I have always harbored interests in obesity medicine, diabetes care, nutrition, and fitness, so entering medical school, I craved clinical experiences that would touch on these topics. Thus, when I heard about Word on the Wards, I was excited to join. During my shifts, I have learned how to coach patients on their lifestyle habits, practice using PEARL statements, and identify the many societal and personal barriers to good health our patients face.
I remember two patients vividly, and I know I will carry these WoW experiences through my career. One was a patient who was fully ready to stop smoking. It seemed that every motivational interview question that we asked was met with a firm, enthusiastic plan by the patient–– ‘I’ve let my housemates and family members know that I will stop smoking.” He happily accepted our brochures on smoking cessation. He was so motivated and ready to turn a new leaf in his general health that my fellow WoW student and I even proceeded to talk about his eating habits after the smoking cessation portion. He told us that his smoking had helped suppress his appetite but now that he stopped smoking, he was hungry all the time! With his newfound appetite, we discussed the essential food groups and general nutrition guidance for building healthy, balanced, and satiating meals. This interaction was invigorating for me and reminded me about the great joys of follow-up care. The patient was truly the driver of his health and we were there to just assist in his journey.
Yet, I would also like to recount a more unfortunate story that reminds me of the wide span of patients we will encounter. This was a 60-year old man who looked 90 –– he had wispy silver hair, a hunched back, and a tube in his throat, and he was not as mentally engaged with us as our first patient. He had smoked for many years, and my WoW partner and I could detect by his tone and body language that there was a lack of enthusiasm behind his responses saying he would quit. Did he really want to decrease his smoking to a quarter-pack per day, or was he saying that because it felt like the “right” thing to say? He declined extra coaching/consultation and was unenthused about smoking cessation. We learned that he had no family and that smoking was something that brought temporary moments of contentment for him. Other than smoking, he wasn’t able to identify any other joys or indulgences in life.
This interaction reminded me that social connectedness, mental well-being, and self-esteem contribute greatly to one’s perceptions and motivations to be healthy. It reminded me of a powerful rhetorical question that a psychiatrist said about why her specialty was so important: “If someone wants to die, what does it matter to them that they take care of their diabetes [or other health condition]?” While this was a more discouraging interaction we had, the interaction taught us the importance of giving a whole-hearted attempt with every patient and to never give up on your patient’s health journey. Perhaps one day –– when they are ready to take a small step forward in their health journey –– our words of encouragement and compassion and education will resonate with them. It is important to meet the patient where they are at currently. Until that day, we as clinicians must be patient and present!
Word on the Wards reminded me why I entered medicine in the first place –– I want to know my patients well, I want to understand their daily struggles, and I want to empower my patients through health education. Thank you to the WoW coordinators and advisor for providing this space for us to learn critical interpersonal skills we will certainly need as future clinicians as we empower our patients and community members to become healthier people!
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