Jack Dickenson opens up about his experience of studying and practising medicine with a stammer
A look of surprise flitted across the woman’s face. I doubt she expected this introduction, but she waited for me to finish and answered my opening question. As the conversation continued, my speech improved, and after a few minutes I had a full history from the patient I’d come to see.
This has been typical of most interactions with patients so far in medical school. I have had a stammer since 13, when it came on suddenly, and, at its worst, I couldn’t say much. My speech therapist once filmed me trying to count to 10. I think I made it to six. Thankfully, that was the darkest point. Aided by understanding family and friends, my stammer gradually improved through my teens, to the point where I’m now almost always fluent.
It’s still there, though. I know when it’s coming—fatigue, stress, and pressured situations all increase my chances of choking on my words, struggling to start sentences, or to finish them without lots of pauses. The times my stammer is worst are when ordering in pubs; the plosive P of ‘pint’ looms large, the drink inevitably starts with a vowel (the devil’s letters) and I’m left gesturing to a bemused barman. It does have some advantages though—I must have had 10 free coffees from Pret by now.
Though it’s sometimes frustrating, I don’t mind stammering in the pub anymore. What worried me when I started medical school was how it would affect my conversations with patients. Three medical school interviews had been fruitless, and I wondered to what extent this was down to my speech. Once I got in to university, I worried that the pressure of a clinical situation would be detrimental.
Having just finished my third year, I have done fifteen weeks of clinical placement, communication skills sessions, and community visits: ample time for difficulties to manifest. Though fluent most of the time, certain situations have inevitably led me to stammer more.
To my pleasant surprise, the responses of other students have encouraged me—all have been understanding and none have mentioned my speech.
Talking to patients, however, filled me with more trepidation. Scenarios played out in my head: jamming up entirely, endlessly repeating the same letter, patients finishing my words for me. All feasible, I thought. I need not have worried. I had forgotten that patients are all humans just like me, and most people don’t mind if you stammer a bit.
However, some occasions have gone less well. The worst involved taking a history in front of a group, which quickly descended into difficult territory. On seeing this calamity unfold, one student promptly took over while I was mid sentence. Good intentions, I’m sure, but not great for the self esteem.
Another memorable encounter took place in the emergency department. On hearing me stumble over my introduction, the patient responded “Why don’t you go and calm down and then come back in a bit”. What can you say to that?
I feel it can be hard to combine the idealised perception of the ‘superhero’ doctor with the reality that doctors also struggle with issues of their own. Some, like depression or dyslexia, are more hidden, whereas physical disabilities are obviously more manifest. I am acutely aware that other students face issues far greater than a stammer, and I have been inspired by seeing others cope with these and continue in medicine nonetheless. Having an illness or disability does not necessarily have a negative impact on one’s practice; I would like to think that we can, with help and determination, become good doctors regardless of the challenges we face.
Jack Dickenson is a 3rd year medical student at St George’s, University of London.
Competing interests: None declared