Although written for a wide audience, Dr. Lisa Sanders’ Every Patient Tells a Story is a book that medical students will find not only entertaining but highly relevant to their education. In her book, Dr. Sanders identifies and expands upon the essential elements that lead a doctor to diagnosis including the patient interview and the physical exam, fading arts that I know at least NEOMED has been trying to revive. Throughout the book are stories from Dr. Sanders’ Diagnosis column in New York Times Magazine as well as some from her own training and practice that show that each element is important but it is the integration of the elements that lead to solving complex cases. Sanders also shows how vital (almost literally) it is to be cognizant of one’s own thinking process in coming up with differentials and is refreshingly honest about being wrong in medicine. These messages serve as a great supplement to many core themes of the longitudinal
course at NEOMED.
Additionally, Every Patient Tells a Story (as well as many other medically-inclined books) will do something that I do not think happens enough in medical education: orient students to where medicine today has come from and where it is going. As medical students, much of what we do seems to be learning from test to test. But there is always a point where a medical student wonders, “Why is it important that I learn this?” What it seems we have little time for is finding out what is out there in the field today and how classroom knowledge is part of that. What are the issues? What is being done? What have people already tried? Books by physician-writers like Dr. Lisa Sanders, Dr. Atul Gawande, Dr. Jerome Groopman, and many others already seek to answer these questions for the public-at-large in plain language. A medical student up to his eyes in his studies can experience even more excitement than the average person as he reads these works and finds he understands a process or recognizes a disease from class.
Now, while I do believe every medical student should try to read this book, I hesitate to recommend that Every Patient Tells a Story be made into required reading in the sense that every student in the class must read this book at the same time whether it be during the academic year or over the summer break. My reasoning is this: forcing students who already feel there is a high volume of studying to be done can make them antagonistic toward the reading and the gain becomes diminished. In high school, I had an English literature teacher that found required reading to be a necessary evil and wanted to remind us that great reading could be done for pleasure. One day, he rolled in a cart with copies of Ken Kessey’s One Flew Over the Cuckoo’s Nest and told us that anybody that was interested in reading the book could have a copy. Another time he did the same thing with J.D. Salinger’s Catcher in the Rye, telling us that Salinger would hate it if he forced us to read this book. Frequently he would bring in reading list from various sources – the 100 best novels, the 100 best non-fiction, etc. “These are important books,” he would say. “Just because we don’t read it in class doesn’t mean you shouldn’t.” When classes would reconvene after breaks he would ask us if anybody read anything interesting and we would all sit around and talk about what different things were read outside of the curriculum.
I believe the same philosophy can be applied in medical education. The greatest service to medical students would be to inform them of what books are out there and what they are about. Rather than have all students read the book at the same time, I would like to see Dr. Sanders’ book be part of an independent reading assignment where the student may choose a book from a list of several and share his or her thoughts on the work in the small group sessions. In this way, every student can feel that there was some personal value in the choice he or she made and has unique thoughts to share with a group of people who did not necessarily read the same work. Fellow group members benefit by getting informed about a book they may not have read. This, I feel, would truly create a good vehicle for discussion amongst students about many of the themes of the longitudinal course at NEOMED.
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