In the early 2000’s the Center for Communication in Medicine created a program for physicians at Southwestern Vermont Medical Center titled “Doctors Conversation Hour.” Before each meeting I would send participants an article to help prompt discussions about ethical and personal issues in practicing medicine. On one occasion, however, I selected a poem, “Not God” by Marc J. Straus, MD. The doctors were presented the option of writing a response to the poem.
One doctor (whom I refer to as Dr. Smith) wrote about what he would say to a patient. He began, “There are some questions only God can answer. We doctors can only do our best to help you with what we know, and to support you and stay by you no matter what happens. If we cannot cure you we’ll do whatever we can to meet your goals—whatever they may be… Together we will do our best to navigate through tough times together. When we see each other as allies in dealing with disease we can tolerate all kinds of uncertainty, change of condition and fear.”
Smith confessed, “It’s hard for me (doctor) to say ‘I don’t know, because I want to have the answers for questions…I love to ‘fix things,’ I want to bring the right resources to you. But I commit to always telling you exactly what I know—the truth—it’s the only way we will both get through this.”
In the next breath he recognized the limits of his medical knowledge and lack of training in addressing existential concerns, which prompted him to ask, “Whom else would you want to talk with? Do you have a spiritual or religious person you’d like to bring to your bedside? What would be most assuring to you? What else would assist you in dealing with this question?”
Not surprisingly, these questions led to an in depth group discussion about unrealistic expectations placed on doctors to “fix” everything. Of course, we hope that our doctors can successfully treat our ailments but we as patients must also try to summon up our internal strength and external sources of support.
Let me interject a bit of a twist here. During my tenure as a medical humanist at the hospital’s cancer center I had spoken with patients who did not view doctors as God nor did they believe in one. They placed their faith in medical science.
Every patient has their own expectation of what his or her doctor can or cannot do for them. That said, it seems to me open and honest communication is the key to humanizing doctor-patient relationships, thereby leaving divine intervention in the hands of someone else.
“The most important questions, don’t have ready answers,
but the questions themselves have a healing power
once they are shared.”
Rachel Naomi Remen, MD
Kitchen Table Wisdom