DMS Alumni Reflections
In my second year, I participated in Partners in Health and taught an occasional health education class at Lyme Elementary School with a group of 5th graders.
It was very educational to try to explain things like the circulatory system and lung cancer. I feel it was very useful in learning how to communicate with patients and families on a level they understand without being condescending. I have seen, in my current clinical duties, many physicians who communicate so poorly to their patients that it seriously damaged any patient-physician relationship.
I feel very lucky to have had so many different experiences at Dartmouth which helped me to develop my communications skills.
—Jennifer
I have very clear memories of many of our professors during the first two years of training. They had such passion for what they taught and were very genuinely interested in what medical students had to say - Dr. Bell, Dr. O'Donnell, Dr. Binder, Dr. Mosenthal, Dr. Padilla, Dr. Pfefferkorn, Dr. Hungerford, Dr. Cochran - to name a few.
I still hear Joe O'Donnell's voice when I am particularly perplexed about a patient saying "listen to the patient he is telling you the diagnosis." I don't think you're ever too trained, too smart, or too old to remember the wisdom and humility of that statement.
If my memory serves me correctly, our class was the "pilot" Class for LCE. I will be the first to admit that I probably did not take the whole experience quite as seriously as I should have. But, some things that I learned in LCE were extremely valuable. I was fortunate to have an incredible LCE small group leader, Sarah Johansen. At the end of our second year, she gave us each a small black 3-ring notebook. She explained a method of keeping track of our patients on "the wards" using this notebook. It proved to be a very valuable tool that I used throughout residency and fellowship. While all the other interns seemed to be developing their own methods of organization, I came very well prepared. Sarah also taught us other tricks of surviving "the wards" which eventually became tricks of surviving internship and residency. I think it would be very useful for all the students to have exposure to these kinds of useful tips and organization methods.
The faculty member who had the greatest impact on my career choice was Dr. Bill Nugent, Chief of Cardiothoracic Surgery. I don't remember how we met, it may have been at a surgical interest group presentation, but during the summer between first and second year I approached him about doing some summer research in his section. Paul Hammerness and I decided to work together on a project. Dr. Nugent had a brainstorming session with us. He is one of those talented clinical researchers who can sit and rattle off 5 or 6 interesting studies that haven't been done yet and assign one to a couple of medical students knowing that the results are going to be relevant even before it's completed. Paul and I did a chart review looking at non-small cell lung cancer diagnosed at the extremes of age. In short, the results were interesting and were published in the Annals of Thoracic Surgery. Paul and I were the second and third authors. When the paper was accepted for presentation, even though Dr. Nugent was going to be the presenter, he invited Paul and me to go with him to Atlanta to the Society of Surgical Oncology meeting. It was my first academic meeting and I was blown away. It was that weekend that I felt I had arrived or had been officially accepted into this fairly exclusive club of allopathic medicine and I was falling in love with surgery.
All through that summer, in addition to chart work for the project, Dr. Nugent had me in the operating room watching open heart and making rounds with the team. I vividly remember my heart pounding with anxiety the first few times I scrubbed and gowned, I didn't want to screw it up. When I approached the table he would always say, "Keep your hands where I can see them". On rounds, he would often look towards me when he and the residents were discussing complicated management issues in the CTICU, and say "What do you think?" I remember the look of "Are you kidding me?" on the nurses' faces. "He's a first year medical student." Dr. Nugent would say, "He needs to start having an opinion." By the end of that summer, I knew that I wanted a career that involved surgery. I'm now a busy private practice Urologist and I love what I do and I was fortunate to have had the mentorship and guidance of Dr. Bill Nugent.
—Mark T. Edney MD, DMS '98
My best memory is the obstacle course during orientations. It served as an important allegory to the experiences to ensue on my route to being an effective physician when I first saw the wall we all had to cross. I felt it was a horrendous task as was medical school. But with help of our group members, every single one of us ended up crossing as we did graduate.
I think the experience I had during my psychiatric rotation was extremely positive. I elected to go to Concord and work with Dr. Denesnera; he had the time and interest to work extremely well with a 3rd year student. I interacted with patients, groups and families and truly felt like I was a member of the treatment team. In general, in the clinical years the experiences in which clinical work cemented book learning were the most valuable for developing clinical skill I use daily now.
My most positive DMS memories are definitely the excellent relationships I developed with my colleagues. Although this definitely contributed to my future as a physician, I believe the most concrete academic experience from DMS was in anatomy. I'm a small group tutor at Harvard Medical School now and I'm shocked at the poor level of anatomy that 1st and 2nd year students have relative to what I recall from DMS. I first read CT scans as part of my anatomy exams and the experience carried through to residency.
My mentor in our Longitudinal Clinical Medical experience as a first year put me in a patient's room alone on day #1 in the clinic.
He said, "Just go talk with her and see what you can learn. I'm running late. She is a nice woman." I introduced myself and began to ask her about her life. She told me about recent hardships, trouble with family, excitement about grandchildren, her husband's drinking, and her challenges with arthritis. I didn't ask about her medicines or diagnosis. I hadn't learned any of that yet. Afterward my preceptor asked me what we talked about. As I told him, he said, "She told you that?" He learned information about her that was important to her and that was never before known to him. I learned that sanctity of the physician-patient relationship where in vulnerable and deep secrets can be shared. It surprised us both, and I remember it still when I enter a patient's room.