by Matthew Lee
It was an exciting day, the day we received our stethoscopes. While the White Coat Ceremony was our initiation into the lifelong pursuit of the field of medicine, the Stethoscope Ceremony was when we truly were recognized as future physicians and the next generation that would carry on the practice of medicine. Anyone can wear a white coat, but it takes a true physician to be able to wield a stethoscope with both skill and compassion. Thus, it was an exciting day when we received our stethoscopes – the day we embarked on a journey to learn what it truly means to be a doctor.
Learning how to perform the physical exam this past semester was an amazing and unique privilege to put into practice what we have been learning in the lecture halls and from our professors. And while learning the basic techniques and skills on each other first is a crucial first step to cultivating the skill of the physical exam, I don’t believe any amount of practice on fellow classmates could have prepared me for the experience of performing the physical exam on an actual patient.
Again, anyone can wear a white coat and ask questions, but being able to perform a physical exam on someone is truly a unique experience and privilege that we as doctors get to participate in. While building up a relationship and rapport with the patient is a critical aspect we were taught to do when taking the patient history, the moment you lay your hands or your stethoscope on the patient, in an instant, you develop a bond with that patient that cuts through any amount of words that one could possibly say. Once you make contact with the patient, you enter the realm of the true doctor-patient relationship, where whatever defenses or walls the patient had up before while talking to you come crashing down and the patient is left completely vulnerable in your hands. I find that it is an odd place to be. Speaking from some amount of personal experience and from whatever observations I have been able to make in the hospital thus far, I feel that, for the patient, the physical exam is a tumultuous experience. On the one hand, the patient is completely vulnerable, as he cannot control what the doctor does, feels, or hears; for most, this level of intimacy with another human being is reserved for only a very select few and, under normal circumstances, would be an extremely uncomfortable experience. Yet, on the other hand, the patient is completely dependent on the doctor and this physical exam for the sake of his health; either for the hope that what he has been doing thus far has not perturbed his health in some negative way or, if it has, that the doctor will know what to do and how to fix the problem. It is an internal conflict that lasts only minutes, but the outcome of which can have tremendous impact on the life of an individual.
It is out of this turbulence where the true test of a physician lies. Again, anyone can wear a white coat, but do you have the skills and compassion to be the light in the darkness – the beacon in the storm? Do you have the skills and compassion to bring your patients back from teetering on the edge – back to where they can place their feet on solid ground? The answer to these questions won’t be found in the embroidering over your chest or the length of your coat, but rather in the touch of your hands and the words that you speak.
Matthew Lee is a third year medical student at the Albert Einstein College of Medicine.