The privilege of our profession

It is a rare pleasure to be able to take any individual and guide them into environments and to experiences that are entirely new to them.

I was fortunate enough this week to be given an opportunity to do just that. The opportunity did not show itself in a good light when I first got to hear of it. The new clinical medical students were coming to the ward, and needed volunteers to take a history from. My colleague was due to run this particular session, but his child had taken ill so he was unable to sort everything out.

Queue a couple of hours of running around the ward like a debutante looking to fill a dance card, and finally things seemed sorted. The students arrived in a nervous gaggle, and were duly corralled into the MDT room. They were split up into threes and I went round introducing them to their first ever patients. They had been talking histories all morning and had a plan, and a pro-forma. They knew how this was meant to go…

And of course, it was nothing like they had imagined.

Each of the groups had experiences as unique as the patients they spoke to. One group struggled to encourage a patient to start their story any more recently than the mid 1960’s, one group encountered a patient who was so straight to the point, that they felt they had nothing more to ask after about 15 minutes, and needed gentle coaxing into delving slightly deeper into the “I woke up and it was there” of the presenting complaint.

It was fascinating to observe a group of four medical students collude as one to avoid asking the most obvious questions in a social history when confronted with one particular case.

However, what struck me most was the absolute privilege these students were getting – within five minutes of meeting of these people (for that is what patients are) the students were being trusted with the most intimate information, trusted with the opportunity to ask probing, personal questions about their fears, concerns and expectations, and were repaid with an experience I hope they will carry with them through their working lives.

Taking histories from patients can be seen as a chore when on take, slogging through an outpatients clinic or clarifying details on a ward round, but really it is an immense privilege, and I hope that the students who met my patients the other day remember that as they move from the lecture theatre to the wards, and onwards in their chosen profession.

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