One of the privileges of working with young people is that the course of their lives is still so flexible and unshaped. I work at a pediatric hospital, and it’s been my distinct pleasure to meet children of all ages, sometimes just once or twice and often despite them seriously not wanting to meet me.
I also work with students and trainees who seem to be starting younger every year and who very quickly grow up to be colleagues. Just by virtue of these youngsters being here in my office, our personal and professional interactions may jiggle the course of their still malleable future.
It strikes me, however, as I “mature” into this career, that we don’t always appreciate how much nonmedical impact, good or bad, we may have on these young people, even when we don’t realize it.
I remember visiting my doctor as a child only a handful of times, but I remember each visit vividly. I would guess I made very little impression on him in his overall life and career; he probably saw 30 clones of me over one day, poor guy. However, I know that watching him and asking him questions was what planted medicine in my neophyte career-option file.
I read that Michael Jordan would carefully groom and dress in a custom-tailored suit to make the very short walk to and from the dressing room on each and every game day. When he was asked why he would make so much effort for so few metres of public exposure, he explained that the fans lining the walkway were often people who might only ever be at one NBA game in their life, waited around after the game, probably scrimped to afford tickets, and it may be the only time that they would ever see him up close. He always wanted to be his best even for just those few seconds with them, and that included dressing respectfully and greeting them nicely.
Wow. Okay, most doctor-patient and mentor-student relationships aren’t complicated by one of them being a multiple championship MVP legendary icon, but you get my drift. We are constantly meeting caseloads of individual people and we tend to lump them together, speed through consults, or define them by their diagnosis, their manners, or their particular misery. They, however (hopefully), have relatively few doctor visits or illnesses in their lives and what we say and do during our interactions may be planted quite deeply, especially when they are young.
I’ve had the pleasure of seeing a patient I operated on as a 10-year-old come through our service on a fourth-year surgical elective 14 years later, telling me that the childhood surgical experience we shared helped lead to the decision to practise medicine. I’ve seen kids with burns who start our relationship screaming in tears when they see me and end up as proud youth leaders mercilessly squirting me with Super Soakers at the Burn Camp Kickoff a decade later.
I know there have been patients who will always have fears of hospitals and doctor visits because of what I have had to do with them, even when I do try to make each visit finish being “sort of” friends. And parents will quote me back to myself years later with something I said to them on the spur of the moment that somehow struck them, and I barely remember saying it. I’m sure everyone has those stories.
Medical students are on service for just a week at a time, sometimes two. Many of them are in the process of trying to decide what to do. There might be one single OR case that we do together—those first sutures they work so hard to put in and that particular case may be seared forever into their brain. That one interaction may help them decide what path their whole life might or might not take, even though I might have trouble recognizing their name if they decide to apply to our program.
Without being overly dramatic and assigning more relative importance to practitioners of medicine than most of us probably deserve, it strikes me as important that we acknowledge and be respectful of the lopsided effect that we can have in our relationships with our students and young patients, even with only a short exposure time. This one may grow up to be prime minister, that one may become our department head, and that other one may be the lawyer whom we all hope not to need.
That prime minister may never forget how her doctor sang a twisted, out-of-tune version of “Old MacDonald” during closure of her laceration, and maybe priorities in health care politics will be subconsciously modified.
Maybe not, but you’d always be able to wonder.