How I stay human

Businessman making notesby Robert Swendiman, MD MPP

For the first time in my medical career, a medical student asked me for feedback. It was July and I was a newly minted intern in General Surgery at a new hospital, only a couple months away from being a fourth year student myself. But here she was, asking me for advice on how she could be a better learner, teammate, and future physician.

She wasn’t just good; she was excellent. Arjeme was a pleasure to work with – she was engaged in the learning, incredibly bright, and had a pleasant bedside manner. I really didn’t have much to tell her. She was doing everything right.

So I offered the only advice I thought to be meaningful, words that a preceptor had bestowed upon me as a fourth year: stay human.

Now I realize this is a bit of a cop out. Stay human, i.e. keep doing the good things you’re already doing. Perhaps words of wisdom, but no anticipatory guidance there. I could identify what those good things were, but what could I say to help her learn how to keep doing those good things? The literature is full of papers that analyze burnout, loss of empathy, and diminishing job satisfaction. These are some of the things that make “staying human” hard to do. Even the lay press is picking up on this professional decline as well (see “Why Doctors are Sick of their Profession” in the Wall Street Journal).

Arjeme picked up on my incomplete feedback quickly. “Well, what do you do to stay human?”

I thought about it. I’m a believer in the importance of having time to reflect. Because of the long hours in the hospital, I need space to collect myself; time to figure out how to improve. How do I figure out how to be a better resident, doctor, researcher, person, and now, teacher? For me, this space has always been writing – putting my thoughts on paper.

So I told her that I write.

Coincidently, I recently came across a post here on this blog in which Dr. Carol Chou discussed five behaviors of highly humanistic physicians. In her study, the author polled internal medicine residents at the University of Pennsylvania to identify attending physicians who exemplified humanistic patient care. They then interviewed these doctors to determine attitudes and habits that they believe contribute to their sustenance of humanistic patient care. They were:

  1. Self-reflecting
  2. Seeking connections with patients
  3. Teaching/role modeling humanism
  4. Striving to achieve balance
  5. Engaging in mindfulness/spiritual practices

After reading the paper, I thought long and hard about writing. I believe that taking just a little time to write can capture all five of these attributes. Within the same piece, I can reflect on my time in the hospital and empathize with patients through their narrative. This is my means to mindfulness, as well as an attempt to achieve balance. I can also model humanistic behavior for readers, and for myself as well, when it’s tough to be human. This is why I blogged every week throughout medical school, and why three of my resident colleagues and I developed Resident Murmurs, an online forum for promoting humanism in medicine through narrative. Subconsciously, we were creating our own means of “staying human.”

I told Arjeme a little about Resident Murmurs, and encouraged her to write (for herself and for us as well). Had I had my thoughts together prior, i.e. had I taken the time to write about what it means to stay human first, I would have referred her to Dr. Chou’s paper and encouraged her find her own, unique way of staying human. So long as it is an active process, one that meets some of the five criteria above.

Writing is my way, but we must each find our own. What’s yours?

LinkedInRobert Swendiman, MD MPP is a first year categorical general surgery resident at the Hospital of the University of Pennsylvania. He is a former winner of the Leonard Tow Humanism in Medicine Student Award and member of the Gold Humanism Honor Society. Along with several other resident colleagues he is a co-founder and writer for Resident Murmurs. Follow him on Twitter @RobertSwendiman and @ResidentMurmurs.