Lorenzo R. Sewanan
Trinity College, Class of 2012
When I start medical school, I fear that I will lose my balance between myself and my work in the pages of my anatomy book, I fear that I will forget the humanity of my patients in between the cuts of my dissections, and I fear I will listen more to my patients but hear less the pain in their voices, their need for compassion. During a session at AMSA's Annual Convention, Dr Coulehan reveals that these fears are common among medical students and not unfounded. It is exactly these elements especially the training of a doctor to be objective rather than empathic that have been taught in medical schools over the past fifty years especially, the philosophy of detached concern. However, research by prominent medical educators has shown this philosophy engenders self-absorption, rigidity, and even a sense of entitlement among physicians, leading to masochistic culture of arrogance, gamesmanship, and to some sense an inadequacy to heal.
In other words, exactly opposite of what make physicians really effective with their patients and legitimately capable of wielding the responsibilities of being a healer. Above all, physicians needs to have intellectual virtues like excellence, practical wisdom, and life-long learning, and moral virtues like integrity, fidelity, compassion, courage, humility, and justice. And, everyone knows this. Everyone knows the qualities it takes to make a good physician, in someone’s immortal words “firmness of mind” and “gentle and humane temper”. Yet, there is a great gap between what medical professionals know and what they are observed to do when it comes to these softer skills, a disparity which is eroding the very foundations of medicine.
So, what can we do to maintain compassion? How do we unite tenderness with steadiness? How do we help medical students develop a personal moral balance? For Dr Coulehan, there’s one way that works for medical students: taking time out formally in a small group format to think, to discuss, and to write about the medical school and residency experience.