Thursday, March 20, 2014

Malcolm Gladwell Is Wrong, Tell Them That You Love Them

Malcolm Gladwell thinks we should tell people whats it's really like to be a doctor.  And by God I have invested the last seven years in doing just that.  I have written countless blogs, given lectures, and traveled to Ireland.  I have coined the term Caring 2.0 to describe the bidirectional flow of empathy.  Patients will tell us what it is like to suffer with disease, and we will tell them of our own battles.  Forged somewhere in the molten lava of truth and disclosure, a deeper relationship will arise.  We will heal not only with our hands, but with our hearts.  In the process, the oozing festering gash of our painful existence will somehow be allayed.


I was wrong.  Years, pages, and a book of poetry later, I have found that my most captive audience is not my patients nor the populace in general, but healthcare professionals.  That's right.  The doctors and nurses are the ones who get the most out of my writing.  It took me nearly a decade to realize that I am preaching to the choir.  It's my fellow PTSD'ers that find release by reading my words.

We are wounded soldiers searching not for a pat on the back nor a bow of recognition as much as knowing glance.  To share with other human beings the impossibly difficult situations we face only has resonance for those stuck in similarly claustrophobic corners.

Do I want to know all the near misses that occur yearly in our aviation system?  Do I want to hear about the accidental deaths by friendly fire in Iraq? NO.  We want to believe that flying is utterly safe, that our military only protects, and that pain and suffering are twentieth century problems long resolved by our excellent medical innovations.

Your average lay person only wants to hear of death when they are forced to.  Face it when mom and dad are taking their last breaths, but otherwise push it back to the farthest reaches of the denying mind.

We physicians need to tell each other,  We need to confide in our brethren.  For those of us stuck in the thick mud of human destruction, the divide is too great for the uninitiated.

But there is something we can do to fight the colossal mess of what Healthcare has become today.

Instead of trying to explain the tangled mess of our daily lives to our patients, we should instead assure them that we are on their side.  We should tell them that we won't stand for the destruction of humanism in medicine by the cold calculus of technology.

We should tell them that we love them.


Anonymous said...

Myself, and another 2 people we know, went to admin and said a particular one of our docs were great but we thought overworked and could they get them some help. For our going to bat for the docs (and yes, they were overworked), not only did the docs "fire" us for it, but then my doc ruined care for me with my PCP and another doc. No care in the area. I'll suffer permanent damage and possibly death for it. That's for helping out a doc who needed it.

When we've asked for reform in terms of missed & delayed diagnosis, where the #1 malpractice lawsuits are, in the way of different training or the like, that would prove to help not only us but docs and NOT the lawyers, did we get any support? NONE. Its all on caps on payments, throw money at us, but don't ask docs to try to do anything that fixes the original problem.

You also have to remember that the top 1% have bio/med type degrees. So we would expect long hours and tough times as part and parcel of the job you chose. Yes there are bad patients, but we never hear it about us good ones: who pay our bills, show up on time, ask questions, partner in our healthcare (and not using Oprah as the "Dr. Google").

Myself and the one other person no longer defend docs when we don't see them doing things about their own that hurt others. This means when you look the other way at screw ups from other doctors, and we get the fallout for it, physically and in the wallet, do you really think we'll defend that? When that is supposed to be part of the honesty bargain from docs and we find ones who have killed or permanently damaged more than one, when complaints mounted up, and risk managers "explained" it all away, well what if that happened to you or your family?

So yes, some of us still do listen, but explain why, in light of the above, we should help the medical profession out when time and again, anything we do since we're not part of the "frat", is tossed by the wayside.


Dana said...

Just my opinion of course but Randy, I feel like you have proven Grumet's point clearly...

"For those of us stuck in the thick mud of human destruction, the divide is too great for the uninitiated."

Sara said...

Dear Dr. Grumet,

I am a patient in another state. I read your blog because I'm concerned that medicine is losing its soul and that at some point I will simply be viewed as a costly burden.

It is so comforting to know that there are doctors who care.

Don't give up.


Anonymous said...

Sara: Most doctors care. Really. It is true. But we get frustrated and angered by a changing system and we take it out on each other, nurses and clerks, and sometimes we take it out on our patients. We often take it our on our families. But I am guessing that mostly we take it out on ourselves.