Chellam “Chellie” Nayar is a medical student in the University of Vermont (UVM) Larner College of Medicine Class of 2025. In November 2021, Nayar rode the elevator to the fourth floor of the UVM Medical Center’s Miller Building, on her way to interview one of her first patients.
The exercise is part of the Vermont Integrated Curriculum’s Professionalism, Communication, and Reflection course, and a rite of passage for first-year medical students at Larner.
After the visit, Nayar and her classmates reflected on their visits, putting their thoughts and emotions into written narratives and, in Nayar’s case, a drawing.
I was the first student to be “dropped off” in a patient’s room by our class’s facilitator. It felt almost like being sent into the classroom by my parents on the first day of grade school.
This was my first patient as a medical student, and I had so much to learn.
My facilitator walked me in, introduced me to the patient, and explained that I was there to learn about her. I took a seat on the stool just next to the patient’s bed.
Initially she began to tell me what had brought her into the hospital—complications associated with congestive heart failure. But soon our conversation shifted, and she began telling me about her life. She talked about her childhood growing up in the Bronx and her move to Vermont – a house in Richmond where she lived with her husband, and later, her four kids. She talked about her garden, and I could imagine the planter beds, filled with flowers and vegetables, and beyond them, green fields rising up into the mountains. She spoke about nursing school and working as a nurse, and the lessons she had learned from her patients.
Yet as the conversation turned to the present, her tone shifted. She talked about her husband’s death, some years previously. Since then, her heart condition had worsened. Her children had moved away long ago, and in the many years since, she had only seen one of her sons. Recently, she had moved away from her house and her garden, which had been untouched for several years, to a nursing facility in Burlington.
As she told me about her move, I realized that it was not just her heart condition that was putting a strain on her health, it was all of this too.
As an emergency medical technician (EMT), I conducted patient interviews countless times before starting medical school, but this interview was a different experience. While I could come away from an emergency call and recall the patient’s heart rate, blood pressure, blood oxygen, pain level, and countless other measures, I could not have recited any of these after I had met my first patient as a medical student. Instead, I could tell you that she was from New York City, that she moved to Vermont with her husband and started a family, she loved to grow flowers in her garden, she loved her job as a nurse, she adored her husband until the day he passed, and that she craved the independence she once had.
Our conversation had little to do with medicine. That is why this exercise was so valuable.
My classmates and I came into the hospital as part of our Professionalism, Communication, and Reflection course to hear patient stories and understand how those stories contribute to our understanding of patients as people. In my first patient encounter, not only did I learn about my patient, but I also learned about the importance of hearing a patient’s story.
In this encounter, I was reminded that being an excellent doctor does not just require the knowledge of medical phenomena and practice of intricate procedures, it requires empathy. It requires us to listen to patients, connect with them, meet them where they are, and work with them in their treatment.
