Over the past few weeks on the inpatient pediatric neurology service I’ve run into some pretty challenging children and families. Mostly, my job on my early morning rounds is to listen to patients and families and gather their concerns so that I can present them for discussion on our more formal rounds later in the day. I have honed my listening skills and my repertoire of sympathetic responses during these encounters because parents often tell the longest, most detailed, and sometimes heart-wrenching stories.
As the medical student on the team, it is usually enough for me to listen and then defer to a higher power. When a parent asks me a difficult question, I sometimes try to answer it but I carefully hedge with, “my understanding of this is ________ but the rest of the team will be able to give you a better answer later.” Usually this is sufficient, and I am grateful to have the chance to practice giving answers to the these questions without the pressure of having to be totally smooth in my delivery! However, I am aware of the fact that in less than a year, I will have to sharpen my skills further so that I am prepared to deliver these answers completely and correctly on my own.
The trouble I have found is, how do you handle it when the patient or parent is going to be displeased with your answer? For instance, if a parent asks you what you think may have been the inciting factor in their child’s autism, what do you say? As the medical student in a similar situation, it was okay for me to waffle a little and say that I couldn’t be sure. But what about the attending who walked into the situation after me and had to say something scientific, accurate, and professional in response, even though it would likely make the parent mad? Being a medical student is certainly challenging at times, but having to render difficult and divisive decisions as a full-fledged physician can’t be easy either. For now, I’ll be grateful for the ability to remain the likable, sympathetic ear during these charged conversations.