Lessons in doctoring

By SHERRI CRUZ
2014-01-06 10:01:44
Know this about Jack Camp. He's 74. He's an accomplished urban
planner. He did the original master plan for the 1,200-acre Irvine
Spectrum complex. He's still in the master-planning business. He
loves his work.
While many people might consider Camp old, he doesn't, and he
considers himself healthy.
Still, he's lived long enough to have had plenty of experiences with
doctors, experiences that he has agreed to share with UC Irvine's first-
year medical students, such as the time when he finally got in to see
the urologist and the urologist swooped in and spent about three minutes with him, prescribed some
medicine, swooped out and charged him $100.
I thought, What a jerk,' he said. And they didn't even validate my parking.
As part of UCI's School of Medicine's Student-Senior Partnership Program, senior mentors such as Camp
give first-year medical students lessons in doctoring do's and don'ts. Don't: forget your patient is a human
being. Do: listen.
Camp likes sharing what he knows with the students and he likes spending time with them.
I'm amazed at the students. They're all so young and healthy, he said. He recalls what he learned from
the architects who volunteered as mentors when he was in college at Cal Poly San Luis Obispo. It's my
opportunity to be a mentor.
Elizabeth O'Toole, coordinator for the program that's part of UCI's Division of Geriatrics & Gerontology,
arranges for students to interact with volunteers who are 65 and older. The program, which spans nearly a
year, also provides an option of being paired with a senior, for students who want to learn more, as well as
opportunities for the students to reflect on their experiences, including watching a theatrical presentation
on the doctor-patient relationship and doing an optional creative project.
The students are young, 20 to 25. They're healthy, and they have little exposure to chronic medical issues,
said Dr. Sonia Sehgal, associate clinical professor in the School of Medicine.
Through the program, we've tried to empower the seniors to take on the teaching role, she said.
All first-year students take part in the program. Learning how to care for older patients will be useful for
students regardless of what area of medicine they decide to specialize in. The federal Administration on
Aging estimates that by 2030, there will be about 72 million people older than 65, more than twice the
number in 2000.
The demand for geriatric doctors is expected to outstrip supply, said Dr. Lisa Gibbs, clinical professor and
chief of Division of Geriatric Medicine and Gerontology in UCI's School of Medicine. The program gives
students a glimpse of what it might be like to practice geriatric medicine.
Most students won't become geriatric doctors, Gibbs said. Geriatrics is often a mission.
It's not a monetary reward. It's really coming from a deep place of wanting to care for older adults, she
said.
Students need to be competent in caring for older adults, Gibbs said.
What intrigues student Gabriela Pauli about geriatrics is that one 65-year-old person's health can be night
and day compared with another. It's not like that, in general, for younger people. Also, in geriatrics, the
doctor works with the whole family, because the older person's health affects their loved ones, she said.
UCI's geriatric program is in the last year of a four-year, $2 million boost from the Donald W. Reynolds
Foundation, which included revamping the Student-Senior Partnership Program.
Our goal was to make sure every medical student here learns to really appreciate the care of older adults
with what we like to say: compassion and confidence,' Gibbs said.
The Student-Senior Partnership Program has several components including a kickoff presentation on
aging and ageism that Gibbs gives for the first-year medical students. She also discusses patient-doctor
relationships, health literacy and motivational interviewing, or encouraging patients to make behavioral
changes that result in better health.
Small student groups have four one-hour sessions with the mentors over a span of three months. The
students share their thoughts on what makes a competent physician. The older person shares what he or
she is looking for in a doctor.
The two don't often line up, Sehgal said. Students have the next three to four years to mold themselves
into what patients really desire in a physician.
The program tries to convey the limitations of the health care system, Sehgal said. Communications and
handoffs of patients, between shifts and from doctor to specialist, for example, are challenges in the health
care system.
The only way to change that is to have future physicians understand the importance of communicating
with their patients, she said. There's no better way, no lasting way to leave that impression on students
unless they hear that from patients themselves.
The program touches on elder abuse too. Through a national grant, UCI runs the Center of Excellence on
Elder Abuse & Neglect. We want the students to know what it is and what their responsibility is when they
see it, Gibbs said.
Borrowing from the humanities, educational theater plays a part in the program. UCI produces a play,
acted and directed by Chapman University's drama department. It explores the relationship between the
patient and a doctor, the patient and a nurse and the patient and daughter.
It looks at how these different people in a patient's life are communicating and interacting, Sehgal said.
After the presentation, there is an actor's studio where the actors, faculty and some of the seniors answer
students' questions.
