Soul of a Patient

There is nothing quite as important as training the next generation of physicians.In an increasingly complex and cruel world, finding a compassionate and skilledphysician is truly a lifeline. Yes, of course we want our doctors to be up-to-dateon all the latest medical knowledge and scientifically savvy; but, above all, weneed physicians to be good listeners and caring practitioners. Conceptualized bythoughtful educators at Harvard Medical School, the Mentored Clinical CasebookProject (MCCP) pairs a first-year medical student with a clinical mentor and apatient to follow closely for one year 1. The student spends time with his or herpatient, both in and out of clinical settings, with the goal of trying to understandthe patient''s life and relation-ship with his or her illness as completely aspossible. The student keeps a written record of the interactions with the patient,and also does research to understand the scientific, socio-economic, and culturalissues that influence the patient''s experience. The casebooks that are produced arequite impressive, some as long as ten thousand words, with extensive bibliographiesand scientific tables. But what shines throughout is the singular relationships thatthese brand new students, not really doctors yet, forge with their patients. They goto appointments with them, have coffee, visit their homes, meet their families, andalso meet the doctors caring for them. The students come away with a newfoundappreciation for all sides of these complex situations. They have been assignedpatients with chronic and sometimes terminal illness, and have the opportunity towitness the bravery and courage that facing these circumstances require. We wantedto share these remarkable casebooks to shine a light on this innovative approach tomedical education. Be¬cause the casebooks were so comprehensive, for this collectionwe decided to emphasize the personal struggles associated with illness and theconnection and communication with the caregiver that is so important topatient-centered care. We took out details of the basic science and clinical care,because these change with new knowledge and techniques, while relationships andcommunication skills are timeless. This collection of first-year medical studentswriting about their year-long experiences with patients is truly unique andinspiring. As a breast surgeon and medical educator, I learn something new every dayfrom my patients and my students. Reading and editing these extraordinary casebookswith a team of talented student-editors has been a privilege and joy. I am thankfulfor the opportunity to share these with a larger audience. 1.Stanton, RC, Mayer, LD,Oriol, NE et al, Acad Med. 2007; 82:516. --- Editors: Susan E. Pories, SamyuktaMullangi, Askash Kaushik Shah, Mounica Vallurupalli