Ndidi Unaka, MD, discovered and nurtured her humanism as a physician with the help of mentors early on during her medical training. The pediatrician at Cincinnati Children’s says it helps her remember her purpose and stay empathetic and connected to patients and colleagues.
"As physicians we are pushed to be self-directed in our learning and to stay abreast of emerging evidence and changing practice,” says Unaka. "We are inquisitive by nature and will spend time generating hypothesis-driven questions and solving clinical conundrums. However, one of the most interesting things I have discovered during my time as a physicians is that the skills I rely on most often aren’t related to my mastery of clinical content.”
"Throughout your career you will learn about the importance of humanism in medicine. While the concept seems very intuitive, living up to the ideal is not easy because of course we are human. I have done quite a bit of reflecting of what defines humanism in medicine and I hope to share with you all a few thoughts about this concept and gained wisdom from individual experiences that have shaped my life and career along the way.”
Unaka, an assistant professor in the University of Cincinnati (UC) Department of Pediatrics, gave the keynote address at the 23rd White Coat Ceremony for first-year medical students held at Cincinnati’s Music Hall on Aug. 10, 2018. The college presented white coats to 179 medical students to mark their entry into the medical profession. The garment is a symbol of the compassion, honesty and care physicians and those in training must aspire to when serving patients.
"With this ceremony we officially acknowledge your entry into the world of medicine and into the UC College of Medicine family,” says Andrew Filak Jr., MD, interim senior vice president for health affairs and dean of the College of Medicine. "We look forward to getting to know each of you over the next four years as individuals, nurturing your strengths and helping you overcome your shortcomings.”
UC President Neville Pinto, PhD, also offered words of congratulation to members of the Class of 2022 and acknowledged them as one of the college’s most diverse groups in history.
Women make up 57 percent of the class or 102 students with men accounting for 43 percent (77 students). Underrepresented minority students account for 30 students or 17 percent of this year’s incoming class. The incoming student body also has the largest representation of African-American men, who account for 10 members of the class. The cumulative undergraduate GPA is 3.74 while the average Medical College Admission Test, or MCAT, score is 515, placing the incoming class in the 94th percentile of students taking the entrance exam for medical school in the United States.
"When we talk about Next Lives Here
, we are talking about our students,” says Pinto. "They are our future. They are our next. We are delighted to welcome you as the next generation of doctors to lead the profession into the future. You will carry on a record of innovation and discovery that dates back to the founding of the medical school in 1819 by Dr. Daniel Drake.”
Unaka urged new medical students to ponder a fundamental question upon training to be a future healer.
"What does it mean to be human?” asks Unaka. "Clearly, this is a complicated question and there are many physical, intellectual, social and emotional aspects of our being that set us apart. I would argue there are three key elements at the core of our humanity: our desire to be anchored to purpose, our desire to be connected to others and our capacity to see the world through the eyes of another.”
Unaka says when she ponders the definition of purpose she reflects on her own decision to practice medicine.
"I still remember the day I got my acceptance letter into medical school and I certainly remember my own White Coat Ceremony 15 years ago,” says Unaka. "I love science and learning about how the human body works. Most importantly I wanted to do something about my life that was bigger than myself. A wise individual once said, ‘he who has a why to live for can bear almost any how.’”
Unaka says remembering one’s purpose can serve as a source of inspiration following a challenging day, week or year.
"You will work long hours and you will miss certain life events of friends and loved ones,” says Unaka. "You will make mistakes. You will love patients. But I know even on my worst day I am still fulfilled. Knowing the ‘what’ gives us focus. However, knowing the ‘why’ fills our passion and makes us want to get up the next morning and want to do it all over again.”
Medical education often places an emphasis on the "what we need to know,” says Unaka, who is the associate program director of the Pediatric Residency Program at Cincinnati Children’s.
"We outline what you should read, what procedures you need to learn, what grades you need to master for a competitive residency, how to find relevant evidence and dispense information and how to critically appraise literature.
"We emphasize the importance of repeated exposure, modeling the mantra of see one, do one and teach one,” says Unaka. "However, it is just as important to reflect on the meaning behind your work. I have been fortunate to have incredible mentors who taught me about the importance of identifying my why and being purpose-driven.”
Unaka says staying connected is essential for individuals entering the medical profession.
"As physicians you can never underestimate these types of connections with your peers, colleagues and most importantly your patients. But connection does not happen without putting in the work. The key to connection is listening,” says Unaka. "Your job would be infinitely harder and I would argue less meaningful if you do not prioritize developing strong therapeutic connections and relationships with those who put your lives and their trust in you. You will make associates and judgements of patients and families if you do not take the time to listen to their story.”
Empathy, the ability to see another person world and appreciate another as human being without judgement is also crucial, says Unaka.
"Push yourselves to see the world not only from your patients’ eyes but don’t forget to display empathy for each other,” says Unaka. "We do not exist in an insular environment. We can learn so much from each other. Take opportunities to talk to people who look and think differently.
"As physicians we interact with people from all walks of life. It much easier to show empathy for people for whom you share familiarities. We are called to do more. You have to be willing to shift your perspective and ensure that your empathy bucket is not rationed for a select few.”
She recounted the story of a mother with a very sick child who taught her the true meaning of empathy.
"I heard from other colleagues she was a challenge and very difficult,” says Unaka. "But I also recognized her daughter was ill with a progressive neuro-generative disorder that would ultimately led to her death. So I made it my business to get to know her. Every afternoon when I was on service I would go visit this mother after rounds.
"I would sometimes just sit next to her in her daughter’s room and she would sometimes say no more than two words to me. I just kept going back and eventually she started to talk. She told me she had three other children who at the time were all at home in high school. They lived in a different state and she felt immense guilt about being away from them since she and her daughter had been in our hospital for months.
"She told me about losing her husband suddenly several years ago when her children were young. She showed me pictures of her daughter as a baby and toddler.”
Unaka and the mother established a connection that served both of them as they worked through difficult conversations about the daughter’s care, management plans and allowing them to celebrate the joy of bringing the young child home briefly.
"After two years being in our hospital I could sit by her side and hold her hand as she decided to make a loving yet heart-wrecking decision to withdraw care of her daughter,” says Unaka. "But the story doesn’t end there.
"I was blessed to be the mentor of her other daughter who just completed her first year of medical school,” says Unaka to applause from the audience.