Focus on Urban Health - Keck School of Medicine of USC ...

S T U D E N T P R O F I L E•Learning Patient Care – While Being One By Jon NalickKeck medical studentJosh Lilienstein bringshis own experience as acancer survivor to hiswork with patients.24 KECK MEDICINE | Winter 2011 IssueI f d o c t o r s m a k e t h e w o r s t p at i e n t s ,Keck School of Medicine student Joshua Liliensteinbelieves the converse may also be true − that patientsmake the best doctors.The 31-year-old Los Angeles resident says that beingable to experience medical care from a patient’sperspective viscerally underscores the importance ofcompassion and empathy.“Being a patient for a long time certainly helpedme understand that”in a way that no classor textbook ever could,he says.And he shouldknow: Lilienstein wasdiagnosed in 2006 withan aggressive form oftesticular cancer thatprompted gruelingrounds of chemotherapy,multiple surgeriesand hospitalizations,derailed his studiesand nearly took his life.During the years hefought the disease, herepeatedly faced frustrationsas a patient that informed his understandingof how to become a better doctor. Among these wasthe difficulty in managing the complexity of his owncare, which he received from multiple physicians andcancer centers over an extended period of time.“As a result of my care being so fragmented, at anumber of junctures, critical pieces of informationslipped through the cracks, leading to dangerous andsometimes life-threatening situations. Since none ofmy medical records could be transmitted electronically,I had to constantly be aware of keeping it all− huge stacks of paper and dozens of compact diskscontaining imaging files − together and up to date, allwhile being so sick that I could often hardly get outof bed,” he says.He notes that while his doctors did their best tostay on top of his complex illness, “it often fell to myfamily and me to make sure that nothing fell throughthe cracks. I really learned about the importance ofgood communication between physicians. In a worldwhere patients are mobile and the practice of medicineincreasingly depends on specialists, we as physicianshave to get exponentially better at communicatingwith each other and with our patients.”Lilienstein adds that his experience has made hima strong proponent of creating a national electronicmedical record, “which has the potential to drasticallydecrease the amount of redundant tests performedand help ensure that critical information doesn’t getlost in the shuffle.”Lilienstein says that being a patient for so long conferssignificant advantages, as well as disadvantages.For example, he says, “I’ve been able to use myexperience to encourage patients to advocate forthemselves in ways that they didn’t know were possible,and I have been able to alert doctors to issuesthat they didn’t know were important.”On the downside though, Lilienstein sometimesstruggles to maintain the emotional distance physiciansneed to treat their patients.“One of our jobs as doctors is to take our personallives out of the equation and focus on what [the patients]need. But there are times when I have difficultmoments and kind of flash back to my ownsituation,” which can make delivering objectiveinformation about patients’ medical options moredifficult, he says.Lilienstein, now performing his internal medicinerotation in his third year of medical school, has beencancer-free for more than a year.Looking back on his time as a patient, he describeshis experience as “an absolute curse, but strangelyand perversely enough, kind of a blessing.” Beyondthat, he adds, “It has certainly made my life moreinteresting and has left me even more dedicated tobecoming a great doctor.” •Photo by Philip Channing