Reflections: Learning Together, Working Together Indiana University School of Medicine 2010-2011 Cover Art: Bridge Joani Rothenberg This picture is of a mural that features a bridge — a powerful metaphor for life’s spiritual and physical journeys. It traveres a landscape of colorful and diverse “experience” elements. It hangs in the lobby of the Western Galilee Hospital which provides care for a diverse population of Arabs, Jews, Druze and Christian patients. The mural was painted in a public space which allowed people to see themselves as partners in the process of its creation. Note from the Editorial Board 2010-2011 The Reflections series began in 2004 through a partnership between the Indiana University School of Medicine Relationship Centered Care Initiative (RCCI) and the Dean’s Office for Medical Education and Curricular Affairs (MECA). Each year the publication is given to faculty and students as a gift from the rising second‐year Indiana University School of Medicine (IUSM) students. It is our hope that Reflections will provide its readers with the opportunity to witness and understand each other’s experiences, to improve our capacity for empathy and professionalism, and to foster dialogue about the quality of health care and of the relationships formed through it. Reflections: Learning Together, Working Together contains a collection of narratives, photographs, and other creative pieces by students, residents, faculty, alumni, and staff of the Indiana University Schools of Dentistry, Nursing, Social Work, and Medicine, as well as other community health care professionals. Their works convey what it means for members of the health care community to develop through experiences—from 1934 to 2010—and through relationships with one another. Some works, noted as excerpts, were more extensively edited for length. The full‐length versions may be found online at http://meca.iusm.iu.edu. Other works are anonymous submissions from then‐ third‐year IUSM students who recorded “Professional Narratives” during their Internal Medicine Clerkship — reflections on interactions between health care professionals, patients, and patients’ families which impacted the students. Our thanks to all those who have shared their talents and experiences in this publication; may it provide inspiration to those who read it. Table of Contents Foreword…………………………..………..………………………………..…………4 Richard Gunderman, MD, PhD Learning Together, Working Together… With Our Patients…...7 Meeting My Donor’s Family: Excerpts……………..……………………..8 Introduction: Ernest F. Talarico, Jr, PhD…………………………………………..8 Jennifer Behzadi, IUSM Class of 2013……………………………………………….9 Lucas Buchler, IUSM Class of 2013…………………………………………………..9 Michael Burk, IUSM Class of 2013………………………………………….………10 Lyndsay Langbehn, IUSM Class of 2013……………………………………….…10 Paul Connors, IUSM Class of 2013………………………………………….………11 Together On Their Journey with Cancer………………………..……...12 M. Elaine Southwood, RN, MSN, CPNP Help Along the Way………………………………………………………………13 Stephanie Nothelle, IUSM Class of 2011 Art Lesson…………..……………………………………...…………………….…..14 Carrie Rupprecht, IUSM Class of 2013 Martha’s Cane…………………………………………………...………….……....16 Benjamin Randel, IUSM Class of 2013 Teaching Hospital…………………………….………..………...…………….…18 Shafer Kurshuk, IUSM Class of 2011 Eula…………………………………………………………………….………………...19 Stephen J. Jay, MD A Reflection on Two Letters…..……………………...………………………22 Lena Franklin, MD With Our Families…...23 When a Twin Dies……………..………………….……………………………….24 Renée M. Stratton, MS, CCRP Dr. Mom…………………………………………………………………...…………...26 Shannon F. Renfrow, IUSM Class of 2012 My Definition of Success - Be a Teacher: An Excerpt…………….28 Nadim M. Islam, BDS Untitled………………………………………………………....………………...…...30 Robert J. McElroy, MD On Our Journeys…...33 “I Learned About Myself as a Person”: An Excerpt.……...….……34 Sonali Sakaria, MD 2 Untitled……………………………………………………………………………..….37 Richard Frankel, PhD An International Social Work Experience……..……………...………38 Michelle Anesu, MSW Time Out From the War…………………………………………..….………...40 Richard Frankel, PhD Teacher…………………...………………………………….…………….………….42 Katherine T. Nichols, DDS Dear Future Katie…………………………………………………………....……43 Katherine McHugh, IUSM Class of 2011 Working Together to Expand Access to Healthcare Abroad……………………………………………………………………….....44 Chuck Dietzen, MD Life and Death on the Nyayo Wards: An Excerpt...……….……….46 David Crabb, MD From Legacies…...48 Indiana Medical School, a Great Foundation……………….………..50 Jim C. Hirschman, MD Into Medicine - 1945: An Excerpt of a Memoir ……………….…...52 Emma Lou Sailors, MD Times Goes By……………………………………………………………….……...54 Pat Foley, MD IU Student Outreach Clinic……...……………………………….………..….56 Henry Chou, IUSM Class of 2011 Hannah Choe, IUSM Class of 2011 Pay It Forward: An Excerpt…..