Unlike a clinical experience, you're watching a skit with your class, participating together, said Neil Saez,
a first-year med student who watched the performance. I loved it, he said.
We learned the right way to do a patient interview in class, he said. But it's a completely different
experience to see the wrong way to do it. Doctors need to realize their patients are often coming to them
in a state of vulnerability, Saez said.
The second skit embodied the good doctor, the one you would drive in the middle of the night to see,
Saez said.
An optional part of the program is pairing the student with a senior partner. Students learn more about their
partner. They visit their home and they tag along with their partner on a doctor's appointment. Jessica
Galant, now a second-year medical student, went to the doctor's office with her senior partner, who had
lost some feeling in his hand. He got some unfortunate news while I was there, she said.
He was told he would have limited use of his hand, which mattered to her partner. He liked to golf, cook
and fix things around the house, she said. Unless a doctor asks a patient what they do for fun and what
their daily routine is, the doctor won't know how a diagnosis might affect them.
At the end of the year, students who are paired with a senior do a creative project that reflects the essence
of what they learned from their partner. Creative projects, whether they be music or art or photography, is
how we process information, Sehgal said.
It's taking their experience and internalizing it, asking yourself what it meant to you, she said.
The student body is creative, Sehgal said. They come in with passions outside of science.
They present their projects in front of classmates and faculty.
One student did a drawing of their senior partner's hands and talked about how hands aren't only used for
such things as holding a glass of wine, they are also used to touch people. It was so moving, Sehgal
said.
The students end up teaching us geriatrics, Gibbs said.
Some of the students in the Student-Senior
Partnership Program choose to take the optional track, which includes creating a piece of art or
music that they present to fellow students and faculty
at the end of the program. The projects allow the
students to reflect on the time they spent with their
senior partner and express that experience in a
creative manner.
The following are three poems written by UCI medical students who were in the Student-Senior
Partnership Program during their first year of medical school.
What's in an age?
By Giancarlo Garca
All his friends may moan and gripe,
But Jack is not the moaning type
Some say he's old, but he says he's ripe
They eat health food; he smokes his pipe
His feet are sore, his knees might ache
But he'll still dance, for Heaven's sake
His teeth have yellowed; his hair is thinning
But when it comes to life, he's always winning
He's got no time for geriatrics
He still drinks beer on St. Patrick's
And as we chat he eats his orange
Hey! he yells, Nothing rhymes with orange!
Old age, he says, is full of great adventures
And he can grin even wider now with his dentures
I hope I'm as vibrant when I retire
His youthful spirit, I most admire
I implore him, Tell me, what's your secret!
He asks me, Promise that you'll keep it?
He looks me kindly in the eyes
He sips his drink, and then replies:
I've made mistakes, but have no regrets
To those I've wronged, I've paid my debts
Life's not about one's brilliance
What matters most is resilience
When times begin to get distressing
I bow my head, and count my blessings
My hands are cold, but my heart is warm
And that's how I've weathered through the storm
And though I've had sorrows throughout the years
I've always smiled away my tears
I refuse to live life with a frown;
I won't let this body slow me down!
My advice to you: don't dwell on the past!
And live each day like it's your last!
Potpourri
By Anjali Hari
A light fragrance waltzes around me.
You know, the kind that tickles your nose,
but only ever so slightly?
It dances about and pulls out memories.
Slowly at first, gathering momentum,
much like a summer thunderstorm.
Rolling, rumbling, then a downpour all at once.
A bike ride.
A book or two.
Laughter.
A ring.
Children.
Adventure.
Rain.
Flowers. Oh there were plenty of flowers!
Those seeds we planted, blossomed into buds,
bloomed into patches of color.
Ah, how I tried to hold onto to the green, red,
gold, yellow!
But they dripped away, muddling together into one
dull grey.
I place my potpourri down.
A light fragrance tangos within me.
It gleefully lingers long after the colors are no more.
A soft handshake
By Hanna Liu
Under weathered, wrinkled hands
Lies
A soft handshake.
Behind thick glasses, gray eyes
Resides
A lilting smile
An inside joke told once upon a time
A trove of stories
Of lessons learned
Of friends, sorrows, triumphs
Of bridges burned
A bittersweet lightness of being
That only he can describe
Carrying something precious
Left behind.
And on he strides,
Steeped in time
Old in history, young in life.
Under weathered, wrinkled hands
Lies
A soft handshake
He smiles with his eyes.
Contact the writer: scruz@ocregister.com
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