The Soul of a Patient

There is nothing quite as important as training the next gener­ation of physicians. In an increasingly complex and cruel world, finding a compassionate and skilled physician is truly a lifeline. Yes, of course we want our doctors to be up-to-date on all the latest medical knowledge and scientifically savvy; but, above all, we need physicians to be good listeners and caring prac­titioners.

Conceptualized by thoughtful educators at Harvard Medi­cal School, the Mentored Clinical Casebook Project (MCCP) pairs a first-year medical student with a clinical mentor and a patient to follow closely for one year1. The student spends time with his or her patient, both in and out of clinical settings, with the goal of trying to understand the patient’s life and relation­ship with his or her illness as completely as possible. The stu­dent keeps a written record of the interactions with the pa­tient, and also does research to understand the scientific, socio­economic, and cultural issues that influence the patient’s experience.

The casebooks that are produced are quite impressive, some as long as ten thousand words, with extensive biblio­graphies and scientific tables. But what shines throughout is the singular relationships that these brand new students, not really doctors yet, forge with their patients. They go to ap­pointments with them, have coffee, visit their homes, meet their families, and also meet the doctors caring for them. The students come away with a newfound appreciation for all sides of these complex situations. They have been assigned patients with chronic and sometimes terminal illness, and have the op­portunity to witness the bravery and courage that facing these circumstances require.

We wanted to share these remarkable casebooks to shine a light on this innovative approach to medical education. Be­cause the casebooks were so comprehensive, for this collection we decided to emphasize the personal struggles associated with illness and the connection and communication with the caregiver that is so important to patient-centered care. We took out details of the basic science and clinical care, because these change with new knowledge and techniques, while rela­tionships and communication skills are timeless.

This collection of first-year medical students writing about their year-long experiences with patients is truly unique and inspiring. As a breast surgeon and medical educator, I learn something new every day from my patients and my students. Reading and editing these extraordinary casebooks with a team of talented student-editors has been a privilege and joy. I am thankful for the opportunity to share these with a larger audience.