During winter break of her first year in college, Simrun Bal ‘19 traveled with her parents to a small rural village in India. It was the first time the American-born Bal had visited her parents’ birthplace, and the first time she’d seen such pervasive poverty and poor health conditions.
The experience deeply affected Bal and she changed course by scrapping her plan to become a science teacher in favor of becoming a physician. “I felt that medicine was where I would have the greatest opportunity to transform people’s lives while also utilizing my desire to teach,” says the first-year Geisel student.
As an undergraduate intern with the World Pediatric Project, a humanitarian organization dedicated to giving critically ill children from developing countries access to care, Bal provided cross-cultural support to the children and their families or guardians. She assisted with medical appointments, and encouraged parents to assuage their fears by talking to their child’s physician about what mattered most to them, such as their treatment expectations or other concerns.
Everyone facing a surgical procedure feels vulnerable, but imagine what it’s like for a child or parent in a place where the power dynamic in place makes you feel even more vulnerable, Bal says. “They are missing their home, other family members, and everything that’s familiar,” she adds. “They are already worried—seeing what these families were going through and being able to lend a helping hand is what I enjoyed most about that experience.”
Empathy is paramount when treating patients. It means you are making a commitment to sharing the patient’s journey and providing support to someone going through a hardship."
- Simrun Bal '19
Bal, who is warm and engaging, also spent one year as an AmeriCorps volunteer in a federally qualified health center in rural California. It was a perfect fit—drawing on her natural teaching skills, she counseled, educated, and coached patients on how to manage their diabetes, and worked on a project designed to promote empathy and foster a person-centered approach to healthcare among the clinic’s providers.
“It was an interesting project,” she recalls. “One of the behavioral health providers at the clinic wanted to understand how to create a person-centered approach to healthcare by cultivating a greater sense of empathy among the clinic’s primary care physicians and nurses—and to reconnect them with the reason they pursued a career in healthcare.”
Working with patients whose diabetes was not well controlled, Bal and her colleagues recorded individual patient stories about what drove their behavior, what values were important to them, and what defined them as a person. When healthcare providers listened to the collected narratives, they began seeing their patients in a different light—as people they were serving rather than as a collection of symptoms.
The population sample was small Bal admits, but the results were compelling and providers began personalizing their advice to patients. While working on a poster presentation about the project, the providers made a surprising discovery—the patients themselves benefitted from telling their stories; they felt valued and more connected to the clinic.
Prior to the project, a health-care provider may not have understood why patients ignored their continued advice to eat a healthier diet—they didn’t realize their one-sided conversation left patients feeling they were being lectured to and less likely to take their advice. And more often that not, the reason most patients weren’t eating as healthily as they may have wanted to had to do with daily barriers they faced.
“If you want to encourage someone to eat a healthier diet or get more exercise, you have to understand the context of a patient’s life—the barriers that may be preventing them from doing those things in the first place—and the project revealed that,” Bal says. “Part of my job included utilizing motivational interviewing, following up with patients, and helping patients overcome those day-to-day barriers. I accompanied patients to local grocery stores and educated them about how to select nutritious foods.”
Through her experience, Bal learned how crucial it is to meet people where they are and to provide healthcare and education beyond the walls of a clinic. She also learned that a few moments spent carefully listening to patients revealed an infinite amount of information. “For some patients, it was simply that they valued something else more than the doctor’s advice,” Bal says. “How do you address that disconnect? You connect their health issues to what matters most to them in their lives.”
To illustrate, she cites a patient with a serious health outcome resulting from his uncontrolled diabetes. A single father living in a rural area, he worked in the fast-food industry and couldn’t afford to take time off to see a doctor—and a lack of transportation complicated his ability to easily get to the clinic. He cherished his children and worked hard to support them, but he put a low priority on his own health.
By listening to this patient with compassion and empathy, Bal worked with the clinic’s health-care providers to help him realize by taking care of his own health he was better able to take care of his children. “When we understand what’s important to patients we change the currency of the exchange, which in turn can change their stories,” she says. “It’s powerful and meaningful to get a sense of what people in rural communities are going through.”
Bal appreciates Geisel’s rural location and the fact that the school’s curriculum supports humanism in medicine. “That’s the direction I want to take as a doctor, hopefully in rural health,” she says. “Empathy is paramount when treating patients. It means you are making a commitment to sharing the patient’s journey and providing support to someone going through a hardship.”