Tuesday, October 29, 2013

Medical treatment - should doctors build empathy?

It seems that the news is full of stories about how our medical system lacks empathy, how we need to increase it, and the benefits of doing so.

Things like this: Thomas Dahlborg "How a lack of Empathy Affects our Healthcare"

And this: Danielle Ofri "My Leap of Faith in Medicine"

And this too: Jessie Gruman "Adding Empathy to Medical School Requirements"

I see (from the patient's point of view) a big difference in how I'm treated by different doctors, and how it makes me feel.

In a typical doctor visit, I check in at the front desk. I wait in the waiting room. I wait in the examination room. The nurse examines me and asks some questions, then the doctor comes in to talk or examine or give results. I've been having doctor visits just like this for all of my life.

However I've noticed that some doctors interact with me quite differently than others. Case in point; the story of Dr C and Dr V.

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Doctor C

Recently I've been having this twitch around my eye that won't go away. So I took the problem to a doctor, to see how he could help me.

When Dr C arrives, he asks me, "How are you doing?" He makes eye contact. He listens to me talk for a good few minutes, then examines me. He says, "Well, I think it's a muscle spasm, named (whatever)." I say, "Okay, what does that mean?"

He says, "Well, it could be an easy fix, but I'm not certain, so let's talk about your options." I told him about what I had read on the internet. He gave me more information about what I had read; how it could be something simple, but it could also mask a more serious problem. He suggested that I go to a specialist. He also asked me to "let him know" how things go with the specialist.

I thanked him and left.

My reaction coming out of this appointment? I felt listened to, and cared for. I felt like this doctor genuinely was interested in my well-being. I would want to share with this doctor how I was doing in the future. His comments were made in an empathetic way, and it made an impression on me. This was brought home even more when, a few weeks later, I got a call from Dr C's office asking if I had made an appointment with the specialist. I told them "Yes, I'm seeing Dr V next week". They reminded me again to please send the results of Dr V's visit to Dr C when I'm done. I asked, "Why do you need that?" and the nurse replied, "Dr C believes in holistic healthcare; knowing the whole picture about a patient."

This seriously could have been a scene from Little House on the Prairie, people. It felt that good, and I still had no idea what was wrong with my eye! :)

Dr V

After several appointments and tests with Dr V, today I had arrived to get (hopefully) some final results. After waiting in the waiting room and in the exam room, Dr V came in and sat down. He looked at his computer monitor and said, "So, you are here for the results of your test, hmmm?" I said yes. He said, "Hmm, well according to this report, (long string of completely unintelligible sci-babble)." I said, "Okay, what does that mean?" He looked up, and was about to reply when the phone rang in the next room. He said, "Oh, excuse me" and went next door to answer it. I know he was answering the phone because he left my exam door open. I know he was talking to an insurance agency, because of the things he said on the phone.

I was a little embarrassed, because I was sitting on the exam table with the door wide open. I was dressed, and all, but still it was a little odd. Then I got a little annoyed, because I did all of the waiting I'm supposed to, and here he is having a phone call. I mean, I realize that my time with him is limited but seriously? Taking calls?

So yeah, I'm feeling a little miffed but not too much, because I'm imagining reasons why he answered the call (his nurse is out today, he's expecting an important call, etc). I'm trying to keep calm and wait for the translation of the results.

Then he hangs up, and takes another call.

So I'm not feeling particularly respected or cared about at this point. I considered walking out, but I still needed to know what all the technobabble meant. So I waited for him to finish his second call.

Then he comes back in, says, "I'm sorry." He looks back at the computer screen and tells me my diagnosis. I've got a torn disc in my back and a pinched nerve in my neck. I look at him. "What does this mean?" I asked. He said, "Well, you are young. You don't need surgery. Just don't lift anything heavy and come back and see me in four months. Try to relax. Lose some weight."

So here I am, sitting there a little shell-shocked by the diagnosis. I still am trying to process this, and I asked him about ways to treat it and things I can do. I took out my notepad to make some notes. He said, "Don't bother writing this down, I'll print out this report for you with the names of the issues," (which he didn't.) We moved on to the second part of our visit, which was a follow-up test, and that was it. He walked me out. End of visit.

