All Doctors Should TeachPrint
A guest columnist’s prescription for MDs
By Paula Marantz Cohen
My daughter, Katherine Penziner, wrote the essay that follows in response to my last column. She is spending a few years teaching in Southwest Arkansas as part of the Teach for America program. She plans eventually to go to medical school.
Every aspiring doctor should be required to teach a year of high school science. First, there is nothing more grueling than standing up, day after day, in front of hormonal and angsty teenagers who are having trouble controlling their attitudes. The emotional toll teaching takes can be exhausting–a perfect training ground for the taxing years of medical school we premeds are always hearing about. Still, a good day of teaching makes you feel good about yourself, and your students.
But what makes teaching most valuable for an aspiring doctor are the communication skills that must be developed in order to convey information to people who don’t yet have the vocabulary to engage fully with a concept. I firmly believe that the principles of chemistry and physics I teach to 15- and 16-year-olds are inherently exciting when the delivery is right.
That delivery is the crucial element missing when people complain of doctors’ bedside manner. Doctors who do not put their patients at ease are generally not bad people. It’s hard for me to believe that my friends who are in medical school now could alienate their patients–they are great communicators. However, there is a difference between the communication of facts and the explication of them. The gap between communication and explication is precisely the point at which the doctor-patient relationship can disintegrate fastest.
On tests in college and, I’m guessing, in medical school, you answer questions for professors, people who already know the answers. Why tell them what they already know? The truest test is if a doctor can give the answer to those who have no idea what hemoglobin is, could not guess the function of the gallbladder, and have never heard of the nephron.
In a recent article about health care in rural areas, a woman commented that poor black Americans might not trust doctors that don’t look like them. I can imagine that in the Mississippi Delta a black patient might be skeptical that white doctors could truly understand their situation, socially and economically. But though skin color can’t change, the vocabulary doctors use can.
I often use words in the classroom that my students don’t know. But I also make sure to either provide plenty of context for them to figure out the meaning, or clearly define them. I’ve seen students shut down when they don’t understand what I’m saying. But with the right explanation, I’ve seen my weakest students grasp a concept.
Similarly, doctors must explain what they are doing to patients without alienating them with the vocabulary they use. I’ll never forget going to the dentist when I was very young and being frightened when he didn’t explain what he was doing. For years, that experience made going to the dentist into an ordeal.
Patients can develop a basic understanding of their illness and their treatment with the guidance of their doctors. Good teachers can make a difference between success and failure in students’ lives. Doctors, if taught to be good teachers, can be the difference between health and sickness, and even life and death.
Paula Marantz Cohen is a distinguished professor of English at Drexel University and the author of the novels Jane Austen in Scarsdale or Love, Death and the SATs and the recent What Alice Knew: A Most Curious Tale of Henry James and Jack the Ripper.
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