Being a Doctor and Taking Care of Patients in Medicine


I think we often forget in this busy era of
the medical industrial practices where we are, we forget that the very nature of a patient
physician encounter is an intimate human encounter. Increasing technology, the burdens from an
electronic health record have a lot to do with us losing the sense of the fundamental
calling that brought us to medicine and the joy, the sheer joy, of connecting with another
human being. A stranger who is choosing to come and tell
us their problems. The nature of the encounter has to be human,
and that doesn’t mean that it can’t be studied with the same rigor that we study sodium levels
or study responses to antibiotics and so on. Well, this whole idea of doing this study
really came about because my sense is that that first moment between patient and physician
is so crucial. For many years, I always thought that the
moment of washing hands was more than just washing hands. It was almost a way to be intentional to remind
myself I’m entering into sacred space. The other thing that I often do as a clinician
is I will look at the patient’s shoes. The most striking moment to me when I think
this all began for me was working at a county hospital in El Paso, Texas, and very often
walking into a two-bed room, you would see their feet in the chair where they were seated
or on the edge of the bed, and I would see someone with big fluffy slippers painted orange
or colored orange, or I might see bare feet in shackles with prisoner-issued rubber slip-ons. And in each case, I was going to approach
that patient already with a slightly different mindset. An ability to put myself in their shoes before
I even got to them. And so, I think there were little steps along
the way, little stories that I had in my mind, I think all clinicians have, that we wanted
to study further. In the time we have with patients, let’s create
a little checklist but an entirely mental one to allow us to get the most out of that
moment even though it’s challenging. So this is not meant to be a panacea. This is not meant to take away the ills of
the way we now practice medicine. There nevertheless needs to be a way to maximize
that patient physician encounter. Not to let it be further in danger of disintegration. Not to let it just get so vaporous that there’s
nothing there, and you just check in on a keyboard and you don’t really see a human
being. We know that won’t work. Ian Forster said many years ago in Howard’s
End, only connect. That’s really what this is all about. Only connect and how do we help all of us
in this profession, in this wonderful profession with the great opportunity we have, how do
we connect? Only connect.

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