When I receive the letter, I do not recognize the return address on the envelope, but “MD” alerts me it is from a physician.
It begins, “Why is it after 40+ years of treating patients am I just hearing of a ‘medical humanist’ now?” The answer is that “medical humanist” is a role I created. Inspired by one of the fundamental principles of humanistic medicine, which is “open communication,” I translated that idea into a practical model to help facilitate physician/patient communication in the medical encounter.
A three-year pilot program in a regional cancer center in Vermont afforded me the opportunity to pioneer the medical humanist communication model in day-to-day practice. As the center’s resident “medical humanist,” I documented-in each patient’s own words-what they understood about their diagnosis and treatment plan as well as how they were coping with the effects of illness on their lives. I asked what more their physicians needed to know to provide more effective, more compassionate care. I recall the patient who answered, “I am looking for a medical companion–a doctor who will link arms with me…” Another patient said, “An important element of care is to recognize the dimension of my fear.” These words echoed what I had come to know as the collective plea of patients entering the world of illness.
The concerns I documented were incorporated into each patient’s medical record under the heading, “Medical Humanist’s Note.” Reviewing my note provided an opening for the physician to address misunderstandings as well as unspoken expectations. The words I took down also helped bridge the gap between the patient’s experience of illness and the doctor’s more clinical approach to care.
This pilot program changed the manner in which medical services were delivered at that cancer center. But every healthcare institution these days must make difficult budgetary decisions. As a result, my role in day-to-day practice at that facility came to an end.
I wrote an essay about that pilot program which appeared in the Journal of the American Medical Association. It was entitled “A Medical Humanist Says Goodbye.” Among the countless e-mails I received in response, one has stayed with me. It said, “I look forward to the day when I will read, ‘A Medical Humanist Says Hello.'”
That day has come. We will all be patients someday, and the care we receive will depend on how well we communicate. But there are barriers-for both patients and professionals–in every room where these conversations happen.
I hope this blog can become a forum where conversations take place and the role of communication is explored. Did you know the origin of the word communicate dates back to the 16th Century: from Latin communicat– meaning “shared”? I will be sharing here some of my firsthand experiences helping facilitate communication, and also handing the microphone off from time to time to patients, loved ones and healthcare professionals, inviting them-and our readers–to share their experiences and views about the lived world of illness.
–Celia Engel Bandman
This is a great letter. I hope you get many positive comments.
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