Thursday, April 2, 2020

"Bugle Notes" - "Words of Comfort"

Abraham Verghese’s must read book, “Cutting for Stone”, addresses powerfully, the human side of medicine. It is a poignant reminder of the sacredness within medicine created by the unique bond that is the doctor-patient relationship; a relationship, I believe, in peril. We are allowed into that most intimate space, the life of a person at their most vulnerable and frightened time.
In the book, a prominent surgeon reads a letter to the house staff from a grieving mother. Her words are piercing and convicting.

                 “… I cannot get over one image, a last image that could have been different. I saw my son was terrified and there was no one there to address his fears. Everyone ignored him. The doctors were busy with his body. They cared only about his chest and belly, not about the little boy who was in fear. Yes, he was a man, but at such a vulnerable moment, he was reduced to a little boy. I saw no sign of the slightest bit of human kindness. My son’s last conscious memory will be of people ignoring him. My last memory of him will be of my little boy watching in terror as his mother is escorted out of the room. It is the graven image I will carry to my own deathbed. The fact that people were attentive to his body does not compensate for their ignoring his being.”

Utter silence followed. He then asks a question, “What treatment in an emergency is administered by ear?” The answer – “words of comfort”. I was struck by the simplicity of the answer and yet the depth of its meaning. Memories of previous patients surfaced from the recesses of my mind. Did I give them “words of comfort” they desperately needed or was I too focused on the tasks at hand, the myriad of things that had to be done?

We are trained exceptionally well medically and surgically. How well, though, are we prepared to give “words of comfort”? I want to think I always spoke these words to my patients but did I? I believe I did, I hope I did. How tragic to not receive this most basic act of humaneness; to be reduced instead to an existence personified by high tech monitors, tubing, IV drips; their world a cacophony of sights and sounds; no longer seen as a person, a human being with dignity, a mother’s “little boy or girl”.

There will always be the human side to medicine. It is predicated on relationships intentionally offered, developed, and nurtured. Without this personal connection, we chance ignoring their “being”, who they are as a person of worth, deserving of kindness and compassion.

 Through medical missions, I learned that the needs of others do not become real to us until they become personal. They become personal when we experience them through the warmth of love given through a touch, acts of kindness and service, or words of hope and comfort. Without these, Verghese quotes, “Call no man happy until he dies.”

We fail our patients when we forget the power that words (and acts) of kindness and comfort carry. May we always remember this simple “treatment” and, in doing so, remember from whence we first loved medicine.

Andy Lamb, MD

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