A natural consequence of caring medically for patients is caring for them as people as well. But in particular I’ve found that my bonds as a medical student have often been strongest with patients who were the least sick. Why it happens that way actually makes a lot of sense– 1) The sicker patients are often less communicative, while the ones who are more well (relatively speaking, but of course they’re still ill if they’re in the hospital) generally have the energy and desire to speak, and language and communication are necessary for bonds to form. 2) If someone is miserable but otherwise stable and there’s not much you can offer them in the way of help, it is awful to watch them feel that way, and they naturally often don’t want to be watched while in pain or suffering.
As a medical student, my knowledge and skills are limited, but my enthusiasm and time are relatively unlimited. One of the main things I have to offer are listening and talking to patients about how they feel, or how their grandchild is doing in school, or what they want to do when they get out of the hospital. So quite naturally, when going from room to room, it’s often the less sick patients who want what I can offer them, just someone to listen, to maybe answer a few basic questions, to help them open the window shades or fetch an extra blanket.
None of this is inherently bad or wrong. You might even be wondering why this is worth reflecting on. But after discussing this phenomenon with a faculty advisor of mine, it became apparent why this bias could be harmful if my “attachments” could affect the care I provided. For example, would I be just as willing and happy to run around the hospital getting errands done for patients I didn’t know as well? I think the answer for me so far has been yes, such that when my help was required, it didn’t matter whether I had “connected” with those patients as much or not. But it’s something to keep in mind going forward, that each and every provider has the capacity to feel varying extents of personal connections to patients, for a wide variety of reasons–such as degree of illness, language or cultural barriers/similarities, shared interests, and external influences at the time of the encounter. Above all, an awareness that this can and does happen all the time is important for continuing to provide excellent care for every single patient. Connections are excellent and strived for, but being inequitable in care when those connections are less strong is not good medicine. Being aware of this possible pitfall is the best way of avoiding it.
