Op-Ed: Be the one who uplifts your patients
He remained silent. His eyes fixed on us, immaculately dressed in a dark three-piece suit adorned with a gold watch and chain, the hair meticulously groomed, a brightly colored bow tie perfectly centered on a freshly starched white shirt, the collar metallic stays in place, the black wing – glittering pointe shoes. Gold cufflinks and heavily crumpled military-style pants, with just a subtle break in the cuff at the tops of the shoes, completed the picture. He could have passed any inspection I had at West Point! Then he spoke:
“Medicine is serious business,” he said firmly. “You should never smile, joke or laugh with a patient, nor sit on a patient’s bed. At all times, you should be professional and maintain a good distance physically and emotionally. You should not allow yourself to be emotionally affected by a patient’s condition, no matter how bad it may be. Otherwise, you risk losing your authority and objectivity, which could end up harming the patient. “
He was my instructor in history and physical exam during my second year in medical school. I was excited, as were my classmates with me, to take these first steps to becoming a “real” doctor. His words burst this bubble of innocence. Speechless, we stood there, heads nodding conscientiously, obediently, in unison. How could we answer otherwise, and what right did we have to say anything? He was, after all, a world famous cardiologist. We quickly understood our place in this daunting new world of medicine in 1980.
I looked at him in all his “glorious perfection” and thought, “This guy is full of shit! That’s one of the most ridiculous things I’ve ever heard.” Only a few years from West Point and after serving three years in Germany as an army officer, I had heard my share of “wisdom” from those above me. Most of the time I learned about it but sometimes … well, sometimes it was. Of course, we have all done exactly what he said these weeks under his omnipotent and omniscient presence. He was tough on us too. We learned to do a full history and a physical exam to her exacting satisfaction. We memorized each exam questions about the systems, repeating them over and over again.
I was grateful for the high expectations he placed on us. We have learned well. However, I knew that as soon as I was alone caring for the patients, I would be smiling, laughing, joking and, God forbid, sitting on the side of their bed, as long as I knew it was okay with them. Being professional was not the problem.
For 30 years as an internist, that’s exactly what I did. I believe patients don’t care what you know until they know how much you care. Everyone has an innate need to feel loved, cared for, and treated as worthy people. This is especially true when they are the most fearful, vulnerable and dependent during illness or injury. This forms the basis of the “sacred trust” that is the doctor / patient relationship. It will only happen when compassion, benevolence, empathy and “the warmth of love” are given and received. It is “the art of medicine” in its truest form. From confidence springs hope. To live without hope is a terrible thing. The emotional pain of despair will soon follow. I know. I have experienced it both in the world and on the deepest level personally.
The world needs more hope givers. Be that person. In doing so, the joy that you once had, you can find again. Medicine is “a serious business”, but above all, it is a deeply personal and fully human endeavor. Humility, empathy, compassion, benevolence and love are its fickle guardians. The business and affairs of medicine can easily blind you to this truth. We build walls and wear masks to protect ourselves from grief, loss, pain, pain that will surely come. May you tear down your wall, take off your mask and let people see who you really are, a person, a doctor who cares about them, understands them and is fully present with them no matter what the circumstances.
Yes, medicine is “serious business”, but more than that, it is a privilege, albeit difficult. Every day what you do matters and makes a difference in the lives of those you touch. Thank you for being that person!
This message appeared on Kevin®.
Last update 23 March 2021