Learning from our Patient Teachers

I'm making the most of my transition back to academia by becoming a mentor in Weill Cornell's innovative LEAP program. The acronym stands for Longitudinal Educational Experience Advancing Patient Partnerships and involves partnering medical students with patients, not as care givers but as observers of the care process. A total of 250 "patient teachers" have been recruited and this year, for the first time, every first year medical student will participate, making home visits, going to doctor's appointments and understanding the wider world which our patients navigate. Monthly mentoring sessions will be student run and are expected to be a forum for sharing patients' stories as well as an opportunity to learn about all aspects of the chronic condition with which most of these patient teachers live.

The kick off session was abuzz with the collective energy of more than a hundred brand new doctors to be. The program director, internist Keith Lascalea, reassured the students that, while following one or two patients might seem overwhelming, by the time they were interns they'd be juggling 10 with no problem. He warned about managing social media connections with patients and reminded the students that they are not the patient teacher's physician and not to do any lumbar punctures in the home!

He then turned the podium over to the patient teachers. Mr W, a retired science teacher, joked about his medical student getting seasick as she followed his colonoscopy and quoted "The King and I" which probably meant nothing to the millennial audience but the room was hushed as he said, "You give meaning to our illness. While we're sick we can help you learn. As I look at your faces I realise that the future is going to be better because of you and because of this place".

Next up was a young woman who could easily have been one of the med students. Describing how her medical students had helped her through difficult visits to discuss lung transplant to replace her pulmonary fibrosis-ravaged lungs, she said "I hope this teaches you not to judge a book by its cover, when you look at me you don't see my lungs". 

Lastly, the mother of a chronically ill child described how much it meant to have her child's medical team, including the students, see the challenges they faced in their daily life away from the clinic setting. She teared up as she left the podium.

Listening to these stories I thought about the responsibility and honor we are afforded by our patients' trust in us.  Do we have any more powerful resource in our quest to learn how to be diagnosticians and healers than the patients we treat? Are those of us for whom first year of medical school was a lifetime ago connected enough with that energizing resource?

Sometimes the irritations of modern practice can seem overwhelming. Logging back in to the EHR for the 20th time in a day when my password requires 12 characters, one ancient rune symbol and several emoji; remembering to check the boxes for PQRS and trying to figure our exactly how many CME credits for MOC I need if the month has an "r" in it can leave me just a little frazzled.

Reconnecting with our patients, especially through their unique ability to teach us, puts those minor stresses in sharp perspective. Learning from their ability to manage their illnesses with humor and grace should humble and inspire us.