Ever since I can remember I have wanted to be a doctor. This summer, through Yeshiva University, I was fortunate to be one of four participants in the Summer Internship Program at Hackensack University Medical Center in Hackensack, New Jersey. Over the course of four weeks, we learned from a group of esteemed physicians and staff from a full range of medical specialties. Endoscopies, imaging techniques, ER, surgery, pathology labs and ICU’s – were among the many areas of medicine we discovered and learned about first-hand.
The uniqueness of this program was that our schedule was not only intensive, but also flexible and accommodating to our interests. For example, I am fascinated by surgery and was able to observe invasive procedures such as heart and brain surgeries. Since Hackensack is a teaching hospital, the doctors took the time to explain and discuss their specialties. We were exposed to the realities of the medical profession and the difficulties doctors face from day-to-day. This brought us a step closer to understanding the complexity of the field of medicine.
Until this summer I had viewed medicine as an exact science. It is true that science does not have all the answers and as a result, people sometimes die. However, in my eyes medicine itself was flawless. Before beginning this internship I would often compare the role of a physician to that of a computer with a list of illnesses, symptoms and medications. The patient would simply input his or her problem; the doctor would then go through the data and in his mind offer a solution. Of course sometimes the doctor would have to draw blood or prescribe an MRI, but ultimately I believed their primary job was to offer a solution.
After spending my first day with a pulmonologist, I sent him an email thanking him for his time. He responded with the following words: Best wishes in mastering the “art of healing”. I didn’t really understand the use of the word “art” in this context. Coincidentally, the same day, I was instructed to go to the Medical Arts Building for a PPD test. Again, Medical “Arts” Building. I kept thinking– isn’t medicine a science?
J. Groopman’s How Doctors Think, a book which was required reading for the program, helped me grapple with this question. The author explores clinical decision-making, emphasizing that poor communication and cognitive errors can often lead to misdiagnosis and inappropriate treatment. This book attributes to my previously held view of the medicinal process as clinical algorithm. But How Doctors Think also explains that physicians are not infallible and doctors do make mistakes. Groopman went on to emphasize that diagnosis and treatment are not dependent on knowledge alone, but also on the physician’s intuition and personal judgment.
Thinking about the art of healing, I realized that artists use acquired skills and personal creative power to create something beautiful. Similarly, doctors use skills they have acquired through academic study, clinical observation, experience in combination, and with personal creative power, are able to diagnose and treat unknown diseases in the face of uncertainty.
Part of the aforementioned creative power is effective doctor-patient communication. Physicians have to create an atmosphere that will engage their patients in an open and fluid dialogue. From dialogue, doctors get clues, which lead to a more accurate diagnosis. It is more than just making patients feel comfortable; it is about being empathetic and showing genuine care. From what I have seen, every doctor has his or her own way of doing this. One doctor may use humor; another may use personal anecdotes. I admired the gastroenterologist who portrayed the perfect amount of professionalism and humor while communicating with his patients. His patients seemed to feel very comfortable and really opened up. I learned that when patients talk, doctors have to listen attentively to their use of language and tone of voice, while at the same time, pay attention to their body language.
This summer I learned that while medicine is deeply rooted in science, it is an art of uncertainty and probability. Moreover, effective doctor-patient communication is indispensable to a correct diagnosis, prognosis and treatment. Hippocrates said that “wherever the art of medicine is loved, there is also a love of humanity.” A wound care specialist said something very powerful, which strongly resonated with me: “patients are entrusting you with their body and their soul, and you have a great but humbling privilege to treat them.” Or as Alan Alda said in his commencement speech at Columbia University College of Physicians and Surgeons this year: “The head bone is connected to the heart bone – and should never come apart.”