about his mental health issues.  He was recently started on a new antidepressant medication for depression and anxiety, and he was open and honest about his challenging feelings.  He shared with me that he was feeling really depressed and had frequent suicidal ideations – and he was quick to say, “I’m sure you don’t struggle with depression, I’m sure your life is really good.”  It was such an important and unexpected conversation to be had; although I don’t personally struggle with depression at this point in my life, I can’t say that I never will, and I can’t say that I don’t understand how he feels.  I shared this with him, and I shared with him the fact that I have family members with depression and bipolar disorder who have been suicidal in the past.

I realize that self-disclosure by physicians and health-care providers is controversial.  However, I think we are in an unique position as medical providers to be able to connect with people and show them that everyone struggles, and they’re not alone. It was important to me to share something personal with this patient so that he doesn’t assume that my life is perfect and I have everything figured out; it’s part of the human experience to struggle and go through a spectrum of emotions.  At the same time, the depression that he’s feeling is something that we can help mediate, and I was fortunate that he trusted me enough to talk to me so we could better understand his symptoms.  Sometimes we expect to spend the day examining other people’s problems, and we don’t expect to have to examine our own.  I find that it can be really meaningful for patients when we are able to connect with them about things that are happening in their life by showing them that we do understand on a personal level.  Through my work at the clinic, I’ve learned that understanding our patients as people and connecting with them on a personal level is absolutely critical to good healthcare.

It will be easy to become jaded by the daily grind of delivering medical care under the constraints and pressures that characterize the current healthcare environment.  Nevertheless, I believe that I can renew my vocation consistently by taking the time to connect with patients, sometimes on very personal level.  Patients make themselves vulnerable, and sometimes we will be challenged to do so as well.

Megan Masten is a third year medical student at Michigan State University College of Human Medicine.  She is planning to pursue Obstetrics and Gynecology and is committed to working with underserved populations.