The one thing I can do as a medical student: listen

by Lorien E. Menhennett

Show me a medical student who only triples my work and I will kiss his feet.

This is one of the “laws” from the satirical novel The House of God, by Samuel Shem. Now that I’m a medical student, I can see the truth in what that fictional medical resident said. It does take extra time to involve the medical student. And the scope of what I can do as a student is very limited. Of course, being included is the only way I’m going to learn — it’s the only way any doctor has ever learned. But when there’s so much to be done, I know there are moments of frustration for the nurses, residents, and attendings.

What I’ve discovered in the last few weeks, though, is that there is one job I can always do: listen. I’m in a unique position to do this. Most of the time the doctors and nurses simply don’t have time to sit there with a patient for very long. They have other patients to attend to, other more pressing tasks.

As I saw during my time rotating through ob/gyn, patients are often scared or upset. Just being present in the moment, hearing a woman’s concerns and holding her hand, makes a huge difference. Two encounters where this happened stand out in my mind.

One woman had presented to labor and delivery after falling. Trauma in pregnancy can induce labor or potentially cause a placental abruption (where the placenta prematurely separates from the uterus, resulting in painful, dangerous bleeding). She didn’t have any worrisome signs or symptoms, but was there for monitoring. I was the one to initially take her history, and noticed right away how anxious she was. Women who come in to triage, which is the emergency department for pregnant women, are all put on electronic fetal monitoring. She kept asking me how her baby was doing. After taking her history, I left to present the case to the resident. We returned together to see the patient. A little while later, my gut told me I should go back to check on the patient. She was still frightened. My reassurances that the baby was doing fine didn’t seem to help. So I went for the distraction technique. I asked whether she had a name picked out, whether she had a nursery ready. Almost immediately, the woman’s demeanor changed. For a few minutes at least, rather than concentrating on the angst of the moment, she focused on how excited she was to welcome this baby into the world in a few short weeks. Clearly wanting to share her excitement, she urged me to feel the baby kicking against her bare belly. It was obvious that a deep love for this unborn child was driving this woman’s fear. My heart went out to her. I know I didn’t take away the anxiety. But for the time I was there, I think she felt understood, cared for, and listened to. I believe that made some sort of difference — if only temporarily.

While on labor and delivery, I was also involved in many births. Some went smoothly, others less so. One woman in particular had a rough labor. This was during one of my night shifts. She’d been in the hospital for hours and hours, accompanied by her very supportive husband. She was exhausted. Her labor was not progressing well. I had been in the room for about two hours, helping her push. When the attending physician came into the room and recommended a C-section, the woman was devastated. The husband and I listened to her frustration. He held her hand, and I put my palm on her shoulder. The next morning, after the surgery, I ran into the husband as I left the unit. I was headed home after my 14-hour overnight shift for much-needed sleep. I walked up to congratulate him on the birth of his child. He dodged my outstretched hand and engulfed me in a hug. He thanked me for being there for his wife. He told me I had a marvelous bedside manner, and that I would make an excellent doctor. Suddenly every moment of my brutal night shift was worth it: I had really helped these people in their time of need. I walked the few blocks home exhausted, but on an emotional high.

Spending time with patients like these, listening to their life stories, jokes, or concerns, may not lessen anyone else’s work load. But I think it does help the patients. And that’s what I’m here for.