Dr. Andy

Reflections on medicine and biology among other things

Tuesday, March 08, 2005


What else would you expect from New York Times reporter with an MD?

This article describes a patient with the temerity to keep some semblence of her normal life while hospitalized:

I recently cared for a woman who insisted on wearing her own pajamas throughout her hospitalization. She also brought along her own quilt and pillowcase, ate her own food (brought from home or a nearby deli by her husband) and kept her own stuffed brown bear nearby.

Eating her own food? Wearing her own pajamas? A simple attempt to feel more at home in a difficult environment during a difficult time? Oh no. For our author this is insurrection:

She was sending her flare of insurgency across the bow of the mighty ship of institutional health care

One shudders at the horrors our author must put up with. As for many patients, things do not go well and she gets sicker. The patient's mood declines, as might anyone's; but for the author this just shows how misguided her attempts to maintain some semblence of normalacy were, and how wrong he was for tolerating them:

What then became unsettling was not her antipathy (which was no fun) but rather the fact that I had agreed to play along and low-ball the gravity of the situation. I had participated in her costume ball, she in her PJ's and I in my starchy white coat. Like many others in the hospital, I was a card-carrying member of her folie à deux.

(ed folie à deux? I had to look it up too.) We never learn how a patient keeping some reminders of her life outside the situation "low-balls" the gravity of the situation.

But in the end our author can comfort himself that he was only doing the right thing:

Is it up to us to rub a patient's face in her own frightening situation, to overwhelm the tricks and sleights of hand used to maintain sanity?

Or should we just play along. I mean there's no harm in hoping, right?

Tricks and sleights of hand to maintain sanity?

I think this article gives a big clue as to why so many people perceive physicians (ed: and NYTimes reporters?) as arrogant jerks.

One of the best attendings I worked with as a medical student was an oncologist who spent almost no time seeing patients, instead running a sucessful research lab. We would laugh at him when he didn't know the name of new medicines or the details of chemotherapy protocols, relying on the residents and fellows for that info.

But I'll always remember him asking relatives to bring in pictures or other reminders of home and how much the patients appreciated them. He also took just enough time to have a sense of the family dynamics and consider the needs not only of the patient, who might be dying of lung cancer, but also the needs of the children, who were losing a father, and the wife, who faced life alone after many years of marriage.

I think we could all learn a lot from that.


At 8:16 AM, Anonymous Anonymous said...

Amen, brother.



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