George Beauregard
From 2018 to 2022, I served as a Physician Director at a large health system on Long Island. During that time, I got to know the provost and executive vice president of New York Institute of Technology. One of the university's departments is the New York College of Osteopathic Medicine (NYCOM), one of the largest osteopathic medical schools in the United States. I saw an opportunity to provide medical students with a high-level introduction to “population health”—something not typically offered in medical school curricula and something they would certainly deal with in some form after completing residency and fellowship. With the support of the Provost and the Dean of the School of Medicine, I designed an elective course for fourth-year students at NYCOM called “Population Health 101,” a four-week rotation through my Population Health Management department. The course is very popular with students and my staff is excited to have students follow them.
Recently, I had the opportunity to return to NYIT and attend NYCOM's “Reflections on Clinical Practice” conference, a bi-monthly meeting where patients and students share their experiences with the health care system. CPR is not an academic lecture. The goal is to share the nuances of real patient experiences and perspectives of their interactions with the healthcare system. In doing so, NYCOM hopes to highlight the importance of caring, empathetic physicians and an often overlooked aspect of health care delivery.
Upon arrival, I headed to the lecture hall, where I familiarized myself with how the technology worked and watched as medical students filed in through the back door of the auditorium.
Some wore short white coats, a sign of their status in the medical hierarchy. Many people greeted their classmates with smiles and warm hugs, indicating that they had not seen each other for a while. They look young, energetic, relaxed and happy.
As someone who has been out of medical school for over forty years, I felt I needed to connect with this audience from the beginning. So my opening line is along the lines of a shared experience during the first few years of medical school. Like me in the mid-eighties, their lives are defined by volume. amount of information. The volume of coffee. and extreme anxiety over whether they could fully memorize the entire Krebs cycle, the origin and insertion of every muscle in the human body, the His bundle, Purkinje fibers, the renin-angiotensin system, the optic chiasm, the corpus callosum, the loop of Henle, and the hypothalamic-pituitary-adrenal axis. One member of this beautiful biological symphony is the human body.
I pointed out that they were learning medical vocabulary. And the vocabulary of survival. this how.
The opening seemed to resonate with the 600-plus students, as many of them nodded “Yes. This guy has to know this stuff too. “
Then I told them I would also talk about WHO. I begin with the story of being adopted at eighteen months old, when I knew nothing about my biological parents. And then there were my adoptive parents, who never finished high school. As for my adoptive father, who worked for the iconic automobile manufacturing company General Motors for 32 years, he wanted me to do the same. But science was ingrained in my brain and flowing through my brain, leading me to medical school at age 28. About my first two children born during medical school.
At age 49, with four children, a busy medical practice and life feeling great, I was diagnosed with terminal cancer, a type of cancer that typically strikes people in their seventies. My wife and four children were on a journey through systemic chemotherapy, major surgery, and the desolate landscape of the aftermath. When it was all done, I carefully put on my survivor's cloak. And think that the King of All Diseases has finished us.
Not so. He visited our home again in 2017 when my then 29-year-old son was diagnosed with stage 4 colorectal cancer. Turning to personal stories, now including someone close to their own age, seemed to heighten their already engrossed attention. The room fell silent. There was a quiet tension in the packed auditorium. Students moved more in their seats, seemingly trying to find a more comfortable position.
I talked about the shocking discovery of Patrick's cancer and his subsequent journey. It's hard for me to finish telling how his life ended. This part of the story brings tears to my eyes.
I also talked about Patrick's medical oncologist. This doctor's bedside manner was full of grace, calm authority, expertise, compassion, and empathy. When she met Patrick, she wasn't looking at her Apple Watch or her laptop; She looked at him. She proposed partnerships — and hope. She makes us feel that although the news is bad, we are not alone in the darkness. She will walk that path with him and with us.
I tell them that that day I saw the positive power of their profession. But I've also seen others do the opposite.
I implore them to be like her.
I told them that although they were all smart, exhibit This is why doctors become healers.
The laptop is not the patient, the person sitting on the exam table or bed is. Look into their eyes. Listen first.
They will be the narrator of someone’s worst day.
They should choose what they say and how they say it carefully, as the words used will forever be etched in the patient's mind rather than burned into theirs.
Every patient is part of a community that hopes and prays that you can be more than “just good” at your job.
Disease does not exist in a vacuum. They are context-sensitive.
The technology cannot replace the doctor-patient relationship.
I tell them that I envy them because their medical careers will include having amazing tools that have never been used before and have not yet been imagined. Most notably, the promise of discovery, artificial intelligence, precision and personalized medicine. And, among other things, I don’t envy them, because gone are the days when patients put their complete trust in medical professionals and passively accepted whatever advice they gave them. Many of the people they care for have easy access to information that is not always accurate, and they need help evaluating the reliability of sources, educating, clarifying and encouraging critical thinking.
I concluded by saying, “Society places an almost miraculous trust in doctors that no other profession has. They think you are good, that you care, and that you will do your best. To live up to that trust, be not only smart, but observant, humble, and most importantly, present. Treat the disease if you can, but always treat the patient because they are the ones who have to live with the consequences of treatment. It's a heavy, terrible, beautiful burden.” Work hard to live up to that, and I'm sure you will. “
After the Q&A, many students approached me. Some looked a little nervous. They asked thoughtful questions. Many of them are in tears as we speak because their lives have also been affected by cancer. Surprisingly, some people are familiar with the motto “Pray, hope and don’t worry,” which appears on several slides as the background to my talk. This motto was coined by the Italian monk and saint Padre Pio, and my son adopted it to provide inspiration for his healing journey. One student said she thinks about this question every time she takes a test.
They asked me what it was like to be the physician father of a child with cancer, and I replied: I will always be his father; The role of the physician consultant comes second.
They asked me how I dealt with my anger at God for what had happened. I told them that toward the end of Patrick's life, a nun brought an almost supernatural strength of love and support to him and our family, showed me how to see tragedy and grief through a different lens, and restored what little faith I had left. Without this, anger might consume me.
They appreciated my willingness to share my story and my honesty.
I thank them exhibit.
Sometimes you just know you've left a mark on someone else. That’s one of them – but actually, it’s the one that has changed the most since I left.
I admit that four decades of experience in American health care—first dealing with its diverse clinical care needs and now its verticalization, burgeoning bureaucracy, and ruthless corporatization—have left me with a layer of professional scars. I became cynical.
But looking at the wet-eyed, compassionate, empathetic students, some holding “Pray, Hope, Don't Worry” amulets, I felt some of those cynicism fade away. Their empathy is more than just a trait; It is the antidote to a system that threatens to hollow us out. I walked out of the auditorium feeling less worried about the future of this profession.
They are the narrators now and the story is in good hands.
George Beauregard, DO, is an internist and the author of Appointment Nine: A Physician Family Confronts Cancer. This comes from his substack
