Don’t Ever Change

by Academy of Clinical Excellence on July 2, 2010

As part of the great privilege of being inducted into the Miller-Coulson Academy of Clinical Excellence, I was asked to reflect on the topic of professionalism and humanism. The following is an excerpt from my remarks:
When I was a medical student, in one of my clerkships I was assigned to follow a patient with schizophrenia, severely disfigured from burns, who had spent most of her life in a state psychiatric hospital. One day, I glimpsed her sitting alone on the day room sofa and sat down next to her to chat – not formally, as had been done the day before at her admission – just as two people talking. I could see she was thought disordered and delusional, but - sitting quietly with her and listening closely - I began to understand her experiences in a more personal and moving way. After a half an hour, the attending psychiatrist stopped over to have a word. Worried that I’d violated some professional code, I was surprised and delighted when he whispered in my ear: “Don’t ever change.”
When I think of professionalism and humanism, I think of those three words: “Don’t ever change.” As Abraham Verghese suggested at the recent Miller Lecture on this campus, students enter medical school as caring individuals who want to help patients by connecting with them on a personal level. However, this desire gets worn down, if not away, by their medical training. Students need all of us to remind them – by words and example - to not ever lose their ability to connect with patients as individuals, and to appreciate that each patient has something important to contribute to their care and to the world we share.
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The human relationship between clinician and patient will always remain of paramount importance to achieve the changes in patients’ attitudes and behavior essential to healing. I am proud to work in an institution that at this moment is vigorously calling for more scholarship to assess health outcomes associated with the teaching and practice of humanistic medicine. I am convinced that clinical excellence can be taught and does improve patient outcomes. The Miller-Coulson Academy of Clinical Excellence provides a forum to address the importance of the art, as well as the science, of medicine in the care of our fellow human beings.
Margaret S. Chisolm, MD
Department of Psychiatry and Behavioral Sciences
Johns Hopkins University
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