Clinical and Global Medicine rotations, by Sarah Humphreys

First-year medical students at Soroka Medical Center

Each week, we are divided into groups and dispersed to various settings throughout the city and in Soroka hospital for our clinical and global medicine interview rotations. They were supposed to begin last semester, but as classes were put on hiatus due to Operation Pillar of Defense, we are currently making up for lost time. A couple of weeks ago, I joined my group in the pediatric emergency department where a social worker took us on a tour of the facilities before we convened in a small room to meet our patients and interview their parents.

            Oftentimes when we do these interviews, the attending, or whoever our supervisor is that day, cherry picks the few English-speaking patients on the wards so we can talk to them in our native tongue. On this day, the social worker explained, she had been unable to do this, and more to the point, she expected us to interview the patients in Hebrew, and if we got really stuck, she would help us translate.  A slight vapor of unease wafted throughout the room, as some of us shifted in our seats and mumbled aloud about the fledgling state of our Hebrew skills, but we knew that this was the deal and that we had signed up for precisely this when we came to medical school in Israel.

            As the interviewees came in, we took turns taking a patient history and inquiring into the family and social history of the parents themselves. The point of the exercise was really about communication, and honing our listening skills, as all the medical knowledge in the world is completely useless if you lack the ability to elicit, and pay attention to, the story your patient is telling you.

We learned so much that day, about Bedouin culture, and how it may not be appropriate to ask a Bedouin mother if she is married (because it is unacceptable to be a single mother), but it is medically relevant to inquire as to whether her husband is also her relative (as consanguineous unions are extremely common), and how many other wives her husband has (as polygamy is the traditional norm), and if she is the first, second or third wife (as her rank may affect her social standing, which may in turn affect her health status). We also learned how important it is to be present with your patients, and to actually make eye contact and listen, without trampling them with a million questions before they’ve had time to answer, and without filling the awkward silences that often lead to valuable truths. In many ways, I found that speaking in our non-native tongue was helpful, as it naturally slowed the pace of the conversation, although we all found it doubly challenging to conjure the right mix of empathy and presence while constructing our next questions in the correct syntax.

 At the end of the day, I had a newfound appreciation and respect for my classmates, all of whom I found to be immensely empathetic, kind, curious and compassionate in their interviewing skills. I also had a newfound appreciation for what a privilege it is to be in a position where random strangers are willing and able to let you in to the details and vulnerable spaces in their lives. It’s a cliché at this point, and everyone says it, but this is why we are here. Now back to learning Hebrew (and Russian, and Arabic, and Amharic . . .).  - Sarah Humphreys, blogger of the month