“What was the most meaningful experience you’ve had during medical school? How did it impact you and the physician you will become?”
I had done my medical student-worthy research to prepare for residency interviews. I repeatedly repositioned my ring light and practiced answers to common interview questions. A number of different answers that I had prepared about meaningful patient interactions came to mind when I was asked the above question, but I immediately knew what answer I would give to this particular permutation of the question. And it did not describe something that took place in the hospital or clinic.
Roommates are great for splitting costs and providing companionship. My roommate and I go grocery shopping together and share the cleaning. She is usually home when I return from the hospital and is always eager to hear about my day while we eat dinner together. Our relationship is unique in that I’ve known her much longer than most of my classmates have known their roommates. She is one of the most inspiring people I know and an amazing role model. So when asked the above question about my most meaningful experience in medical school, I instantly replied, “living with my grandmother.”
I was fortunate to grow up living near all of my grandparents. As I grew older, I transitioned from having a grandparent stay with me when I stayed home sick from school to visiting my grandfather regularly in the hospital. After he died, my grandmother, Nomi, and I became even closer. As we both grew older, our relationship changed in some ways. I started doing more driving and carrying more groceries. We began going to more of her doctor’s appointments together and fewer of mine. The topics of our conversations changed as I became an adult; I was no longer shielded from difficult topics, such as her and her friends’ health problems. But mostly, our relationship stayed the same. She was still a best friend, the sister I never had and an extra parent for me. We still went shopping together, baked together, and had sleepovers at her house.
Living with Nomi since graduating college, I’ve learned many lessons simply by watching her in her daily life. I try to emulate many of her wonderful character traits, including many that pertain to the practice of medicine. In addition to everything else written here, she was my second-grade teacher, one of my early educators who instilled in me a love of learning, the importance of reading, and how to write in meticulous cursive (a doctor’s frequently-used skill).
Nomi began teaching in New York City in the 1950s. Even after many decades in education (and teaching two of her grandchildren), she considers her years teaching in Harlem to be the best of her career. During that time, she was able to contribute to a community that desperately needed educators and made a stronger impact on those students than any others she taught afterwards. I’ve thought about this often as I cared for patients in Baltimore City. It feels so special to provide services for children and families who have limited resources and access to care, just as Nomi provided a foundational education for her first students from similar backgrounds.
On a daily basis, Nomi models what it means to be a lifelong learner, something integral to the practice of medicine. Every day during dinner, she asks about the patients I saw that day and what I learned. She learned about the pathogenesis of retinopathy of prematurity during “our” ophthalmology elective and the differences between inpatient and outpatient insulin regimens on endocrinology. She approaches all opportunities to learn with this same enthusiasm, including learning how to use new technology, studying current events or biographies that she reads.
This drive and determination pervades Nomi’s daily life. She starts each day on the treadmill, regardless of how she feels. She makes a list of everything she wants to do during the day and will not rest until every task is completed. She pushes herself to what most people would believe to be beyond her limits (despite my pleas not to do so). Seeing her willpower to overcome more than her fair share of challenges is truly inspiring.
Living with someone outside of medicine has kept me grounded throughout medical school, as medical jargon integrated itself into my vocabulary and I became (somewhat) accustomed to observing patient suffering. When I explain things that I’ve seen or done, Nomi quickly asks for definitions of terms I use or further explanations of unclear points. This has provided me with practice talking to patients and their families, and serves as a reminder that, unlike Nomi, many patients will not interrupt me to ask for clarification. I know that it is my job to assess their understanding and explain things clearly. But more importantly, any interesting case I share with Nomi is met with the same sympathy for the patient and their family. While I know that some degree of mentally separating the case from the patient may be important for practicing medicine, I appreciate this daily reminder that, first and foremost, my patients are people who are suffering.
Thankfully, Nomi does not have any one particular devastating illness, such as dementia, cancer or heart failure. Rather, she deals with the many health changes that accompany aging and simply doesn’t feel well a lot of the time. I’ve seen the frustration that not having a true diagnosis or known treatment causes for the patient and their family. My front row seat to the life of a patient and personal experience as a caregiver are invaluable in relating to my patients and their families.
Nomi often apologizes to me for “complaining” when she doesn’t feel well. My answer to her is always the same: “telling me how you feel isn’t complaining.” And so, I cringe at the term “chief complaint” and when I hear during rounds that a patient “complains” of a particular symptom. Shouldn’t we want our patients to tell us how they feel? If we ask why they have come in, is the reason they provide us truly a “complaint”? Perhaps a different term for this would help us change our collective mental framework.
Living with Nomi, I have been fortunate to become close with many of her friends, adding breadth to the depth of my supplementary education. In the hospital and clinic, we see the variety of presentations that are possible for a given condition. At home, I have seen the different ways patients cope with similar ailments and how each person makes different choices given the same options for medications and treatments. This has emphasized for me the importance of shared decision making in prioritizing a patient’s preferences, which should always be our goal in practicing medicine.
For all of these reasons and many others (such as having my lunch packed for me on a daily basis), living with my grandmother has been the most transformative experience of my life. I know I am a better person and will be a better physician as a result. Her influence has, and will continue to, impact every interaction I have with patients and their families.
Image credit: Custom artwork by the author for this Mosaic in Medicine piece.
Medical Student Contributing Writer
University of Maryland
Lani Roskes is a third year categorical pediatrics resident at the University of Maryland in Baltimore. She grew up in the Baltimore area and attending the University of Maryland for medical school as well. In her free time, she enjoys sports, board games, arts and crafts and spending time with her family and friends.
