By Anne Enright Shepherd
April 6, 2001
Claudia Mink's mother was critically ill, and it seemed as if she was developing a new set of symptoms every few days. As her mother's caregiver, Mink found herself interpreting and explaining results from the many doctors involved in the treatment.
"The doctors really just didn't seem to know what to say," she said as she recounted her mother's final weeks to a rapt audience of first-year medical students.
Mink's account was part of Discourse in Doctoring, a new selective course intended to help students understand the role of storytelling in health-care communication.
Elliot Gellman, M.D., course master and Mink's brother, invited her to share their mother's story as a way of emphasizing that doctors do not always communicate well with patients and their families.
"As physicians, most of our communication skills are acquired through on-the-job training," said Gellman, also clinical professor of pediatrics. "This course provides freshmen with means of dealing with patients and recognizing their satisfaction or dissatisfaction. Communication is the very foundation of it."
The course is designed to stimulate thinking about the importance of discourse in healing. Although there are no exams, students are asked to participate in critiques, a self-assessment narrative and storytelling.
This semester, the focal point of the multidisciplinary class was a concert reading of the Pulitzer Prize-winning play "Wit." In the play, a literature professor with ovarian cancer becomes overwhelmed by the insensitivity of the medical staff providing her care. Students and faculty attended the reading, sponsored by the St. Louis Children's Hospital Staff Society, and discussed its ramifications.
First-year student Alison Snyder said the best thing about the course is the diverse perspectives offered by faculty with very different backgrounds. In addition to physicians with training in various specialties, presenters included a professional storyteller, an occupational therapist, faculty members in education and psychology and the associate artistic director of the Repertory Theatre of St. Louis.
"It's definitely something we would not experience in the traditional medical curriculum," Snyder said. "This class is great."
After hearing Mink's moving narrative of frustration with some of her mother's doctors, James Keating, M.D., the W. McKim O. Marriott, M.D., St. Louis Children's Hospital Professor of Pediatrics, provided students with a take-home message. "Try to analyze for yourselves why you think physicians may fail to communicate with patients so you can avoid such situations in your own work," he said.
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