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Stanford University School of Medicine

When the medical student is no longer the most important person in the room

For the first two years of medical school, everything was all about us.

Day one was our white coat ceremony. Our family and friends traveled from near and far to come celebrate our achievements; the school gifted us stethoscopes and white coats to mark the beginning of our journeys. We had already accomplished amazing feats to get here, we were told, and we were expected to continue to do great things. As the year began in earnest, we were surrounded by people who were there for the sole purpose of making us better.

We met patients who volunteered their time to come and share their stories for our learning. We learned anatomy from the bodies of people who had generously given themselves to our cause. Our encounters with “patients” (who were actually actors) were carefully designed for the purpose of giving us feedback and improving our clinical skills. It was only natural, then, to have been focusing on the “me” – passing my exams, improving my knowledge and skills, planning for my residency and my future career.

During third year, everything changed.

One day last month, I found myself squeezed into a small hospital room, standing at the foot of a bed of a patient who was gravely sick from metastatic cancer. His tumors were growing, and our team was running out of reasonable options to relieve the problems that it was causing in his body. As our patient fought back tears, my attending – the head doctor of our team – expressed this news and delicately approached the topic of understanding how our patient wanted to live out the final period of his life. The attending spoke words that have stayed with me since. “What we think doesn’t matter,” he said. "You’re the most important person in this room. The only reason we’re here at all is to support you.”

There it was: In stark, plain language, it was no longer about me. He was right, of course. To be sure, I continue to study, learn, be evaluated, take exams, and complete applications – all of the “me” things. The bottom line, though, is that when I show up to work, there’s no longer a team of people looking out for me; I’m in the team of people looking out for somebody else. In some ways, this is challenging: more responsibility, less hand-holding. In another way, it became liberating to realize that my journey through medicine had reached a point where it was no longer all about me. I can finally learn from my patients. I can finally learn for my patients.

I went for a run that evening to escape the bright lights and machinery of the hospital. As I wound my way through the grassy hills, I caught sight of a great egret and stopped short. It stood majestically, calmly fixing one of its yellow eyes on me. Yes, it told me, there was an entire world outside that had gone on without me – bigger than me, bigger than my patients, bigger than the hospital. “It never was about me, was it?” I asked. I didn’t hear an answer. I didn’t need to.

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category. 

Nathaniel Fleming is a third-year medical student and a native Oregonian. His interests include health policy and clinical research. 

Photo by Roco Julie

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