The most admired leaders of our country have been the ones who trusted us, valued us, and actually loved us. President Reagan called America a “shining city upon a hill,” a biblical reference to the country’s position of service to the world; and in his final goodbye letter he reminded us that it is still dawn in America. Think of President Kennedy’s call for us to rise up and serve others; he knew we could and we would. Even Reverend Martin Luther King’s I have a dream speech conveys his expectation that we are up to the task.
Motivated by love
I’ve been pondering about whether there is a need for this kind of confident appreciation in medicine. By love, I do not mean that doctors need to have their patients over for dinner or give them physical affection. Rather, I’m thinking that they need to have passion for patients as a group and for our success as individuals.
- Doctors who care passionately for patients would believe in our rights and abilities to handle our information. They would believe us when we claim to have symptoms and trust us if say we have side effects. They would work hard alongside of us to find ways to make our lives as healthy and comfortable as possible.
- Doctors who love patients would not be biased according to negative prejudices of patients with chronic disease, assuming we’re seeking more pain drugs than we need or exaggerating symptoms to obtain disability benefits or some kind of “secondary gain.” They would not scoff at or minimize our symptoms because that is unkind. They wouldn’t write things in our charts that they know we would call inaccurate.
All of these positive and negative actions could be motivated by love, more than by fear of legal complaints or bad publicity. Operating from a position of fear or suspicion can interfere with the ability to be a trusted helper. But operating from a position of love makes a doctor a healer.
Can medical students be taught to reach beyond a paternalistic approach as a model of caring for patients and actually respect patients and trust patients’ ability to contribute?
Would love have an effect?
I clearly remember saying that it didn’t matter that Dr. Smart Rheum (Bone Scan) wasn’t the warm and fuzzy type. I was satisfied that I found what I really needed: a rheumatologist who didn’t waste precious time telling me I’m not sick anymore because my labs are improved; that I’m in remission no matter what my symptoms are. This doctor never tried to talk me out of my RA symptoms or blame them on some syndrome or other.
From our side we gave gratitude, respect, and cooperation …and paid all our bills. I would have gladly had dinner, too.
However, in the end, when I needed help, Dave deBronkart put it correctly: my well being did not turn out to be their priority. I kind of suspected that for a long time. But when you have RA, you really need a doctor, so I compromised. And I’ll probably do it again.
Meanwhile, this is my front porch. And I invite you to sit with me and wonder about what might be best. And what might be possible. Should doctors love patients?
Recommended reading
- Dear Bridget Duffy from a Rheumatoid Arthritis Patient
- Yale Medical School Graduation Address: a Patient Centered Approach
- Meeting the New Rheumatoid Arthritis Specialist
- My Doctor Fired Me
- What happened next: New Reading of the Nuclear Bone Scan: Credibility is Everything
