Introduction
This reflective essay, written from the perspective of a medical student, explores a personal experience of health coaching through a narrative lens. It describes a conversation with my cousin aimed at addressing his obesity-related health issues, including sleep apnea, reduced mobility, heavy breathing, and lethargy. Drawing on principles of health coaching and reflective practice in medical education, the essay examines the transition from a familial role to a coaching one, associated emotions, underlying assumptions, and the impact of emerging clinical skills. The narrative structure highlights key moments, supported by academic sources, to illustrate broader implications for future medical practice (Rollnick et al., 2008). This reflection underscores the challenges and potential of applying motivational techniques in informal settings, while considering limitations such as personal biases.
The Initial Conversation: A Familial Wake-Up Call
It was a rainy afternoon last month when I visited my cousin, Alex, at his home in Manchester. We had always been close, sharing laughs over family dinners, but lately, I noticed his health deteriorating. At 35 years old and weighing over 120 kilograms, Alex struggled with obesity that manifested in sleep apnea—waking him multiple times a night—along with decreased mobility that made simple tasks like climbing stairs exhausting, heavy breathing even during rest, and a pervasive sense of lethargy that left him unmotivated (NHS, 2022). As a medical student, I felt compelled to intervene, but initially, our talk felt like any family chat. “You look tired, mate,” I said casually, sipping tea in his living room. He shrugged, admitting he felt “stuck” but blamed it on work stress.
Intentionally practicing health coaching, I drew on techniques from my training, such as motivational interviewing, which emphasises empathy and collaboration to evoke change (Miller and Rollnick, 2013). However, my approach was harsh—a deliberate “wake-up call.” I bluntly listed his symptoms: “Your breathing sounds laboured, and that sleep apnea could lead to serious heart issues if unchecked.” This was not gentle; it mirrored evidence-based confrontational styles sometimes used in coaching, though arguably less effective for all individuals (Apodaca and Longabaugh, 2009). Alex resisted at first, pointing out my own overweight status: “You’re not exactly a fitness guru yourself.” Indeed, I was overweight too, which made me question my credibility as an example.
The Shift to a Coaching Role: A Pivotal Moment
The transition happened midway through our conversation, as we moved from the couch to the kitchen for more tea. Alex joked about ordering takeaway, but I paused, shifting gears. “Let’s think about this differently,” I said, intentionally adopting a coaching stance. Instead of nagging as a cousin, I asked open-ended questions: “What would a healthier you look like? How might small changes help with your energy?” This marked the shift—I noticed myself engaging as a medical student, applying skills like active listening and goal-setting from clinical modules.
This change felt both empowering and uneasy. Internally, there was tension; I worried about overstepping familial boundaries, feeling discomfort in potentially straining our relationship. Uncertainty crept in—would my harshness alienate him? Yet, there was confidence from my training, easing the process as I recalled how such coaching can empower patients (Rollnick et al., 2008). It was like flipping a switch: from casual empathy to structured guidance, which arguably enhanced the interaction’s depth but introduced relational risks.
Reflections on Assumptions, Emotions, and Clinical Insights
I realised I had assumptions about Alex—assuming his lethargy stemmed solely from laziness rather than deeper psychological factors, such as depression linked to obesity (Luppino et al., 2010). This bias, common in novice practitioners, overlooked comorbidities. Applying clinical skills changed my understanding; by using empathetic questioning, I uncovered his fears of failure, reframing the situation from a simple weight issue to a holistic health challenge. This fostered a more nuanced view, revealing his vulnerability beyond the physical symptoms.
Emotions varied: discomfort from my own hypocrisy as an overweight coach, yet ease when he opened up after weeks of resistance. To set an example, I decided to improve myself using Mounjaro (tirzepatide), a medication for weight management that I researched thoroughly, aligning with evidence on GLP-1 agonists for obesity (Wilding et al., 2021). This personal step reduced my internal tension, building confidence in authentic coaching.
Future Applications: Evolving as a Health Coach
Looking ahead, I envision refining this coaching in clinical settings, perhaps with patients facing similar issues. In the future, I might adopt softer, patient-centred approaches to minimise discomfort, integrating tools like shared decision-making to address assumptions more effectively (Elwyn et al., 2012). This experience highlights the value of self-reflection in medical practice, ensuring coaching remains empathetic and evidence-based.
Conclusion
In summary, this narrative reflection on coaching my cousin illustrates the complexities of blending familial roles with medical skills. The shift brought tension and confidence, challenged assumptions, and deepened understanding through clinical application. Ultimately, it reinforces the importance of adaptable coaching for better health outcomes, with implications for my growth as a future clinician. By addressing personal limitations, such as my own health journey with Mounjaro, I can model sustainable change, though further training will be essential to handle diverse patient needs more sensitively.
References
- Apodaca, T.R. and Longabaugh, R. (2009) Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence. Addiction, 104(5), pp.705-715.
- Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A. and Barry, M. (2012) Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), pp.1361-1367.
- Luppino, F.S., de Wit, L.M., Bouvy, P.F., Stijnen, T., Cuijpers, P., Penninx, B.W. and Zitman, F.G. (2010) Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry, 67(3), pp.220-229.
- Miller, W.R. and Rollnick, S. (2013) Motivational interviewing: Helping people change. 3rd edn. New York: Guilford Press.
- NHS (2022) Obesity. NHS.uk.
- Rollnick, S., Miller, W.R. and Butler, C.C. (2008) Motivational interviewing in health care: Helping patients change behavior. New York: Guilford Press.
- Wilding, J.P.H., Batterham, R.L., Calanna, S., Davies, M., Van Gaal, L.F., Lingvay, I., McGowan, B.M., Rosenstock, J., Tran, M.T.D., Wadden, T.A., Wharton, S., Yokote, K., Zeuthen, N. and Kushner, R.F. (2021) Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), pp.989-1002.
