Mrs. M is in her 70’s. She has led a good life and is in general good spirits despite her failing heart, the fluid on her lungs, and current low blood pressure. I have been taking care of her for the past week and find her to be cheery and pleasant. Her husband usually comes in around 9 with the paper and coffee and stays with her through the day. I sneak in to chat with them whenever I get a chance.

On this particular morning Mrs. M gets an uneasy look on her face when I ask if she has any questions. “Well yes,” She says “I don’t mean to be snotty about it, but I was wondering since I seem to be getting a lot of attention, and my husband and I don’t have a lot of money… is this all going to cost us more?”

Apparently she was feeling that she was getting an awful lot of attention during her stay at Providence and thought that she should clear it up in case there was some misunderstanding, because she really was on a fixed income and couldn’t afford such fancy attention.

I explained to her that this was one of the perks of being at a teaching hospital. Lots of young doctors in training like myself coming by to see how things are progressing. I assured her that her “extra” care was not at an “extra” cost and that as a medical student I am encouraged to sit and talk with my patients and learn from them as much as possible. “It is an important aspect of providing quality care that we get to know you,” I said. “and frankly, from my perspective it is the best part of the job. It is why I do what I do.” Anyway, we both chuckled a little bit and I excused myself to my morning report meeting hoping she didn't get charged extra.