My Summer in Barre
Jason Denoncourt
“I’m not this skinny by choice.”
These were the words of one of my first patients during my family medicine clerkship this past summer. She was a new patient to the clinic, and I wasn’t sure what to expect when I first entered the exam room. I spent over 40 minutes with her, much longer than the scheduled 15-minute time slot. I can only imagine what the resident I was working with thought as time dragged on. But behind that closed door, the patient shared with me bits of her past abusive relationship, substance abuse, and recent financial challenges. There were tears, on both sides, and good use of that small tissue box in the room. When I came out of the room, the resident commented, “that took a while.” I delivered my oral presentation and explained that this was not a patient I could rush. The resident then went into the exam room herself and spent nearly the same amount of time with the patient. After hearing her story, the resident connected her directly with a psychologist at the clinic for more care, before bringing in the attending physician as well. At the end of the visit, the patient expressed how supported she felt by the team. The resident later thanked me for not rushing and taking the extra time with her.
As an engineer in college, I was afraid family medicine wouldn’t have enough problems to solve. But every encounter presented several interconnected problems without clear solutions — not just medically but emotionally and socially. This moment was just one of many during my family medicine clerkship that reminded me of the challenging role primary care plays in healthcare. It’s a specialty that demands adaptability, empathy, and a deep understanding of patients within the context of their lives. I saw patients across every stage of life, from newborns coming in for their first check-ups to elderly patients managing multiple chronic conditions. There is nothing “easy” about primary care. There are algorithms for ACS or even diabetes management, but there is no Up-to-Date page on how to address concerns caused by a unique amalgamation of chronic medical conditions, mental health, the social determinants of health, insurance coverage, domestic violence, among others. That patient on my first day decided for the first time in years to share parts of her story and seek medical care — a decision that required courage. It was truly an honor and challenge to be the first member of the care team to welcome her back into the health system.
While the words, stories, and emotions shared are often heavy, the trust patients place in the medical profession is profoundly humbling and honoring. I’ve been in school since kindergarten; I’m a 22-year-old, “professional” student. These interactions aren’t with standardized patients where mistakes have no consequences and a basic “how has this been affecting you emotionally” will suffice. At the beginning of my clerkship, I felt tremendously unequipped to discuss the non-medical concerns of patients. Reflecting on the end, I’ve realized that I don’t need to have all the answers. My role isn’t to dictate their emotions or even give advice. Just listening, I’ve come to understand, can be profoundly therapeutic. Unlike many members of the care team, medical students have the luxury of time and an ignorance that leads to less advice-giving and more curiosity.
As I near the end of my pre-clinical learning, I look forward to starting my next clerkship. These experiences remind me of the privilege and responsibility of entering the medical profession and of the profound impact we can have simply by listening.
Jason Denoncourt is a medical student at UMass Chan interested in family medicine and community health.
