How to Bring Back Humanity: Patients Teaching Doctors How to Care

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It’s 3am. I’m tired, hungry and over-worked. I am an Intern. I put in 99 hours this week, and the last thing I want to do is answer another page that a patient needs Colace for constipation. A 3am bowel movement…really? 

The code pager went off shortly thereafter, and I was summoned to the cancer ward; taking with me a senior resident.

 On the way in the elevator, my senior sneered under their breath ‘Let’s make this quick so I can get some sleep.’

 The odds were already against this patient; for one, they had metastatic cancer in every organ, and two, a senior resident that wanted to make this quick so they could catch some Zzz’s.

With my hands interlocked, I compressed the chest of a 65 year old male destined for a brighter tomorrow if we would just call the time of death, yet the Code went on for what seemed like hours. Green liquid oozed from the patient’s endogastric tube onto my white coat. My knees were becoming sore as they pressed against the bedrail with every compression I was giving. Heat from the above room light beamed on my head causing sweat to drip onto the lifeless man that I was trying to revive. I was so tired.

Finally the moment came, ‘Time of Death 3:53am’.

‘Our work is done here. Another one bites the dust kid,’ my senior said to me. ‘Now go fill out of the death packet so I can get some rest now…’

Somewhere in the transition from Medical Student to Physician, we loose our Humanity.  Caught up in the endless hours of studying Human Anatomy and Physiology in medical school, we are taught to think of individuals as a collection of organ systems of which we learn from, never to show human emotion such as Fear. We were thought to be undignified if we showed any real human emotion.

Maybe it starts in the Anatomy Lab, the first time when we dissect cadavers. It is the lack of fear that helped us to proceed with the scalpel and dissect the body of a man that once lived, laughed and knew how to love. The cadavers resembled the pictures straight out of Netter’s Anatomy Textbook, and we were able to separate any emotions because the corpse no longer resembled human beings.  Or maybe it stems from Histology when we look under the microscope for countless hours at diseased bone marrow infiltrated by cancerous cells or red blood cells shaped abnormally. We lack any apprehension at all making the diagnosis. We forgot that the sickled shaped red blood cells came from a real human being, one that is suffering unimaginable pain from Sickle Cell Disease.

When 2nd year of Medical School comes around, we become so Pathology oriented that we begin referring to patients as a ‘condition’ rather than recognizing them as human beings with a special suffering. I can remember many times in medical school when I felt that my humanity was taken over by medical fundamentalism.

During the 3rd and 4th year, the Clinical Training Years, we spend countless hours in the hospital seeing patients on a medical team of Doctors, and the practice of learning how to conduct a complete History and Physical exam is drilled deep into our already knowledge soaked brain. The format, as it does offer benefits, is so structured that it asphyxiates our creativity. Spontaneous human interaction is lost, and will not be found again until sometime later on in Residency when we eventually know the steps well enough that we stop fixating on them, and the elements of human interaction are once again accessible.

Medical Education is stripping young physicians of their humanity, but can we blame them? The general decline for attention to humanity is a collective measure, and should start well before medical school. Infact, we should be raised on it.

One morning, not too long ago, as I was scrolling through my social media newsfeed while having a cup of morning coffee, I came across a post by a fellow colleague of mine at the hospital. Dr. Disha Narula, a 1st year Nephrology Fellow, had posted a picture of a young woman’s hand, her own, placed gently over the hand of an old man, her patient. Before even reading the caption on the photo, it was obvious that she made a fundamental human connection with her patient.

 

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I spent part of my morning sitting down and talking to this wonderful 88 year old patient. This is quite different from the usual running around from room to room, floor to floor I usually do.

This 88 year old man was refusing a procedure and I was curious to know why. He told me he had lived a good life, he had seen things and places through his Navy service that I couldn’t have even imagined. He told me he had 3 children, 6 grandchildren and 8 great grandchildren.

He told me he married a beautiful woman and they had been married for 63 years until he lost her 7 years ago.

 

He started to cry and said how happy they had been together. He had tears rolling down his eyes while talking about her. I couldn’t hold back my tears and we held hands and sat in silence with tears in our eyes. Then he said..”I’ve had a good life and I’m willing to roll the dice. Now it’s between me and Him and I’m okay with that.”

Sometimes patients can teach us about life, family and humanity. Moments like these is why I went into Medicine and makes every sacrifice worth it.


I took the picture of us holding hands to always remind myself of our connection and about the important things in life.

 

Symbolic in nature, the hands represent to me the connections between human beings passed down from one generation to the next, within it being the soul of Humanity. It is inspiring stories from my patients and reading about moments like Disha experienced that reaffirm my decision to become a doctor. But why are not more stories of humanism shared amongst our colleagues? It is the opposite- they are all too few and far in between.

By looking only at the biologics of the human body, doctors fail to appreciate the links between their patient’s lifestyles, cultural and social conditions, and their illness. Patients are more of a nameless number and a ‘chief complaint’ than a person with an amazing life or a fascinating story.

It’s a rewarding experience going to work everyday, and I constantly remind myself that I am part of a humbling profession. We are honored to meet people from all walks of life, and privileged to care for their health at the same time. We are fortunate to do what we do, and that’s why I feel so strongly that we must help new doctors recognize and recover from the loss of humanity, sympathy, and even their sense of self during medical school training.

Communication, just as Medicine, is an art. If Residents and Fellows in training don’t do it, then who will?

 

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DanielleKrolMD
Dr. Danielle Krol, a native of the Philadelphia area, spent the majority of her early life growing up in New Jersey. With over 15 years’ experience in Dance and Theatrical Arts, Dr. Krol was pursuing a career as an actress until her mother was diagnosed with metastatic breast cancer. For the 3 years that followed, Dr. Krol placed her life on hold and took the responsibility of Caretaker for her terminally ill mother. Her passion for medicine came about during her mother’s illness, and her determination to become a doctor came about after her passing in 2002.