Shadowing

Yesterday was Susie’s last day shadowing me at ABC Clinic. Sometimes she really was like my shadow, quietly observing my conversations and treatment courses with patients and taking notes of her questions to ask me after they left. But most of the time she was more like my second self, running down the hallway to get something for a patient, or keeping a patient company in the room as I rushed around collecting items and information. She’s seen me at my strongest, diagnosing a patient based on a few lines of history or a couple taps to the elbow. She’s also seen me at my worst, like last week as I unsuccessfully struggled to contain my stress that time we were late and lost on progressively narrowing dirt roads on the way to our village outreach. Or the time a few weeks ago where I sat on the floor and kicked up my heels, throwing an exaggerated temper tantrum as an intentional demonstration that neither missionaries nor doctors were exactly perfect.

Working with a student, or any learner-observer, gives me a chance to examine my life. When I am trying to mentor someone and explain my actions to them both in the clinic and beyond, it makes me think about where I am, what I am doing, and the reason behind my actions with renewed intentionality. Often, when I interacted with Susie, I thought about what I was like as a pre-med student a dozen years ago. As we discussed everything from work-life balance to logistics of praying with patient, I tell Susie my life lessons, things I’ve learned during the different phases of my training, and things I wish I had learned sooner. I wonder how my life would have been different if I realized some concepts of boundaries and balance earlier. Most likely, I wouldn’t have listened to myself. But at least Susie seems to be processing, and growing.

Having Susie around gave me the energy to start an improvement project in the clinic. We discussed areas that were concerning clinic leadership and decided to try measuring how long patients spent at the clinic each day. With the help of Susie and some amazing front and back office staff, we went from not knowing when any patients left to having leave times of 50% of patients and then 80% of patients. We introduced some forms and adjusted some processes so that we could track which patients waited the longest and why. Then we looked into some areas of improvement. After Susie and I gave our first report to Administration showing that some delays were due to waits for drawing blood and taking it to the lab, we were shocked that clinic leadership already had a suggested improvement in mind and ready to implement. In just a couple weeks, everything was streamlined, and the steps causing delay were cut out of patient processes. I made sure to tell Susie that usually Quality Improvement is not that easy. But it was fun to see the results of our efforts. Much like the afternoon we re-wrote a white board for the clinic, it was a great visual of how quickly things could improve with good teamwork and leadership support.

I was amazed that the white board that I bought to help our small team plan lunch breaks in 2017 was still in use in 2021, and a little horrified the condition it was in, hanging on an otherwise pristine wall. Greg helped us remove a thin film of plastic (had we kept on the manufacturer’s plastic covering and used the board improperly for 5 years?). Susie, who had much better handwriting than me, helped write the names of current clinicians and the days of the week each was available. It was amazing how our little team of doctors had expanded in the past years. Amazing that patients were still keeping us all busy. Refreshing to see something so dramatically improved in such a short amount of time.

We definitely appreciated Susie. We appreciated her all the more when she surprised us with a cake to celebrate Greg’s birthday yesterday. It’s weird to think that we had never heard of her two months ago, before she cold-contacted the ABC clinic e-mail from her position as a volunteer at Northwest Mission. We will miss Susie, for sure, but we’ll look forward to hearing about her journey and supporting her as she goes. And we will look forward to other divine appointments in the future, people who will help us grow even as we try to mentor them.