 |
THE BEST MEDICINE In my new role as patient, I have learned that medicine is not merely about performing tests or surgeries, or administering drugs. These functions, important as they are, are just the beginning. For as skilled and knowledgeable as my caregivers are, what matters most is that they have empathized with me in a way that gives me hope and makes me feel like a human being, not just an illness. Again and again, I have been touched by the smallest kind gestures — a squeeze of my hand, a gentle touch, a reassuring word. In some ways, these quiet acts of humanity have felt more healing than the high-dose radiation and chemotherapy that hold the hope of a cure. I deeply appreciate the care I have had as a patient. But I can't help wonder why I have had such a heartening experience. Is it attributable to the exceptional quality of care and caring delivered at Massachusetts General Hospital? Is it due to the particular caregivers that I happened to meet? Or have I benefited in some way from my family's medical connections, since my father and brother were trained in Boston academic institutions and have ties to senior MGH physicians? Perhaps my experience has not been the result of happenstance or special relationships but of a health-care environment that still places the patient ahead of the bottom line. If so, for how long will such a compassionate approach endure? Medicaid and Medicare cuts, both present and future, will have devastating effects on hospital care. Managed care is already making its mark in Massachusetts, and it will only accelerate implementation of its cardinal principles: efficiency, conservation of time and resources, and budget cuts. And now, for-profit insurers and large national hospital chains are trying to penetrate Massachusetts for the first time. In such a cost-conscious world, with its inevitable reductions in staff and morale, can any hospital continue to nurture those precious moments of engagement between patient and caregiver that provide hope to the patient and vital support to the healing process ? Time is a prerequisite for real engagement between caregiver and patient. Even the most compassionate caregivers cannot use their healing gifts if they don't have the time to do so. A friend who worked at the National Cancer Institute, in Maryland, quoted his mentor as saying that when physicians give bad news to a patient, they must give that person more of their time — to explain, to answer questions, and to provide comfort. Time alone is not enough, however. Caregivers need to be trained and encouraged to engage with their patients. My understanding is that medical-school training now emphasizes to a greater degree the importance of the physician-patient relationship, a bond that ultimately reaffirms the humanity of both. As an eminent Harvard Medical School professor, himself a cancer patient, once taught: ‘‘The secret of the care of the patient is caring for the patient.’’ - Kenneth B. Schwartz |
|