"Now I'm going to listen to your heart and lungs..."

It never occurred to me that I would need to tell a patient something like my blog title. In the United States I simply say, "Now I'm going to take a listen," and then proceed with the physical exam. I have had enough patients here in Cambodia look confused by my stethoscope that I've started telling every patient its use. I had to take a moment when I realized why my preface of "taking a listen" was not descriptive enough for them to understand. The truth is that I have no way of knowing how many times these patients have even seen a stethoscope before, or received any medical care at all. That reality is striking, convicting, and powerful, and it's something myself and my teammates have been living during our time here.
Today we set up our clinic in what has been called The Blue Church in the middle of a field. We parked the bus a short distance away and walked past cows to set up our clinic. This setting provides an accurate depiction of what we're doing here. We set up a clinic in a field, demonstrating how we are reaching into the lives of these people where they live and trying to make some sort of difference in the process. I couldn't help but think as I was rolling a suitcase filled with shampoo and toothpaste through the dirt how different the access to medical care is between here and the United States.
The distinction between our worlds is not always so vast, though. I was involved in the treatment of a farmer today who reminded me of my grandfather. My grandfather was a soybean farmer who lived in South Carolina. I looked down at the hands of this farmer and saw my grandfather's hands, a weathered and worn look showing years of hard work. In that moment, I wanted to know so much about his story. Where did he live? What did he farm? I also found myself curious as to how he was affected by the Khmer Rouge, which is a horrible collective history and pain these people share. I found out that he is a rice farmer who works not far from our clinic. I told him my grandfather was a farmer, and I hoped that he would sell a lot of rice this year.
What has really affected me about Mercer on Mission is the connections between the things I've just written. Though we are worlds apart, my world and the world of this hardworking farmer collided in the clinic today and I was finding similarities instead of differences. There is also a profound connection between giving medical care and listening to the patient's story. I have found through this mission that those are always connected. I've had professors say that if you listen to a patient's history, they will tell you what's wrong with them. That has happened with every patient of mine here, and it's sometimes almost as if they are telling me their diagnosis. The realization of that lesson is only one example of the outstanding opportunity my classmates and I have been afforded to learn together and learn from these patients in a setting that both shows us what we already know and how much we have yet to learn. In so many ways, I have found this experience shaping the doctor I hope I will become. That shaping includes how I approach patients with phrases such as, "Now I'm going to listen to your heart and lungs." The greatest change, however, is not how I will now preface the physical exam but in how I first approach a patient. Whether mental or verbal, after Cambodia I will start with, "Now I'm going to listen to your story."

Catherine Roe (medical student) 

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