Thursday, December 15, 2011

The Three Most Important Non-Science Classes A Physician Will Ever Take

Recently, I was chatting with a cardiologist of about 30 years experience. He’d lived in Israel for several years, and went to all four years of college there. He considered pursuing his MD at an Israeli medical school, but through circumstance, he ended up back in the US. In the course of our discussion, he mentioned that Israel follows a European model for medical education, one which features a truncated pre-med program consisting solely of science classes, rather than a four-year college education which balances the sciences and humanities. We agreed that while the sciences comprise the core of a pre-med education, the education shouldn’t start and end there. This week I’m devoting my column to three non-science courses that every physician should take.

Contrary to the opinion of some, a physician is not merely a scientist. A physician is a scientist who communicates that information to his or her patients, relates it to the life they live, and tries to help them put it in context. While this a role well-known to pediatricians, primary care docs, naturopathic doctors, and other healthcare providers who work in a primary care environment, this is equally important for surgeons and other specialists. The ability to communicate to a patient about their health is especially important when that patient’s health is in acute distress.

Last year, the New York Times ran an article about a program run by Mount Sinai School of Medical, the Humanities and Medicine Program, which accepts a small number of students every year who have not taken some of the traditional pre-requisite classes (physics and organic chemistry) nor taken the dreaded MCAT exam. Instead, students are encouraged to major in a humanities subject of their choice, and so long as they maintain a high GPA, they matriculate along with all of the other students. While I myself believe in the value of physics and organic chemistry, I like the fact that this program encourages study in the humanities. A well-rounded education creates a well-rounded doctor, and with that, here’s my list of the three humanities classes that every physician should take.

A Literature Class – The poet in me sometimes likes to say that a physician must deeply feel and understand the human condition. While this is perhaps more poetry than practice, it is absolutely true that a doctor has to understand the character of the patient who comes to see him/her. It’s important to be able to anticipate the emotional or mental needs of our patients, so that we can communicate in ways that are appropriate to our patients’ needs. Good literature, especially but not exclusively good modern literature, explores human needs, motivations and behaviors in a profound way that educates us about the people around us. In our culture, we rarely give each other true insight into our inner lives, but books thrive on this. A well-read doctor reads and learns, and then understands his patients better, being able to both relate compassionately and cater individually.

A History, Anthropology or Sociology Class – In the same way that a patient doesn’t start and end at an injured body part, a patient extends beyond the individual person who presents in the exam room. A patient’s health is determined by a whole host of factors in the world around them, including their work, their home environment, their ethnicity, their economic status, and their culture – in short, their place in the world around them. These factors play important roles in an individual’s health by influencing factors such as their diet and ability to access healthcare, and yet they are rarely discussed in biology, chemistry or other pre-med science classes. A well-rounded education, in which the student learns about the individual’s place in the broader world helps that future physician to understand what factors may be influencing a patient’s health, and to make recommendations that fit within that patient’s real-life experience.

A Foreign Language – As I said earlier, a physician is not merely a scientist, but a communicator. Learning a foreign language has important philosophical and practical value for a physician. On the one hand, a doctor should have a broad mind and flexible way of thinking, two attributes that come with studying a foreign language and the culture that created it. On the other hand, in a multicultural society such as the United States, it is increasingly important that a physician be able to speak a second language in order to serve his or her community. Certain languages thrive in certain parts of the United States (such as French, German, Chinese, Vietnamese, and others), but Spanish in particular is now becoming a clinically important language, with at least 10% of American families primarily speaking Spanish at home. Speaking a patient’s native language allows for better communication, not only by allowing the patient to better describe their situation, but also by giving them the confidence and comfort of knowing that they are being understood.

Being a physician is not merely being a scientist. Being a physician is being a translator, an intermediary between the concepts of science and the human experience. In order to fulfill that role successfully, a physician has to have a strong grasp of the world beyond the sciences, and so these courses must be a part of his or her education. A physician needs to understand his or her patients’ inner life and character, the social forces that affect them, and needs to be able to communicate to them in a language they understand. As I said earlier, a well-rounded education creates a well-rounded physician, and a better servant of his or her community.