Tag: doctor-patient relationship

Chandni Jain Chandni Jain (1 Posts)

Contributing Writer

Boston University School of Medicine


Chandni Jain (she/her/hers) is a fourth-year medical student at Boston University School of Medicine in Boston, MA, Class of 2021. In 2015, she graduated from the University of California, Berkeley with a Bachelor of Arts in molecular and cell biology and a minor in global poverty and practice, after completing an internship at the Family Planning Institute of India working on reproductive health education and access as a means to address poverty. She then worked for two years as the Northwest Region Community Engagement Fellow at UNICEF USA to advocate for the world's most vulnerable children. She enjoys dancing, painting, yoga, and vegan cooking in her free time. After graduating from medical school, Chandni would like to pursue a career in pediatrics and looks forward to working with underserved communities. Her passions include adolescent and reproductive health, social/racial and health equity, universal healthcare, and environmentalism.




Patient 15

Patient 15 was a fit 38-year-old female with a past medical history of dilated cardiomyopathy who presented for follow-up on her most recent echocardiogram results. Flipping through the past notes, prior echos, family histories, I was captivated. A previous echo revealed an ejection fraction of about 50% — her heart was already revealing its impending fragility. The most recent echo, just five months later, revealed an ejection fraction of 20% — her heart was failing!

A Clarification: Reducing Patient Fear

In the extremely efficient and fast-paced environment of health care, the emotional needs of patients and their families may become secondary to their medical treatment plan. But emotional stressors may be directly associated with poor outcomes in regards to the healing process and overall quality of life. Thus, these needs may be addressed by face-to-face communication that allows for better patient education. Such investment of time is most rewarding when both the patient and family members have the opportunity to explain their fears and worries regarding treatment.

The Family Meeting

For me, one of these moments occurred during my neurology clerkship, a week into working in the Neuro Intensive Care Unit (NICU). I took part in a meeting with my team to update a family on the status of their loved one. It was my first time in this type of meeting, especially for a patient that I was directly involved in caring for. To our team of medical professionals, he is our 51-year-old male patient with a 45-pack-year smoking history but to his family, he’s a son, a husband and a father. All they understood about his condition up to this point was that Mr. R had a heart attack that led to some swelling in his brain.

The Vulnerability of Our Patients and Ourselves: A Parallel Chart Reflection

I actually don’t remember his name; he wasn’t my patient. I just saw him during rounds every day during my internal medicine clerkship. He was in his late-80s, and he was very ill. He had a long history of COPD, most likely attributed to his even longer history of smoking. He had been admitted to our service for a severe respiratory infection a few days prior to me starting the rotation. This was my last rotation of my 3rd year, and I walked in thinking I had seen enough COPD patients to know exactly what to expect.

“I Can’t Be Here Anymore”

Mr. K had been admitted with dehydration and malnutrition secondary to diarrhea in the setting of HIV. During his stay, he developed refeeding syndrome. When the resulting electrolyte imbalances paved the way for cardiac arrhythmias, he coded twice in the ICU. The care team managed to bring him back each time, but not without consequence; the brutality of numerous cycles of CPR left him with multiple rib fractures, inflicting him with sharp pain every breath. 

The Privilege of Patient Care

Each morning, Mr. E had a new concern — too hot, too cold, too dizzy, too stiff. He was admitted for what seemed to be a straightforward heart failure exacerbation, but his echocardiography showed severe hypertrophy in both sides of his heart that the cardiologists described as “concerning for infiltrative cardiomyopathy.”

Brian James Brian James (6 Posts)

Managing Editor and Contributing Writer

University of South Florida Morsani College of Medicine


Currently, Brian is a fourth-year medical student at the University of South Florida Morsani College of Medicine. He was born in Westchester County, NY, and moved to Laguna Beach, CA in 2007. He graduated with a Bachelor of Science in Pharmacology and a Bachelor of Science in Biopsychology from the University of California, Santa Barbara in 2017. Brian is planning on becoming an OB/GYN and is currently interested in Surgical Oncology. Outside of the classroom, Brian enjoys playing racquetball, reading on personal finance and nutrition, and enjoying outdoor activities at the beach and hiking.