Heart to Heart

"Raman, it's time to see your first patient. Interview and exam," my supervisor said firmly, placing a thick file in front of me. It had already been three weeks since I started my hematology elective, and although I'd relished every moment, I had kept declining to see the patients on my own. The very thought of it made my stomach queasy. But now my supervisor, convinced that I was ready, was throwing me in the deep end.

I slung on a stethoscope and headed to Exam Room 6. The patient, an elderly woman in her 70s, was suffering from a rare blood cancer. Her chart had informed me that she'd recently come back from a skiing trip to the States, and so I broke the ice by asking her about her trip. Both she and her husband enthusiastically recounted their adventures on the slopes.

Flipping back to the medical interview, I started off with open-ended questions that became more and more focused. There was a beautiful moment in our conversation when I forgot my anxieties and fell completely in lockstep with the patient. Each question flowed naturally and spontaneously one after the other until I gained a deep understanding of her case. For those few minutes, I was fully immersed in the interview, all my attention focused on her words and expressions.

Communicating with others has not always come naturally to me. As a little boy I immigrated to Canada with my family and was at first painfully shy. Every time I tried to talk to someone outside my immediate family, I would become consumed with my own fears. As a result, conversations with strangers were uncomfortable and I would avoid them, becoming isolated and lonely. Someone in Grade 3 called me a "loner" ... racing home, I looked up the definition in the dictionary, hoping it was something good. After realizing what it really meant, I just lay on my bed feeling sad and frustrated. 

Once I hit middle school, I finally started to make more friends. But I've never forgotten the pain of shyness, and still consider the ability to connect with another to be one of the most miraculous aspects of life. In the clinic that day, I felt a strong connection with the patient, turning what could have been a series of routine questions and answers into a heart-to-heart discussion. While a mere medical interview is scripted and emotionless, a true "heart-to-heart" is spontaneous, imbued with trust and mutual respect. It builds the foundation for a productive and rewarding doctor-patient relationship.

After I completed the interview and physical exam, my supervisor walked in. "So how did he do?" he asked. 

"Oh he did just fine," the woman said. Her face lit up into a warm smile. The doctor nodded approvingly and handed me the next patient file. This time, I felt genuinely excited. 

By the end of my shift, dusk was falling. I had to hurry home to have a bite to eat before heading out to a medical school party. Over the course of the next four hours,  I managed to make new friends and also master the art of "beer pong". The hostess, a second year med student, affectionately dubbed me "Noodles" after the popular "Ramen Noodles" soup brand. As I chatted with my friends, we connected easily through laughter and stories ... person to person, heart to heart.