Vital Signs

Dartmouth students are all ears for patient stories

By Alissa Poh

Photo by Jon Gilbert Fox

DMS first-years Menaka Nageswaran, center, and Nora Barmawi, right, are all ears—Dartmouth Ears, that is—as they chat with DHMC patient Shirley Daniels.

It started out as a casual dinnertime conversation in the fall of 2009. Song Li, now a DMS fourth-year, was then in the middle of his surgery rotation. Li observed to his housemate and fellow medical student Christopher Audu that he saw many hospitalized patients whiling away long days with no visitors. Finding volunteers to spend time with them might help, Li mused. But, he added, he was too busy to tackle such a project.

Audu, however, a student in the M.D.-Ph.D. program, was at that time doing laboratory research and so had a more flexible schedule. Soon Dartmouth Ears, a student-run patient visitation program, was born.

Initiative: "We initially envisioned an undergraduates-only initiative," Audu explains, "but we realized that most would be unfamiliar with a hospital setting. Instead, we paired them with DMS 1 students."

Audu and Li invited Dartmouth juniors Jie Sun and Marietta Smith, both premeds, to join them as cofounders, and recruited Drs. Joseph O'Donnell and Lee Witters as the group's advisors. Inspired by traditional depictions of the Buddha with large, pendulous ears to hear the world's suffering, Witters suggested the program's name and spread the word about it through Dartmouth's Nathan Smith Premedical Society.

In the spring of 2010, the first Dartmouth Ears volunteers were introduced to DHMC's Medical Specialties Unit, where they're supervised by nurses Laura Madden and Justin Montgomery. "Justin was laying the foundation for an elder-care program, and he welcomed us," Audu says. "We couldn't have timed the program better."

Volunteers commit to spending 25 hours visiting patients during each of two consecutive terms. Madden organizes the timetables and requires that students sign in and out of the unit. "On average, they're here one to three hours weekly," she says. "We're pretty flexible, because they have busy schedules."

Training: Madden and Montgomery give the volunteers informal training so they are ready for the visits. "Patients could be suffering from dementia, puffed up from edema, or have weeping leg wounds; we don't want the students to go in unprepared," says Montgomery. He and Madden also point volunteers to patients in particular need of friendly interaction and suggest possible conversation topics.

Attention: Some encounters are more random; a volunteer might answer a patient's call bell, for instance, and wind up talking for a while. "Once, we heard a patient yelling in her room—that was her history; she wanted attention," Madden says. "The volunteer offered to check on her. Afterwards, he told me, 'That was so cool—I made her feel better simply by spending time with her.' "

As for the DMS students, they find their role with Dartmouth Ears refreshingly nonmedical. They're there to listen, to chat with patients about anything from the day's headlines to the weather. The patients' stories are amusing, uplifting, and sometimes sobering. "During one of my first visits with a patient, I asked what he did during the day when his family wasn't around," says DMS first-year Nora Barmawi. "He told me he was just waiting to die. I wasn't expecting that; he looked very healthy. It was amazing how calm he was in the face of death. I also hadn't realized how lonely patients can feel in a hospital."

Audu recalls talking with an Army veteran who'd traveled to every continent; Paris was his favorite city. Talking with him about classical music, Audu learned that Vienna's cathedrals offer acoustic perfection for live performances. "At the end of the visit, I was ready to see a travel agent," Audu says.

Trusting: "When I'm a physician," observes DMS first-year Menaka Nageswaran, "I hope I'll remember what I've discovered [through Dartmouth Ears] about building trusting relationships with patients and take time to truly hear all they have to say."

"Listening to patients' stories helps us see that they're more than their ailments," Audu says. "I think that with Dartmouth Ears, everybody wins."

Both Montgomery and Madden would love the program to expand. Audu, too, wants to see Dartmouth Ears grow—and to continue long after he and the other founders graduate.

So what does he think about that simple dinnertime conversation, which has evolved into a unique, robust volunteer program? "It's surreal," Audu says.