Overcoming Uncertainty through Experience

By Michelle Sergi

Coming out of my first year of medical school I struggled with my sense of confidence.  After endless nights of studying, a multitude of experiences at our Clinical Training and Assessment Center, and specialized clinical experiences, I felt that I could take on the challenge of counseling patients.  On the other hand, when I thought about being on my own to take care of patients, I was terrified.  My pharmacology knowledge was insufficient, and even though I knew how to conduct a full physical exam, did I really know what was normal compared to abnormal?  These questions proved to me that I lacked the clinical experience necessary to become a good physician.

When I heard of the opportunity to apply for the Leroy Rogers Preceptorship, I immediately knew that it could help bridge the gap between my medical textbooks and clinical knowledge.  This program gives preclinical students the opportunity to choose a preceptor for a four week, hands-on family medicine clinical experience.  I had shadowed a family physician, Dr. Andrews, in my hometown several times before so I knew he would be the perfect preceptor.  I also felt that I would learn from his patients, especially because many are medically underserved.Read More »

The Physician’s Role in the Rising Cost of Prescription Drugs

By Angira Patel

When I started my medical training, my pediatrics residency program banned all pharmaceutical sponsorship of activities.  No free lunch in the middle of the day, no fancy dinners at expensive restaurants, or trips to conferences paid for by a pharmaceutical company.  Even my lab coat was unadorned by the colorful pens given by various drug representatives.  At the time, I remember thinking a pen or a free lunch would never influence how and what I prescribe to my patients.

As a young trainee, I did not appreciate why my residency program took this stance, but I do now.   Read More »

“You Had To Be There …” Caring for a Patient to the End of Her Life

By David C. Leach

It has been more than thirty years since she first came to see me – a vital woman in her early seventies who had detected a lump in her breast on a self-exam. A diagnostic work up confirmed cancer and the smallish lesion was removed. It never recurred. By the time a second lump appeared in the other breast we had come to know each other. She was now in her late seventies and this lump also proved to be cancer. It was removed. Postoperatively in the hospital she looked a bit depressed.

She was not an alcoholic, however, she had told me that she enjoyed an occasional martini before dinner. I did something I had never done before and have never done since. I brought a Waterford crystal glass containing a nicely mixed martini to her hospital room. She accepted it without comment. We talked while she sipped. She told me that she had discovered and joined the Hemlock Society. In her words: “Dr. Leach, I know that given your lily white ethics you would never countenance euthanasia so I joined the Hemlock Society. I now know what to do and you needn’t trouble yourself.” I thanked her for her consideration and we talked briefly about her concerns and choices. In my opinion she was not at risk for suicide. She knew that this lesion also was small and with negative nodes would likely not recur. What she wanted was to be empowered to make her own life decisions. I assured her that she was. . .

Read More »

New Year’s Resolutions – Walking the Talk with Compassion

By Hedy S. Wald

Take two Tootsie Rolls and call me in the morning. Self-prescribed for sweet tooth me. Not such a blasphemous “drug of choice” (I’m not even using caffeine!) but it’s New Year’s, that infamous time of resolutions. And I’d like to “kick the habit,” do all that stuff the nutritionist advised and ramp up the gym visits. Jogged 2 miles and took a 1/2 mile swim today to start the new year “right” – hopefully burned off the chocolate high. Fueled by endorphins and feeling oh so optimistic, I’m writing this blog. The question is – what happens on January 2?

The ongoing effort to implement and sustain behavior change has given me a profound appreciation for some of the struggles our patients (and even our colleagues and students) endure. Harnessing motivation can be tough and self-flagellation for not following through can make it tougher . . .  this is where some self-compassion with an attitude of kindness and acceptance toward ourselves may make a difference (1). Self-compassion can promote self-improvement motivation given that it encourages us to confront mistakes or weaknesses without either self-deprecation or defensive self-enhancement. (2) According to Breines and Chen, “resolving to make changes can be scary, as roadblocks and setbacks are inevitable along the way. From a self-compassionate perspective, however, there is less to fear.” (2)

Read More »

What do Advent and Christmas Have to do with Medical Education, Anyway?

By Virginia McCarthy

As a Jesuit, Catholic medical school, we have had several preparations for Christmas that may not be as “front-and-center” in other institutions.  These traditions are deeply engrained in our culture and expected by our students.  With the flurry of academic activity in the final weeks of the semester, the true miracle of Christmas might lie in the simple fact that anyone shows up to spend time together at all.  In the busy-ness, we pause, but what exactly is it that we are trying to remember about ourselves, the community, the world?
Read More »

Is ‘The Good Doctor’ Any Good at Representing Neurodiversity?

By Kayhan Parsi

The Good Doctor recently debuted on ABC.  Billed as an unconventional medical drama, it features an autistic surgical resident, Dr. Shaun Murphy, played by Freddie Highmore.  As a parent of an autistic adolescent, I welcome more varied depictions of autistic individuals in popular culture.  Unfortunately, the trailer for the show concerned me, as it played up some now familiar tropes in depicting individuals with autism.  Dr. Murphy is not only autistic but is a savant as well.  The autistic savant is an irresistible cliché for creators of film and television programs.  For example, Dustin Hoffman’s depiction of Raymond in Rain Man is the granddaddy of savants in popular culture.  Raymond was able to count cards at an incredible level, something his estranged brother (played by Tom Cruise) tried to exploit to his own advantage.  The savant trope also reared its head in the recently released Netflix series Atypical featuring an adolescent male with autism (played by Keir Gilchrist).  Although he doesn’t exhibit the kind of genius-level savant characteristics that Dr. Murphy displays, Sam in Atypical goes to a mainstream school, holds down a part-time job, and is struggling with dating…
Read More »