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I can't help but feel the different types of treatment from the different doctors acutely, because of all this thinking about empathy. It's clear to me that Dr C wants to show that he cares about the feelings of his patients. It's also clear to me that Dr V, regardless of how much he cares about his patients, doesn't find it important to show that to us. I feel disrespected coming out of Dr V's appointment, and as a result I feel like I want to take my money and my business elsewhere. As good as he may be at 'doctoring' he hasn't made me feel good.

Dr C and Dr V could be anyone's doctors. I can't help but feel bad for the people who only have Dr V's in their life, and grateful that we have some Dr C's around. 

More empathy in healthcare? Yes, I agree. We definitely need it.

Tuesday, October 22, 2013

From closed to open

Sometimes I get asked the question, "Why are you focusing on empathy, and building up connections with other people?" I used to be a self-reliant person, and I rarely wanted to reach out. "So what's the difference now?"

I talk to them about when I saw this video about empathy and outrospection. I connected with his message, partially because I remember a time many years ago when I followed the self-help movement.

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In my twenties, I was not happy. I didn't like my job. It was fun and inspiring (which was great!) but it was also part time, didn't pay well and had no future prospects (not so great). I felt scared; I wanted things to change but was afraid of making bad decisions. I didn't want to admit I had failed. I thought, "Let me try reading a 'self-help' book, then if I made a mistake, I can figure it out without telling anyone."

All of the books I read (and I read a few) seemed to be saying the same thing; they all told me to look inward, and find my center. I was to look inside myself and see my true nature - only then would I learn to follow my heart. According to these book authors, I was a golden star of shining light, and if I nurtured my soul I would be able to polish that star to a gleaming glow, and to find what I needed inside myself. Now in my forties I look back and think, what a load of crap. :)

Not that I'm not a golden star of shining light, or anything, but if I had the solution inside myself I would have done it already. I wasn't lost. I was just unhappy and full of fear of making the wrong choice.

It took me several years of working at that job and reading those books and looking inside myself before I realized I wasn't getting anywhere. It was a growing moment for me; I stopped looking in and instead reached out, to talk about my concerns and share my feelings. I remember I was so embarrassed, and scared, I could hardly get the words out (cough, cough, hack!). I couldn't look my friends in the eye but I did talk, and they listened to me. They made me feel safe, and made me realize it was okay to move forward. Only after that day was I able to be done with the dead-end job and move on.

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Now I look back and think again about all that time of (to me) useless introspection. Once I was able to open myself up and be vulnerable with the people in my life who cared about me, that's when I was able to make a choice. Those friends listened to me, and they were what I needed to get me through.

Now I'm definitely more open of a person. I believe that all this empathy growing and connection building has made a difference. It's still not comfortable to share but it does come more easily. 

I'm just not so scared anymore. I don't feel alone; instead, I look out at the world every day and think, "Look at all these amazing people living their lives. I can talk to them, find out how they do it, and then maybe by hearing their stories I'll learn how to be an amazing person living a good life, too.'

Has empathy and connection-building helped you?

Janet

Tuesday, October 8, 2013

Personal post - A parking lot moment

I had one of those parking lot moments tonight. Head pressed firmly to my steering wheel I was late for an appointment and didn't care one bit. I was listening to my favorite song. How many of us love a song so much that we try to stop the world when we hear it? We may say to everyone around, "Everyone be quiet, I need to turn this up." For me, this is the one. Nothing gets to me like the song "In Your Eyes" by Peter Gabriel. This is a song full of emotional power.

"How do you know you are in love? All the songs make sense." - Castle, TV Series

Listening, I feel my heart pound. I sweat. It's like I'm falling in love all over again hearing this song; feeling that moment when I want to believe with all of my being that

this person

standing in front of me

is the one person who will complete my world.

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It's been many years since I've listened to something new. Unless you count the kid's music or television shows, which I don't. However, I still have Peter Gabriel. He's stayed with me through failing exams, through falling out of love and then back in again, and through the birth of both of my children.

I can't imagine a time when I won't want to hear his music. 

Do you have a favorite song? How does it make you feel?

Janet