How a young doctor treats young patients

On a typical day in a major hospital, patients pass through the emergency room with different ailments. Some of them are coming in to check out minor aches and pains, and others are coming in barely responsive with a life-threatening condition. Outside of the pediatric ward, all of the patients coming in are adults, and the majority of them are advanced in years, showing signs of chronic conditions taking effect as they become older.

You can imagine that for someone like me, just starting out in his career, it creates an interesting dynamic. Coming from a culture where respect for elders is paramount, at times, it can feel weird to make decisions regarding the care of patients who are many years my senior. As an internist and a current cardiology fellow, however, that is my typical patient population, and I have had to learn to adjust to the dynamic with regards to the difference in age.

Every once in a while, however, the appearance of the patient that comes through the hospital doors changes. Instead of a middle-aged or elderly patient, a young person appears with a medical condition requiring evaluation. Most of the time, it is an unexpected occurrence given the images we have of young people in society, images that remind us of how energetic, passionate, and healthy they are. When a young patient comes into the hospital, we tend to become more concerned, because it goes against the images of vitality that we associate with young people.

When young patients come across my path, at times it feels like the colliding of two unexpected worlds. On one hand, as they see me walk into the room as someone directing their care, it goes against the likely image they have about their doctor having many years of experience and having an appearance that demonstrates this. It is very likely that they are not expecting someone close to their age to be their doctor. On the other hand, for me, I am not expecting to see a young patient, since it is rare to see sickness and youth mixed together given what my usual experience of patients has been in the past. However, when these worlds collide, the youth perspective comes into play with all the nuances that come with it, and we become more aware about how it impacts the way we see our experiences in the medical world.

Through my conversations with young patients, it becomes apparent that being in a hospital is a significant shock, an unexpected turn from the way they live their lives. At baseline, they live lives where things are moving at a constant pace with few interruptions and without any perceived limits. However, being in a hospital bed causes a challenge to how a perceived life of a young person should be. There is a sudden reminder of vulnerability, and life is temporarily interrupted; there is an eagerness to get out of the hospital bed and get back to their normal lives.

For me as a young doctor, the question about experience comes to the forefront. It is interesting to be in a situation where a young person is looking to me for guidance in their care, especially if I am around their age. I feel that I still have so much to learn, like any young person, but that for this period of time, they depend on me with regards to their medical care. In a different, and I would dare say usual, world, we would probably be hanging out with mutual friends, talking about the different concerns that we have as young people growing up in a changing world. Instead, in this temporary world, the hope is that I give the right medical advice to speed up their recovery.

Whether on the patient side or physician side, youth introduces a unique perspective into medical care. The aspirations, questions and fears of young people become much more pronounced when it comes to medical care. When the unexpected vulnerability of a young patient comes into contact with a young physician who is continuing to gain experience, expected roles and ideas of young people are challenged temporarily. The hope is that even in the midst of this unexpected colliding of two unexpected worlds, young patients walk away better than when they first came into the hospital, and young physicians walk away better doctors than when they first entered their patient encounters.

Chiduzie Madubata is a cardiology fellow.

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