………………………………………………58 Paul Blusys, MD With Our Colleagues…...60 Visual Thinking Strategies.………..…………………….……………………61 Jeffrey Rothenberg, MD, MS & Meg Moorman, RN Caring at Christmas…………..…………….…...……………………………….62 David C Steele, DDS Hope in Full Color………………………………………………………..………..64 Carrie Rupprecht, IUSM Class of 2013 The Case of the Dysfunctional Eustachian Tube……………....……65 Henry Chou, IUSM Class of 2011 Untitled……………………………………………………………………………..….66 Gene Beyt, MD, MS 3 Foreword: Together A celebrated historian, a man who had won many awards for his writing, was invited to give an address at a great American university. In conjunction with his visit, the university’s former president, a highly distinguished scholar and leader in his own right, invited him to lunch. As the two were dining, the former president asked the historian whether he had majored in history in college. “No,” the historian replied, “I was an English major. In fact, I did not take a single history course until my very last semester.” “That must have been quite a course,” the former president replied. The historian paused, looking off into the distance, “Actually, I do not remember much about it. I cannot even tell you the name of the instructor. He was not a faculty member, but a graduate student.” “So the course didn’t make much of an impression on you?” prompted the former president. “Actually, I was very inspired by something the instructor said on the first day of class,” the historian replied. “He told us, ‘We are going to be studying many different historical ages, events, and personages. As we do so, never forget that we are not just talking about names in books. We are talking about real, flesh‐and‐blood human beings, people as real as you and I.’” The historian again looked away. “That really impressed me. I have never forgotten it. In everything I have written, I have always tried to capture the sense that we are dealing with real people who got up every morning and laid their heads down every night. They were human beings just like us, who bore children, buried their parents, and who were in turn buried by their children. They gazed up at the very same sun, moon, and starry night sky that shine now above us.” “That’s a beautiful story,” the former president replied, “to which I would add one coda. The graduate student who taught that course?” “Yes?” said the historian. “You’re looking at him.” Henry Adams, one of the great American intellectual historians, once wrote about teaching: “A teacher affects eternity; no one can tell where his influence stops.” 4 Every educator was once a learner, and every learner becomes an educator. Whether we hold a faculty position or not, to practice medicine is to be a teacher. For one thing, the title by which our patients know us, doctor, comes from a Latin root that means “teacher.” Moreover, every interaction with a patient or fellow health professional is an opportunity to teach. We teach not only formally, with syllabi and curricula; but also informally, through the questions we ask and the examples we set. Everyone knows that we learners model ourselves, unconsciously as well as consciously, after our teachers. We remember what we are assigned to study; we mimic the styles and phrasings of those who taught us; and when faced with difficult situations, we ask ourselves how our most esteemed teachers would respond. Yet we sometimes forget the profound impact of learners on educators. There is a story about the behaviorist psychologist B. F. Skinner, whose students at Harvard decided to test out the theory of behaviorism on their instructor. During lecture, every time Skinner leaned to his right, the students would feign boredom, looking out the window or putting their heads on their desks. Every time Skinner leaned to his left, the students would show great interest, hanging on his every word. By the midpoint of the lecture, so the story goes, Skinner was leaning so far to his left that he fell from the podium. Do students care about what instructors have to teach and how they teach it? Do they have learning objectives beyond the material that is going to be included on the next test? Do they realize that excellence in medicine has more to do with attitude, style, and philosophy than with facts and rules? Do they see that it is less about downloading, storing, and retrieving information than about imbibing and embodying character? Do the members of the faculty come prepared to convey genuine curiosity, commitment, and excitement about their approach to health and disease? Do the members of the student body come prepared not only to memorize but to be challenged and inspired? What if faculty members never really invest themselves in the teaching, instead just reading their notes?