Tacked to my bulletin board within my line of sight are the words of Dr. William Osler,a 19th century physician who pioneered taking medical students out of the classroom to learn at the bedside. Dr. Osler understood that medicine was more than science. He encouraged the students to:
“Observe, record, tabulate and communicate.
Use your five senses. Learn to see,
learn to hear, learn to feel…and
know that by practice alone
you can become an expert. “
During my tenure as a medical humanist at Southwestern Vermont Regional Cancer Center I had the good fortune of working with the late Dr. James Wallace, a pioneer in the field of oncology and the first medical oncologist in Vermont. He practiced when there were not many treatment options. Dr. Wallace understood the limits of science and recognized that taking care of a patient meant providing supports and resources to ease suffering. Like Dr. Osler, he viewed the doctor-patient relationship as a human interactive process.
I will never forget sitting in on Dr. Wallace’s conversation with a patient who had recently developed cardiac issues unrelated to cancer. New symptoms meant more doctors’ appointments and more treatment decisions.
“Who,” she asked, “is in charge of my care?”
Dr. Wallace paused for a moment, touched her hand and said, “You are.” He went on to explain that she has a healthcare team that can guide her but she needs to ask herself “what matters most.”
We are now in the 21st century where the demands and time pressures on doctors have increased. More than ever, we as patients need to be prepared to communicate our questions and concerns to help our doctors offer care options that align with the values and goals of the person who is the patient. I imagine that Drs. Osler and Wallace would be pleased that we are helping patients, loved ones and healthcare providers actively engage in these difficult but meaningful conversations.