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Teaching and Learning Moments

Schlener, Jennifer M.

doi: 10.1097/ACM.0b013e318248d75c
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Ms. Schlener is chief of staff, Association of American Medical Colleges, Washington, DC; e-mail:

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Reflections on the Ideal Physician

My 62-year-old mother has always been relatively healthy, but, in the past year and a half, she has had two significant encounters with our health care system. In the fall of 2010, she was treated successfully for early-stage, noninvasive breast cancer, and, in the spring of 2011, she spent seven days in the hospital, five of them in the ICU and three of them intubated. Her official diagnosis was kidney stone/sepsis. An undetected, half-inch kidney stone lodged at the base of her right kidney led to an infection that raged through her body, and the outcome was anything but certain. My family and I were at the hospital most of the time that she was there, and, now that she is home and recovering, I have been reflecting on the experience. One of several encounters with her care team remains vivid for me.

Approaching my mom's ICU room on the second day of our stay, I encountered a new face among the flow of specialists caring for her. Dr. Nirav, a soft-spoken man, warmly introduced himself as a member of the hematology–oncology practice where my mom received her breast cancer care. I stepped aside, and he returned his attention to my mother's expansive chart, which chronicled her medical twists and turns for the last 24 hours. Still intubated, my mom appeared to be resting comfortably amid the tubes, wires, beeps, and cacophony of the fast-paced ICU.

My aunt and I were chatting quietly in the hallway, our backs to her room, when we heard: “Hello, Mrs. Schlener. My name is Dr. Nirav … I work with your oncologist, Dr. Healy … I am going to listen to your heart.”

Somewhat startled, we asked one another the same question: “Is she awake?”

I glanced into the room to find my mother still fully sedated. “He is talking to her,” I thought to myself.

I watched as he took her hand and said: “Keep fighting, Mrs. Schlener. You will be fine. I will see you tomorrow.”

Dr. Nirav kindly nodded to me as he left my mom's bedside to record his brief visit in her chart.

“He talked to her,” I told myself again.

My mother received superb and compassionate medical care throughout her stay, and I can offer words of appreciation to every member of her care team. But Dr. Nirav stands out in my mind.

I am privileged to work at the Association of American Medical Colleges, where we regularly engage in discussions about “the ideal physician of the future.” We question what kind of physician we want standing by our bedsides and those of our loved ones.

Dr. Nirav provided the answer for me. Prior to seeing him interact with my mother, I did not question why all of the other specialists merely were “doing their jobs”—staring at monitors, listening to my mom's heart, poking and prodding. But, hearing Dr. Nirav call my mother by her name and speak to her with the utmost compassion and respect, even in her sedated state, was an incredibly powerful moment for me. Dr. Nirav epitomizes the type of physician I want by the bedside, for me and my loved ones, today and in the future.

Author's Note: The names in this essay have been changed to protect the identities of the physicians.

© 2012 Association of American Medical Colleges