Daily Dose of Humanities

Dear XXX,

This is a letter of thanks and gratitude that I have been meaning to write for several decades.

This story is about my encounter with you one night while I was on call as an intern and you were the attending physician. It is very likely that you have no recollection of this brief encounter but it was one that, as it turns out, had a great impact on my life and career.

Let me explain. One night as an intern on call at PMC I admitted a patient with a GI bleed. We called the attending to come in to consult that night, and it happened to be you. You came in and after hearing the history of the patient, you turned to me and said, “What would you do to manage the patient?” I replied that I would summon the gastroenterologist on call and get their advice on management.

You replied, “What if I were not here, what would you do?” I was somewhat taken back by this, and responded, I would call another gastroenterologist. “Well,” you said. “I want you to analyze the situation and give it your best shot. What would you do? I won’t let you harm a patient with over or under treatment, but I really want you to think through the problem as though I was not here. And, I don’t care if I have to stay all night while we figure this out.”

I was stunned. Most attending physicians and teachers wanted to swoop in, demonstrate how much they knew, impress the interns, and get back home as quickly as possible. You were different. You created a safe environment in which no patient would be harmed. But you wanted me to grow-up as a physician and think through decisions in advance of asking for help. Your insight and generosity as a teacher has stuck with me for many years. I cannot tell you how many times I have shared this story with others as an example of effective teaching.

I have applied what I learned that night to my interactions with patients. I have found that my questions can be more powerful than answers. I have often found it more effective to elicit patient-generated solutions by asking “What do you think might help or work for you?” rather than flooding them with advice.

Similarly, when managing co-workers I will often ask them, “If I were not here, what would you recommend doing or deciding?” I have found this often builds their competence, confidence and leadership ability.

So you see, your night of teaching me at PMC has had happy repercussions throughout my career and I am very grateful to you.

I do hope you are thriving!

Your “student,”

David Sobel, MD