Academic Medicine Podcast

“The shame and guilt over my inept handling of that first terrible diagnosis have stayed with me. When I make an awful discovery, the dread is still there, but I confront it. … I acknowledge that we both may have more questions than answers but promise that we’ll make a plan to get the answers.” Michelle Kittleson remembers a patient she saw more than 2 decades ago and what she learned about delivering bad news and providing comfort to patients who may be confused and scared. This essay was published in the Teaching and Learning Moments column in the October 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"The nature of clinical medicine teaches us to hear difficult stories from patients without being knocked over by them. But I think it will require intentional awareness and self-reflection throughout my career as a physician to respect every heavy moment for its immense worth." Medical student Nicholas Lenze reminds readers that although the normalization of the extraordinary may be a common experience in medicine, it doesn't have to be harmful if physicians remember to notice and remain aware of the people and happenings around them. This essay was published in the Teaching and Learning Moments column in the September 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"When a patient’s story does not match up with the physical exam, we must accept the dissonance and take everything into account or else risk throwing away something our patient is trying to tell us." Medical student Rebecca Yanovsky recounts what she learned from a patient whose verbal account of her illness didn't match the physical exam findings--that doctors must listen with their eyes, ears, and heart. This essay was published in the Teaching and Learning Moments column in the September 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

Joining the podcast to discuss shame in medicine and medical education and their research and other work in this area are Will Bynum (Twitter: WillBynumMD), Lara Varpio (Twitter: LaraVarpio), and Ashley Adams (Twitter: AshleyAdamsMD). Read more about these topics, including the articles discussed in this episode, at academicmedicine.org. Disclaimer: The views expressed in this podcast are those of the authors and are not necessarily those of the Department of Defense or any other American federal agency.

"I will remember that singing imperfect songs might be better medicine than reciting a perfect care plan." Christine Bridges recounts how singing “I Want to Hold Your Hand” by the Beatles with a patient and her care team brought life into the patient's hospital room in a way that no medical intervention could. This essay was published in the Teaching and Learning Moments column in the August 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

“During our conversations, I gained insight into Paul, and Paul gained insight into himself. And I realized that insight is contagious. I’m hoping we’ll have an epidemic soon.” Resident Nara Michaelson remembers a patient who taught her about the importance of building trust and understanding patients beyond their lab values and imaging results. This essay was published in the Teaching and Learning Moments column in the July 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

“You’re describing what I think of as ‘clean sorrow,’” he said ... "Instead of frustration or regret, it sounds like you’re feeling a very pure sorrow.” He paused. “And your sorrow is beautiful, because it’s completely tied up in your love for him.” Medical student Jo Glaser remembers a patient's family that reminded her about the importance of focusing on the beauty of her work and relationships. This essay was published in the Teaching and Learning Moments column in the July 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"I used to think that establishing boundaries required strong emotional responses. I was wrong. Learning to say no and express oneself in an empathetic way is a valid alternative." James Agapoff (Twitter: @ dragonnovelist) recounts an experience that taught him about establishing boundaries, making compromises, and knowing when to keep his opinions to himself. This essay was published in the Teaching and Learning Moments column in the July 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

Darrell Kirch, MD, president and CEO of the Association of American Medical Colleges (Twitter: @ AAMCtoday), joins the podcast to discuss his work at the AAMC and as part of the Coalition for Physician Accountability; important issues in medical education today including physician well-being, competency-based medical education, and GME selection and training; and the future of academic medicine. Read more about these topics, including the articles discussed in this episode, at academicmedicine.org.

"On the first night of my labor and delivery rotation, I watched a story unfold that reminded me of medicine’s potential to arouse our innermost humanity." Medical student Nicholas Lenze remembers an experience that reminded him that medicine is more than just the next task, that it is the extraordinary moments of humanity physicians experience when they are present with patients. This essay was published in the Teaching and Learning Moments column in the June 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"Leah taught me to actively listen and offer the support my patients need to be able to find, hold onto, and reclaim their stories and their selves." Medical student Amali Gunawardana remembers a patient who reminded her that listening and observing patients’ stories must remain at the center of their care. This essay was published in the Teaching and Learning Moments column in the June 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"And I fear that something crucial is lost if we regard discomfort as an unequivocally negative experience, if we fail as teachers to separate humility from humiliation." Amy Caruso Brown recounts an experience that reminded her that discomfort is good and necessary in that it encourages physicians-in-training to be humble when so many cultural forces tell them just the opposite. This essay was published in the Teaching and Learning Moments column in the June 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"The most important thing that I teach the students is to be human. To see the person sitting in front of you. To be kind." Joanne Rolls remembers a patient who reminded her that, even in the face of bad news and uncertainty, being human and kind can make all the difference. This essay was published in the Teaching and Learning Moments column in the June 2019 issue of Academic Medicine. Read the essay at academicmedicine.org.

"Teaching is about learning, curiosity, and community. I just needed a reminder from my students." Jessica Servey recounts a time when her students reminded her what it means to be a teacher and that learning can happen in more than one direction. Her essay was published in the Teaching and Learning Moments column in the May 2019 issue of Academic Medicine. Read her essay at academicmedicine.org.

"We were so busy that night; everyone was. Yet residents on other services would just stop by to check on the boy, to ask if there was any improvement. I was so moved. It was simple humanity." Medical student Teddy Peng remembers a young boy he met in the trauma bay and the lessons he learned about the art of medicine and truly caring for patients. His essay was published in the Teaching and Learning Moments column in the May 2019 issue of Academic Medicine. Read his essay at academicmedicine.org.