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Before They Are Doctors

Eric Lagergren

December 13, 2007

This week, Eric interviews one of his Family Centered Experience medical students. But before you jump into the interview, you may want to click on over to "A Healthier Husband." That’s right, it’s the same Eric (although he wants you to know that the photograph accompanying the article is not him). He was contacted a few months ago by the author of the Good Housekeeping article for the interview, and thought he’d share it with the readers of his blog. After all, why did the author contact Eric? Because she’d read The Diabetes Self-Management Blog, of course!

It’s not often that we find we’re able to make a positive difference in a doctor’s life. I mean, so often it’s the other way around, right? A doctor provides outstanding care or goes beyond what we’d expect and ends up having an enormous influence on how we deal with illness. But what if we were able to have an impact on a doctor before he or she actually became a doctor? What if we—those millions out there who have a chronic medical condition—could talk to future doctors about what living with our condition is like?

Thanks to the Family Centered Experience (FCE) program here at the University of Michigan, that kind of opportunity is available. Over the past few weeks, I’ve been writing about my time volunteering in the FCE. This week, I talk with Megan Ring, a first-year medical student at UM. Megan, who at 21 years old is already five months into medical school, got her bachelor’s degree in neuroscience at UM. She is also the fundraising budget coordinator for Project Suyana, a medical-student organization devoted to assisting medical clinics in southern Peru. And she’s also someone whose company my wife and I have enjoyed in the evenings we’ve spent talking with her and Andrew (who’s the other member of my FCE med student team).

Here’s our interview.

Eric: Megan, this question may make you feel as if you’re applying to school all over again, but really quickly, what interested you in medicine? Were you pulled more towards the science and research, or were you swayed by the human aspect of it?

Megan: I was definitely pulled more toward the human aspect of medicine. I wanted to make my career about something that not only made money to support myself and my future family, but was also rewarding on a different level. I wanted a career that I felt was a noble one, which medicine can easily fit into. However, I realized that lots of jobs fell under this description—teaching, for example. So I would say that the science and wonder of the complexity of the human body also steered me in the biology direction.

E: Did you know about the Family Centered Experience portion of your medical school training when you applied to the University of Michigan? Did you give FCE much thought?

M: The Family Centered Experience was a large portion of my decision-making process when I applied to med schools. Lots of medical schools have great reputations for turning out critical findings through research that help us develop new treatments and medications and a better understanding of the pathology of the human body. The University of Michigan happens to be one of those institutions, but it also has the very important quality of turning out great clinicians. This was important to me; I wanted an education from a reputable school, as well as an education that would help me relate to patients and really make a difference in their lives. The Family Centered Experience is a critical part of our clinical training. We learn how to talk to patients, to relate to them, and to see illness as it affects a person’s entire life.

E: You’ve only been in medical school for a semester now, but I wonder, how have the meetings you’ve had with Kathryn and me, your “volunteer family,” as well as your interactions with other members of your class and your discussions about the families that they work with, changed your thinking about your pursuit of an MD?

M: I think the biggest thing I’ve learned from our discussions with you and Kathryn, as well as hearing the stories from other medical students and their family centered experiences, is that whenever a patient goes in to see the doctor, the patient and the doctor have different goals in mind, different ways of thinking about the illness, and different agendas for the visit.

Sometimes this is a problem and sometimes it is not. For example, a clinician often thinks of a patient presenting with an illness as a puzzle that needs to be solved, a machine with parts that are malfunctioning. This model is useful when reviewing systems and making a differential diagnosis. However, the reality is that we are people and not just machines. We have an emotional part, a spiritual part, and a cognitive part, as well as our mechanical body parts. Unfortunately, some physicians neglect these aspects of health and rely solely on their knowledge of anatomy and physiology.

There are mounds of evidence to support the fact that emotional and spiritual well-being have drastic effects on our health as well. It all comes down to humanity and what that means… Should our textbooks simply resemble a parts manual? Or are we more than that? The FCE really addresses this issue and shows the University of Michigan Medical School’s initiative in changing the previous notions.

E: What was your biggest “fear” or anxiety in meeting your volunteer family for the first time?

Ha. Well, my biggest fear was that you wouldn’t be a talker. I was afraid that the conversations would be awkward or my questions would come off as offensive.

E: I guess we quickly relieved you of that fear! What did you think about diabetes before you began your meetings with me and Kathryn?

M: Honestly, I didn’t know much about it. I had heard there were different types of diabetes, but I didn’t know how many different types or what each meant, and of course I didn’t know that there are different methods of treatment for each, as well as different causes. I do know family and friends who have diabetes and I had seen insulin pumps in the past, and I also knew that it was something that you needed to manage throughout your life and change your eating habits for, for example.

I remember when I was about 13 and had a friend who had Type 1 diabetes. We all went on a skiing trip and her dad told her she couldn’t eat certain things or had to limit the amount that she ate. She wasn’t very happy about it. This is the classic example I always used to think of whenever diabetes was mentioned. I also have another friend who has a relative dying of complications from diabetes because he refuses to take care of himself and manage his blood sugar. This made me aware of the seriousness of diabetes.

E: And what do you think about diabetes now—that is, if your thinking has changed in the past few months?

M: A lot of my perspectives have changed, although quite a few haven’t. For example, I still think of diabetes as something that you just have to manage throughout your life—there’s no escaping the lifestyle of counting carbs and such. However, before this Family Centered Experience program, I didn’t have a sense of the confusion that can come with first being diagnosed. I had never really thought about how your self-image can change. While lots of time is spent counseling cancer patients on how their lives will change and what they need to do to manage, I now realize that with something as common as diabetes, this type of counseling is often absent.

E: Well, I think that wraps it up for our interview. Thanks for taking the time to answer these questions.

M: No problem. I enjoyed it.



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