I heard on the news last night that 70 people had been killed by a bomb in Somalia. What do you think about that? What do you think about those 70 people? What did the terrorist think about those 70 people? Did he, or she, know any of them? Could the bomber name any of them?
Reduction of individuals to a mass, by terrorists, by journalists, by governments, businesses, scientists, blinds everyone to the absolute uniqueness of every person.
It’s not possible to see the uniqueness of an individual when we absorb them into a mass.
But there’s another way to lose the uniqueness of individuals. Go in too close. In Medicine we focus on a part of a person – their blood pressure reading, their cholesterol level, their “lesion” – but when we do that we lose sight of the individual, the person whose body we are peering into, and in so doing their uniqueness is lost in their becoming a “case of hypertension”, or “a cancer patient”.
Zoom out to the mass, and we lose the individuals and everything which makes them unique, makes them uniquely human. Zoom in to the lesions or the biological parameters, and we lose the individuals and everything that makes them unique (even looking at an individual’s DNA doesn’t reveal anything like their full uniqueness)
There’s only one level at which we can see a person’s uniqueness – the level of the person – one to one, me to you, you to me. That’s what I’ll be doing again today. Sitting listening to individual, unique stories of men, women and children. I think that’s what being a doctor is about – fully focusing on the uniqueness of each and every person I see for the time I spend with them. The knowledge of the mass might enter the exchange, the knowledge of the parts might enter the exchange, but the consultation has to begin and end with a clear focus on this whole, unique person.
Heroes Not Zombies 
I had to go see a GP in Amsterdam in the last few days and I was astonished how positive the experience was compared to my occaisonal trips to my frazzled UK GP. The differences were little – he faced me not his computer, he looked at me when he spoke and somehow conveyed he had enough time for me. Small things but it really did make a difference.
Hey, I’m so pleased to hear how great a quality of consultation you got in Amsterdam. Why is it that this is not the norm? It’s sure what we should expect, aim for, support, create etc
I’m sure Ian is right that there are a multitude of ways of engaging and dealing with problems, but I’m a great believer in the foundation of a good, empathic, compassionate understanding. These might seem like small things, as you say, but they really DO make all the difference.
“Something is rotten in the state of Denmark.”….oops! Well, maybe not Denmark…..
I wonder if the GP’s in the Netherlands are locked into the QOF points chasing . Perhaps that makes a difference in some situations?
Sometimes, sitting and listening does not always allow you to know a person as a whole or create postive practical change. That is my opinion and experience in life….
Sometimes people reveal more of themselves non – verbally and problems can often improve through activities and actions.? Therapeutically this may occur in things like somatic psychotherapy and more physically orientated disciplines.
I liked this piece and feel the same way whether its on a cycle , running by a river or climbing a hill….http://www.guardian.co.uk/lifeandstyle/2011/mar/20/school-of-life-cycling
Bob, I do agree with you .
Often it is time pressure for sure that is the problem but often its a deeper problem both within the system and the indvidual.
Care can be revealed by action and empathic consideration of another person. I try to do this through the ‘ritual’ of simple physical examination and the use of appropriate touch (described so well by the inspiring TED talk by Dr Verghese). Somewhere along the way this has been lost in many aspects of general practice here.
I remember having a problem and asking a Dr to have a look at it —the Dr’s manner and touch was both hostile and uncaring, the other Dr’s manner and the way he handled me was completely different. I felt better immediately.
Some people are definately in medicine for the wrong reasons (status/prestige etc) and people treated by these kind of Drs know this (they often tell me).