Every patient has a narrative ... the tale of how they became sick, and how their life changed forever, right down to the most mundane bits. For me, the key to humanism in medicine lies in remembering these stories. Working in health care, constantly surrounded by disease, it's sometimes easy to forget that the vast majority of people are not born sick, and live years of beautiful, full life before we meet them in the hospital. They had crushes on the boy next to them in geometry, were best friends with the family dog, or wanted to be astronauts and/or the best parents ever. They have favorite foods and favorite shoes; favored chairs, songs, and weather. In fact, the more you get to know them, the more they might start to remind you of an uncle, or perhaps a best friend, or perhaps - even you.
And every so often your patients are just the opposite: mean-spirited, bitter, contemptuous of any advice given or prescription written, and furthermore completely absent of any intention of changing, hospitalization after hospitalization. No matter what benign intentions you may have, looking into those hostile, unyielding eyes will do a number on anyone's patience. In these more trying situations, I prefer a change of scenery: I picture the patient at home, in his favorite easy chair, watching his favorite TV show. I picture him playing with the dog he's told me he has, or the grandson that lives 3 hours away. Does he hobble over to the kitchen - slowly, since you know he's got arthritic knees - and survey his pantry before settling on his favorite cereal? Maybe it's Cap'n Crunch, which you used to love. And suddenly, there it is: your similarity. And therefore the likelihood that there may be others; perhaps after a 30-year-history of illness and constant frustration, you would be just as "difficult."
... In our most honest moments, we must acknowledge that the landscape of illness is oftern murky and considerably lacking in home-run solutions; although treating the sickness is certainly part of the deal, it's in treating the person that doctors actually find most of their utility. Because, cure or no cure, patients will always remember the doctor that looked them in the eyes - that treated them as a human.
Cindy Koh
UICOM-P Class of 2012
