Early in the morning in a physician workroom on the 15th floor of a busy county hospital, I thought about summer camp. My mind drifted to warm, sunny days by the lake and the sweet sounds of friendship. I thought of my campers, ranging from energetic six-year-olds to rambunctious teenagers. I remembered them fondly as I listened to my team discuss our patients for the day.
Medical school teaches the proper components of the patient presentation. You begin with the subjective elements of a patient’s story: their chief complaint, history of illness, and review of systems. Next comes objective data: vital signs, laboratory and imaging findings, and the physical examination. Finally, you synthesize that information into an assessment and plan for the patient. Beyond these formalities are many subtle differences in how physicians, residents, and students present.
Some doctors choose to frame the patient as “ours.” This reflects that while hospitalized patients have placed their care, and sometimes their lives, in our hands. Their clothing is exchanged for a thin gown, they are woken up throughout the night for examinations, and various teams shuffle in and out of their rooms.
It is all too easy to lose one’s sense of individual humanity in the sea of modern medicine.
As a medical student, I was responsible for several patients under a resident physician’s supervision. During my early rotations I gathered information from the patients, looked up their medical history, and reported it to my team after rounds. As I continued my training, I began to develop patient plans of my own.
Once I developed such a plan for one of my patients, my attending physician asked me a question I hadn’t considered yet.
“Can Mrs. J eat lunch?”
This caught me off guard. A more experienced student might have included it as part of a preoperative plan. If Mrs. J were to undergo any surgeries during her hospital admission, she wouldn’t be able to eat starting the night before.
“What about moving around? Can she move freely, or do we need to require assistance? How much liquid can she drink?”
The point of these questions was to remind me that we had assumed total responsibility for Mrs. J’s care. She was our patient. In addition to deciding on a diagnosis and course of action for her, we had to come up with the boundaries within which she could function. Of course, patient autonomy remained central, and Mrs. J. had a say in these decisions, but it was my duty to consider all the elements of her stay.
I went to summer camp for 14 years. Ten of those were spent as a camper and the remaining four as a counselor and activity director. As a counselor, I got to peek behind the curtain of camp’s magic. I learned that the job was much more than ensuring your campers made it through the summer. That was fundamental, just like diagnosing and treating my hospital patients. But I was also responsible for countless other details of my campers’ day-to-day activities. Their parents had entrusted me with the most precious part of their lives. No matter the time or how difficult, those campers were mine to nurture, protect, and love. I had to have a plan for the picky eater, the homesick child, and the kid feeling left out. My co-counselor and I cherished each of our campers uniquely, and we strove to know as much as we could about their hopes and worries.
So, when my resident brought up “our patient,” I couldn’t help but smile. While patients are fundamentally different from campers, a common and vital thread exists. Both the hospital and camp are sacred places where critical decisions are made. Both our campers and our patients have families and friends who have placed their trust in us.
To best care for them and recognize their individuality, we must see them as ours.
Over the drone of hospital announcements and beeping alerts, I thought I could just perceive water lapping on the lakeshore.
Looking back to my team, I began, “Mrs. J, our 57-year-old female . . .”
And I made sure to mention what kind of lunch she could have.
Benjamin Popokh spent 14 summers at Camp Champions in Marble Falls, Texas, first as a camper, then as a counselor, and eventually as an activity director. He is now a family medicine resident in Fort Worth, TX, with a special interest in full-spectrum rural healthcare.
