Content Expert/Context Expert

It’s 11:30 PM on a Friday night. I am running on five hours of sleep, and I still have seven hours left on this shift. No, I am not a resident. I’m not even a third- or fourth-year medical student. I am an M1, a first-year medical student. My white coat is still fresh off the rack, and I am currently helping two paramedics transport a patient who has severely dislocated her ankle. Don’t worry, I am now a Nationally Registered EMT, so this isn’t quite the “Training Day” scenario. This lady, we’ll call her “Mrs. Smith,” was incredibly sweet and had quite a sense of humor. I was completely confounded by her tolerance for pain. Her foot looks like it is hanging on to her leg by a thread, and she is not phased one bit.

We wrapped up her ankle as much as we could. The paramedics gave her morphine to make her as comfortable as possible because driving the roads of Greenville County is like driving down the Reedy River. We loaded her in the back of the ambulance and headed on our way.

“This ride is going to be something else,” I thought. “If I can just keep her mind off of her ankle for the next 15 minutes.”

I asked Mrs. Smith if she was originally from Greenville. She said she was but had lived in Charlotte for a while. My dad, his side of the family, and my girlfriend are all from Charlotte.

“There is something to talk about!”

Lo and behold, this sweet woman lived right down the road from my grandparents. She actually lived on the road that my grandparents’ cemetery is on. We talked about Charlotte the whole way to the hospital, talking about how bad the traffic has gotten there over the years, but how nice of a town Mint Hill was. She had two sons who both lived in Greenville. She enjoyed being closer to them and their families. She kept peeking out the back window to see her husband following us in his SUV.

“That poor man has got to be exhausted,” she said considerately.

She asked me how long I had been in medical school and how I was able to ride along in the ambulance. I told her that I was a first-year student, that we completed EMT training in our first six weeks of school and now complete one 12-hour shift each month. “You’re going to go into Emergency Medicine, aren’t you? I’ll bet you right now you will, and I can tell you that you are going to be good at it!”

“Well ma’am, I actually am interested in Emergency Medicine, but I’m trying to keep an open mind for now,” I said. “I’ve also been interested in Orthopedics for as long as I can remember and would love to pursue that if I can. But we will see what the good Lord has in store.”

As soon as I said it, she looked down at her ankle and exclaimed, “Well I would love for you to be an Orthopedic Surgeon right about now!”

So much for keeping her mind off of her ankle!

I was working full-time this past June when I got accepted into school, and I moved to Greenville and started classes in July. I knew that medical school would be hard, but they’re not kidding around when they tell you it is like a constant fire hose to the mouth. There is so much to know, and as hard as I study, I have to accept the fact that I simply will not know it all. Whenever I get tired, I just try to remind myself how hard it was to get to this point. Six months ago, I was a research assistant looking for jobs that promised opportunities for growth and the start to a fruitful career path. I had numerous people tell me that maybe I was not meant to be a doctor. Maybe God had different plans for me. Maybe I should pursue other career interests. I started accepting the fact that maybe medical school was not going to happen. Yet, here I was with this amazing woman on the back of a Greenville County ambulance, talking about life, our families, how we as complete strangers have found something that has brought our worlds together. I am doing whatever I possibly can to get her mind off of her current predicament, and I couldn’t help but think, “We’re here now, man. We are IN it now.”

Recently, our Dean of the medical school, Dr. Jerry Youkey; the President of the Greenville Health System, Dr. Spence Taylor; and the Senior Associate Dean for Academic Affairs, Dr. Angela Sharkey, came and spoke to members of my class as part of a “Dean’s Hour” luncheon we occasionally have. In our time together, all three physicians discussed conscious professionalism and leadership development, and how those things have been intentionally integrated into our curriculum. They discussed the idea of medical students not only working towards becoming content experts, but also context experts. By context experts, they meant understanding the context surrounding the patients we see, where they come from, what their circumstances are. Understanding the social determinants of their health and accepting that every patient we see presents with their own set of values, beliefs, culture, and biases, while also realizing that we also bring our own set of values, beliefs, and biases into the relationship. As I listened to these three individuals discuss the beginning of our school and why it is designed in the way that it is, I became filled with a sense of contentment. In that moment, I thought of Mrs. Smith and our time together. I walked out of that luncheon thinking, I am going to give this journey everything I have. I am going to stop worrying about how far this ride will take me and start enjoying the ride itself. If I can shine a light in one person’s life in their darkest hour, then surely, that will make all the difference.

Yes, medical school is difficult. In the words of Ron Washington in the movie Moneyball, “It’s incredibly hard.” There is a lot we have to know. It can be stressful, but ultimately, it is all going to be worth it. As I sat there with Mrs. Smith, right in the middle of a 12-hour shift on a Friday night, I cannot tell you how happy I was to call myself a medical student. I cannot speak for all of my classmates, but I would like to think that this is why we are here. Every meaningful relationship we can make with a patient makes up for every sleepless night, every weekend spent in the books, every sacrifice we have had to make while we have been in school. We wake up every day hoping that what we will learn will ultimately help our patients receive the best care possible. And while the anatomy, physiology, and pathology are all incredibly important, the art of the bedside manner is just as important. For what good is the science if we do not know how to implement it in a way that empowers our patients and better serves them?

Austin Foster

I was born in Indianapolis, IN, grew up in Jackson, MS, finished high school in Louisville, KY, and have called Charleston, SC, home since my family moved there in 2014. I found my way to Greenville five years ago to pursue an undergraduate education at Furman University. I graduated in May 2017 with a degree in Business Administration, and I cannot express how excited I am to now call Greenville home. I am passionate about USC School of Medicine Greenville’s commitment to patient-centered care and developing physicians who, in the words of Dr. Spence Taylor, President of Greenville Health System, are not only learning how to become experts in content, but also in context. I am excited to share this journey with you and thank you for reading.