Is there a therapeutic basis for hope? Probably yes and this is a must-read for every clinician. One patient’s review of his doctor.
Culled from: A Prescription For Healing, Newsweek, June 6, 1993
Hi, Doc! I saw your picture and the article about you in the paper. Didn’t recognize you at first. Maybe because you were smiling. I never saw you do that before. It changed your whole appearance. Pretty impressive story. Congratulations! The paper spelled out how you’re responsible for providing advanced surgical care from laser surgery to oncology. Wow!
You wouldn’t remember my face if you saw it. You did the job on me six months ago. A lot of bladders must have passed under your scalpel in the interim. Actually, you didn’t seem to recognize me then, until you had my folder in your hand. I remember the file number. So that’s who this is from – Bladder # 139.
I understand your not recognizing me. No hard feelings. In your office you were always busy, running from one examining room to another. Or you were on the phone: to the hospital, another doctor, a lab, another patient. Nurses ran after you with papers. When you did get to me – you were always at least a half hour late – you frowned over your Ben Franklin glasses as though I had made some mistake. I was never a person, just a case.
I was scared, so I asked questions. But this seemed to annoy you. My layman’s ignorance was so profound, your expression seemed to say, that, really, there was no point in any discussion. I simply wouldn’t understand.
You pulled no punches. I guess in becoming a great surgeon you forgot those early courses in doctor/patient relations: that patients tend to panic and imagine the worst; that they need reassurance. You said outright that I had two malignant tumors that must be removed at once. That meant cancer. The word scared the hell out of me. I broke out in a sweat. But you didn’t seem to notice. You frowned your usual frown and said that radiation or chemotherapy were not options. You gave no explanation and I was too clobbered to ask.
“Speak to my nurse,” you said. “She’ll arrange the details, tell you what to do and set up the surgery date.” Then you were out the door, your white coat flapping, as comforting as an ice-water douche. You were certainly no kindly healer; rather a competent master plumber, assaying a faulty drainage system and prescribing the necessary repairs-to it, not me. There was no compassion in your kit. Maybe you think that’s so much mush. Well, it’s not. Along with scanners, beepers, lasers, faxes and imaging machines, hope and reassurance can save lives, reduce pain and speed recovery. But that’s not your department, is it? That’s head stuff, for psychiatrists and psychologists. You deal directly with the biology of life.
Hope is biology, Doc. You did nothing to lessen my fears. You didn’t reassure me by explaining (as my M.D. brother-in-law did, after it was all over) that my type of tumor was common, easily excised and, if followed by periodic inspection, not likely to shorten my life or impede my functions. A doctor’s ability to reassure a patient can help to activate the body’s healing system. Positive emotions, like faith, love and determination are biochemical realities. It seems to me, Doc, that you overlooked the mind’s power to heal.
Because of you I suffered needlessly, night after night, unable to sleep because of what lay ahead. I barely ate, my mind obsessed. Would you eradicate all the cancer? Had it spread? Was this the beginning of the end? How could my family get along without me?
Compassion is good medicine:
After the operation I lay worrying, in intermittent pain, three tubes draining, sedating and replenishing me; every movement agony. Would I make it? I asked for you, Doc. The nurse explained you had been in several times while I was unconscious. Couldn’t you have managed one visit while I was awake? Just to say that I was doing fine.
I know you’re not heartless. You did tell my wife the operation was a success. But that’s all. How was I going to be? The nurse explained that you had a very busy schedule, but if anything went wrong she would call you. Like what? Everything was going wrong. One night I got tangled in my tubes when I had a hurry call and couldn’t make it to the john. No one told me that this was normal, that the medication frequently did that. I thought I was dying. Somehow you might have found a minute to drop by, to tell me the cancer was gone, how well my recovery was going. But you didn’t. Compassion is not mere handholding. It is good medicine. Here’s a big word I’ve just learned: psycho-neuroimmunology – the interaction between the brain, the endocrine system and the immune system. In short: the degree to which belief becomes biology.
Your hospital thinks you’re super. You’ve saved many lives and made others more comfortable. You put in grueling days, carry a crushing load, operate in life-or-death crises. Yet, there is no visible indication that you have the slightest feeling for your patients. You are so immersed in the functioning of the organism you are repairing that you seem to forget that each is a person – a thinking creature of hopes and fears, joys and sorrows. And, sometimes, like yourself, a leader in his chosen field.
What should you do about all this, Doc? Possibly nothing. But, couldn’t you lighten your caseload? Use some of your precious time to listen to your patients with an unhurried mind and an open heart? Try viewing them as whole people, not merely the containers of malfunctioning parts? Understanding all the factors (including the emotional) leading up to an illness can be as important as the identification of the actual pathology.
Just as a thousand-mile journey begins with one step forward, a step forward for you would be to erase that perpetual frown, that expression of annoyance at uninformed, fearful laymen and replace it with a smile and a few encouraging words. I know you can do it, Doc. Because I have that smiling picture of you from the newspaper.
Source:
- Newsweek (1993, June 6). A Prescription For Healing. Available from: https://www.newsweek.com/prescription-healing-193844