Francis Peabody of Harvard, way back in 1925 said –
The secret of the care of the patient is in caring for the patient.
I showed a group of medical students a video of a consultation I’d had with a patient. She had strong ideas about her illness and what she would or wouldn’t accept as a treatment. Patients with such clear and strong opinions are frequently viewed by doctors as “difficult” and sure enough the medical students didn’t like her. They admitted as much. Now, nobody can like everybody, and no doctor will be able to like all of his or her patients, so what’s important is that a doctor is self-aware and knows what feelings he has about a particular patient.
The physician’s internal state, his state of tension, enters into and strongly influences his clinical judgements and actions.
This is why I write this blog – to encourage people to become self-aware, for without self-awareness we cannot make conscious choices. Doctors have a special duty to be heroes not zombies. But let me say this, too, it’s not enough for a doctor to just be self-aware, if a doctor does not honestly care about his or her patients, then it’s time for that doctor to find another job. If I ever have to consult a doctor, I want one who, frankly, gives a damn! (about ME!)
Heroes Not Zombies 
I think we’ve gotten ourselves too deeply into the “what can I get out of it” mentality. Far too few of us recognize, I think, that we make our own lives better by helping and being present with others.
People often ask me why I, a hetero married woman, give a damn about gay rights. I’M not gay, and whether or not GLBTQ people can marry or adopt or serve in the military has no direct bearing on the quality of my life, they say. They’re wrong. I take to heart the words of Archbishop Desmond Tutu who told us that “none are free until all are free.” I’m not being a good citizen, or a good person, for that matter, if I stand by and let others be poorly treated. I belong to the world – and it to me – and, frankly, I AM my brother’s keeper.
I just wish more people understood that in lifting others up, we lift EVERYONE up, ourselves included….
I’d like to have a word or three with your students, I admit! Did you ask them, would they accept taking random chemicals into their bodies that had common side effects that would make their quality of life less just because a doctor said so? I *WILL NOT* take anti-psychotics, at all. I do not need them. I *might* take valium for a time, but it would be coupled with intensive behavior modification therapy and other therapy. (Valium has been around long enough that I feel that the pros and cons of taking it into the system are fairly well known, unlike other medicines.)
I’m going to have to go in, when I find a psychiatrist I can trust that won’t just shove scripts at me, and get help. I’m pretty sure I have GAD, (General Anxiety Disorder) I am not kidding, and I am not hypochondriac. While lookingon Wikipedia at various anxiety disorders the other day, (the day I wrote you) I came across that article, and said “Yeah. Oh, I’ve been there! Yeah, yeah, hey I felt like that just the other day but I call it waking up from anesthesia.” It was more than four symptoms that I had, and the Mr. agreed too.
Because that psychiatrist gave me the prescription for heavy duty medicines that I didn’t need, that went against all my concerns as far as grogginess, weight gain, inability to exert myself for fear of overheating, and required me to get eye checkups every few months I’ve not felt I could trust anyone from that clinic since my counselor got promoted. (It was counter-indicated in patients with glaucoma, or diabetes in the family. Both are in my family, my first cousin has gone into diabetic comas before.)
I don’t know if I ever will find someone I can trust, unless I find myself living in your area and you can give a nod or two for a door I can knock on. (I’ve spoken of this in another comment, I don’t remember what it was he tried to fob off on me, and made me promise not to read the patient info sheet too. It was an anti-psychotic that I do remember. I went in due to sadness, inability to sleep, and anxiety from a seperation/divorce from my very abusive first husband.) Tell your students, that there are patients aware of their attitude, and that they do indeed stay home, and do not seek help. I certainly do. I don’t want their help, they can keep their degrees until they can grow to be able to look at the individual and their needs and not try to use a “one size fits all” magical cure all. Harsh, but maybe it’ll wake one or two of ’em up so they will grow.
Part of the problem, I sort of brought on myself. I thought the fellow would be able to have a reasoned debate as to religion. I made the mistake of telling him I don’t practice the Christian religion anymore (I think he’d asked me about my Faith/Sprituality) and was researching other religions, and that as far as I could see, what Wiccans thought of as “magick” was really a form of prayer, and if Christian or Jewish prayer works, why not Wiccan prayer? (And I don’t see why the Higher Power wouldn’t answer a sincere plea from people even if they aren’t using the Christian rituals do make the plea.) Then he tried to con me into taking the anti-psychotics. I am aware, that by the book belief in “magic” makes one psychotic. His mind closed and he didn’t see that it wasn’t magical thinking or loss of touch with reality, it was an open mind seeing there is more than one way to pray.
For now, I’m staying away from “triggers” for my anxiety (as in, mostly staying to myself/friends/family when offline, not exactly a hermit but not a social butterfly by any means.) and hanging in there until I can have more ability to shop around for a psychiatrist who will actually listen to me, and not knee jerk and apply a text book cure. I’ll still have to be careful, right now I am on the Gov’t medical insurance, so I don’t much chance to tell the doctoro “No”. They can report me, or make me follow their instructions. (My friends are going through this right now, their doctor thinks they are allergic to cats, they aren’t, he just hates cats. They are no better now they have had to give away their pets.) Even after I am off the Gov’t medical coverage I will have to be careful. Doctors in this country “fire” patients who are difficult, and put black marks on patient records making it so other doctors will be prejudiced ahead of time, or not willing to take the patient on in the first place.
Patients wouldn’t have to speak up so loudly, if the doctors (Not all doctors, I know, I do have some faith. But enough out there are deaf and blind to their patients, training the patients to be difficult just to get good quality care, then punishing htem for pursuing good quality care.) would unplug their ears, and take off the blinders and really SEE their patients! Print this comment, and my other comment out if you want, show your students, let them see things from the other side if you think it will help. Write me if you want other details, I very well may answer. If it will help this generation of doctors being raised to learn to do better by their patients, I’m up for a bit of letting the pain well forth to get my point across.
mrschili, I agree with your sentiment. That is why I also believe in Gay Rights. It is why I became a Voice for the murdered Tori Vienneau and her baby Dean Springstube. I take the words of the Lakota Instructions for Living to heart, I believe we are all connected in ways we cannot grasp.
http://www.legendsofamerica.com/NA-SiouxLegends.html
Excerpt: “All of Creation is related.
And the hurt of one is the hurt of all.
And the honor of one is the honor of all.
And whatever we do effects everything in the universe.”
Another, simpler way to put it is “Because nice matters”.
[…] on this). I think it’s also a common experience that a good doctor is one who gives a damn ie one who cares. However, the specifics of the working life of a doctor depend a lot on the context of the […]