There was a patient who made a huge impression on me the first day that we met. He was a diabetic who’d let himself go, had multiple amputations, and was now undergoing a long course of treatment for widespread infections. He knew he wouldn’t live much longer when our team visited him.
We were led by a well-respected physician, one that I’d known in my first two years as exemplifying competence and bedside etiquette. When this doctor started to explain the plan, the patient became hostile, hurling insults and profanities. “My surgeon told me the opposite! What you say doesn’t count. You’re just the University doctor.”
The doctor nodded quietly and continued to listen as the patient ranted about the surgeon, the infectious disease specialist, the nurses, the lack of communication, and other problems of the American health care system. Finally, he deescalated to asking how long our doctor had been living in Reno. “You see! I knew you weren’t from here! I’ve lived here for 55 years, and you and I both know that what they’re doing ain’t right!”
Within days, he became a vegetable. But until then, every day of his remaining life, this man made a dogged effort to burn all his bridges with the medical staff.
This is the part where I would like to say that his demeaning attitude did not affect the quality of his medical care, that we were just as concerned about him as we would have been about a sweet old lady who brought us cookies. But that would be a blatant lie. And this is hard for me to accept, at this stage of my training. I want us to be impartial. I want us to uphold the exact same standard for everyone.
But we are human, after all. And the doctor-patient relationship is a relationship. Don’t get me wrong, this guy had his meals brought, blood pressures checked, labs drawn, wound dressings changed. Actually, a great many extra hours were spent trying to figure out how to deal with him. It just could have been a better experience for everyone involved.
Being human, we can also be influenced to provide better care. That’s why most of the time, we are encouraged to practice medicine with “humanity.” Caring about our patients motivates us to go that extra mile.
Here are some things that patients can do to maximize their benefit from our humanity:
1) Treat us like human beings. This should start with basic courtesy to us and our staff, but also goes beyond that. If you act like your doctor is “just the check-up person” (as one girl put it), that’s probably all you’re going to get out of that relationship. We like jokes and insights. We like to hear about major life events. Looking back on my own writing, the patients who really stood out have had a sense of humor and a positive outlook. They were able to teach me about overcoming adversity.
2) Treat us like allies. Bad outcomes do happen, but believe it or not, it’s not because your doctors are trying to kill you. Demonizing and alienating us usually will not make us sympathize. Like everyone else, doctors are more willing to keep trying when our best efforts are acknowledged and appreciated. If you do have a complaint, try to make it constructive.
3) Pull your own weight. We all love patients who exercise, eat healthy, stay on top of their meds, and generally heed our advice. Show us that you care about your health! Because if you don’t care, why should we?
4) Tell us about the “alternative medicine” you’re using, but please spare us the lecture about how that is superior to our methods. Just wanted to throw that in there in case you didn’t realize that was a turnoff. =]