What physicians do isn’t normal.
I remember leaving the soccer fields of Emory University, where I was an All-American player, to arrive in medical school to a room full of cadavers.
That’s just not normal.
Several years later, I was working as a resident in the emergency room at Atlanta’s Grady Memorial Hospital. I had to tell two girls, ages nine and 10, that their mother had just expired as the result of a car accident, that she wouldn’t be there to hold their hands and walk them through life.
I wanted to linger with those children and comfort them as best as I could. Yet duty called. Grady is a major trauma center, and I was informed that another patient in critical condition required my immediate attention.
Having to leave those two young girls like that — that’s just not normal.
I am not unique. My experiences as a spine specialist with Resurgens Orthopaedics are no different than those of any other physician. We have all been present during emotionally grueling circumstances. Over the years, we have hardened ourselves to these situations, perhaps owing to necessity, to one degree or another. I know that I have been guilty of misplacing my priorities at times.
Being a physician is a great responsibility and not something to be taken lightly. I treasure that responsibility. Part of that responsibility, I believe, is to bring compassion back to the doctor-patient relationship.
I think back to when I was at the Medical College of Georgia and I was struggling with the vision of medicine that was being presented. It was quite different from what I expected, and I was somewhat disillusioned. So I went during office hours to seek the advice of Dr. Thomas Weidman, an assistant anatomy professor.
“Create your own vision,” he told me.
Those are words I have tried to take to heart during my career as a physician. When I ponder the subject of showing more compassion to patients, a couple of passages from the modern Hippocratic Oath come to mind (the italics, for emphasis, are mine):
“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”
“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”
A young mother’s illness
The surgeon’s knife and the chemist’s drug – those are the skills that we learn in medical school, during our residencies and as young physicians. They are the skills of the trade and without them, we cannot practice.
However, we must remember the humanity in our patients and, perhaps equally as important, in ourselves. Think of an orchestra conductor who only looks at his sheet music without listening to the efforts of the musicians performing before him. If he does not feel what they are emoting and respond in kind, his efforts will fall flat. He will fail.
Such is it with medicine. As a young medical student, resident and impressionable young doctor, I kept journals. I can think of a memorable instance in which listening to a patient helped me to make a correct diagnosis and, significantly, offered the patient some peace.
It was the fall of 2000 and I had just started private practice. A married mother of two young children – I’ll call her Katie – had begun experiencing numbness. She was training for a marathon and her primary care physician counseled her to rest.
The symptoms, however, continued. She visited her primary care physician again and was referred to a psychiatrist. She was advised of the effects of stress on her body, which the psychiatrist thought might be causing Katie some depression. He offered a prescription drug.
A friend of hers encouraged her to see me for a second opinion. I sat and listened to her story. A highly educated woman, Katie suspected that she might have multiple sclerosis and asked me if I would order an MRI of her brain. I agreed. Her relief was palpable.
I spoke to the radiologist the next day. The MRI revealed, in fact, that Katie had MS. As I waited in my office later that day for her to arrive and hear the results, I kept thinking of the impact the disease would have on her life, her marriage and her children.
I tried to comfort her as I broke the news. “I knew it,” she said. She was laughing and crying at the same time.
Katie told me that even though the news was terrible, she felt relieved in a way to know that she was not crazy, that what she felt was “real.” Again, what we physicians do is not normal, so we should try to bring as much “normality” as possible to a patient in a moment like that. In a way, listening to a patient can be empowering.
In recounting this story, my intention is not to gloat. I detest few things more than a doctor’s gloating when another misses a diagnosis. In a case like Katie’s, I don’t feel I deserve any credit for making the diagnosis. Katie did it. All I had to do was to listen to her.
When a patient’s symptoms fall outside the norm, I often think of Katie. She serves as a constant reminder to me to listen to my patients. She has made me a better physician.
And what I learned from her remains true. Regardless of how technologies change, we actively seek as physicians to improve quality of life and relieve pain, and the most important tools that we physicians will ever have are our ears.
Scott A. Kelly, M.D., is the co-medical director of Resurgens Orthopaedics’ Spine Center and the author of “What I’ve Learned From You.”