Clinical Professor and Chief,
Division of Hospital Medicine, UC San Diego, Department of Medicine
In medicine, as in life, our growth is often influenced by a few powerful figures or experiences, which shape our perspective and impact our direction as we proceed down our path. Volunteering at the LA Free Clinic was that experience for me, and Dr. Eric Cohen was that figure.
As a college student stumbling toward a career in medicine, I explored the field in various forms to see if it was right for me. At UCLA, I volunteered in several roles at our renowned tertiary-care medical center, where opportunities for pre-med students were plentiful. I volunteered on the Pediatric Cancer ward and played with the children who were not too sick to come to the volunteer playroom. The nurses and program coordinator provided great oversight. I volunteered in the Pediatric Nephrology lab, where we processed blood samples to help find potential kidney transplant recipients a matching donor. I worked closely with the lab techs who taught me about careful technique and about scientific rigor. Both experiences were fascinating glimpses into the technical but somewhat cold and sterile work of medicine at a large tertiary care center. Both were noticeably lacking any real interaction with physician role models.
I had no expectations of anything different at the LA Free Clinic, where as a pre-med student I was qualified only to help welcome and register patients to the Clinic by performing intake interviews amongst a crew of other volunteers in the front office. It was interesting work during which I began to learn the rudimentary skills of medical history taking and to interface with a quirky and intriguing group of marginalized patients that were LA’s homeless youth.
Fairly early in my tenure as an intake counselor, something different occurred that distinguished this volunteer experience from the others. The attending physician at the time, Dr. Eric Cohen, would come out to the intake area periodically to talk to us workers and thank us for what we did. The impact of our contributions on the medical care of the patient became quickly apparent, where it was distant and nebulous in my other experiences. When Eric (no one seemed to call him “Dr. Cohen,” that was just his style) found out that I was a pre-med student, he pulled me from my volunteer duties to sit with him and the residents who would discuss the cases in the back so I could listen and observe. In between cases, he would challenge me with thought- provoking ethical dilemmas about cases and patients, and shockingly, he would actually LISTEN to my opinions.
I watched him do the same with the trainees who presented their cases to him, and then follow with eloquent, thoughtful and reasoned discussion of the issues that impacted the patients’ lives. He could teach about pathophysiology, but he also offered insights into the human elements of care, and most importantly role modeled the ability to understand the whole patient, so important with adolescents struggling with numerous barriers to compliance including homelessness, drugs, sex, and mental illness. Eric’s ability to connect with people in any capacity was electrifying at the bedside, where we watched him relate to and impact the lives of the youth who would traditionally shun such authority figures. He asked them difficult questions about the most intimate parts of their lives, and they answered him freely and comfortably, a dynamic interaction which I had never witnessed before. Despite their frequent poor choices, Eric modeled respect for his patients at all times, and I learned from him how to be direct and up front about difficult issues without compromising a patient’s dignity.
At the LA Free Clinic I rediscovered the idealism that pulled me toward a career in medicine in the first place. This place was not cold or sterile in the least, rather it was a dynamic environment where real human connections were made on all levels to further the mission of improving the lives of these disenfranchised youth. Dr. Cohen spoke about morals, ethics, and the complexities of patient care, not about money, government overregulation, or the perils of the future of medicine. He exuded genuine passion for his career and convinced me that cynicism about the field was not universal. Watching him assured me that I could find satisfaction in a medical career and cemented my decision to proceed.
Several years later as a medical student, I was lucky enough to be selected as the Jim Slotnick Fellow at the Clinic. Thankfully Eric was still there and I continued to learn from him. One day, during a team meeting of what seemed like the entire clinic staff in the room, he shared a heartfelt story about a doctor who helped a young patient suffering in pain from terminal cancer, a doctor who actually went out to the home to help administer palliative care and help the patient pass in peace. At the end of the story, he revealed that the doctor was him, and the patient was Jim Slotnick, for whom the Fellowship was named. In this way, Eric Cohen is connected to every Fellow who has served in honor of Jim, and I feel fortunate for the opportunity to have interfaced with him as a mentor. I often reflect back to my LA Free Clinic experiences when interacting with challenging patients, and try my best to channel Eric’s ability to use respect to engage patients and enable the open communication that is so integral to a productive doctor-patient relationship.