Dr. Jeff Kane: Tell me about yourself
As a freshman medical student, I took a course called “Introduction to the Doctor-Patient Relationship.” I was placed at the bedside of a randomly chosen patient for a half-hour. I knew no medicine, so we small-talked. Then I joined a group of four other students and two practicing doctors to discuss our experience.
One of our instructors was a behavioral psychologist, the other an orthopedist, Dr. Lorin Stephens. The conversation rambled around, as if no one was sure of the curriculum. The psychologist droned a turgid thread of theory and turned to Dr. Stephens for corroboration. Dr. Stephens was asleep. The psychologist elbowed him.
“Dr. Stephens. Do you agree?”
He sheepishly awakened. “Excuse me,” he said. “I was just thinking about the smell of my wife’s pillow.”
Now, almost six decades later, that memory remains crystal-clear. Dr. Stephens’ comment was all the course I needed. He defined what was important not as any abstraction, but as our connection with the person we’re with. The famous advice, “It’s more important to know what sort of patient has a disease than what sort of disease a patient has” has been attributed to so many legendary physicians that there’s got to be something to it.
Although we’re taught that diagnosis is medicine’s Holy Grail, it’s actually the consolation prize. Since attitude and emotion invariably inhabit both ends of the stethoscope, medicine is more than just fixing what’s out of whack. It’s an invitation to soothe troubled souls as well, which can be done only within a genuine relationship. So cheers to us docs for nailing that elusive Saethre-Chotzen Syndrome, but is the patient feeling better as a result of our presence? Now, that’s something.
Not that it’s easy for doctors to know patients more deeply. Commercial healthcare has labeled docs “providers” and patients “consumers,” hoping both parties pretend they’re conducting just another transaction, like buying a pack of gum. That is, we’re under continual, subtle pressure to play impersonal roles: docs as professional, objective scientists and patients as compromised supplicants.
That asks too little of us, and minimizes potential reward. To the extent the relationship is closer, the patient will be more knowledgeable, trusting, and responsible. And the doctor will enjoy more stimulation, fulfillment, and, over years of practice, significant wisdom.
We’re all aware that healthcare’s current pace militates against cultivating intimacy. Still, determined souls can find a way. Patients can choose to ask personal questions of their docs (trust me; they love it), and docs can ask at least one patient a day, “Tell me about yourself.”
Jeff Kane is a physician and writer in Nevada City.
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As of Thursday, 90,754 doses have been administered to Nevada County residents, according to the state’s COVID-19 Vaccine Dashboard.