I can’t always cure, but I can always care

I can’t always cure, but I can always care

I started kissing patients in med school. And I haven’t stopped.

During my third year pediatric rotation, I used to stay up late at night in the hospital, holding sick and dying children. I’d lift them from their cribs, kiss them, and sing to them, rocking them back and forth until they fell asleep. One day the head of the department pulled me aside. He said that I was a doctor when my patients needed a doctor and a mother when they needed a mother.

Twenty years later, I’m still mothering my patients.

I’m a family physician born into a family of physicians. My parents warned me not to pursue medicine. They worried that big government would kill the small-town physician. But I love being a family doctor. And I love my patients. I hug them and kiss them, and I do housecalls. And most patients call me Pamela or sweetie, or honey. They all have my home phone number. I’m on call 24/7, but I never feel like I’m working.

I’m not good with boundaries. I’m never sure when work ends and play begins. It all feels the same to me. Many of my patients are friends. I do their physicals and eat over their homes for dinner.

I’m not a fan of professional distance. But I’ve been trained to maintain distance from patients. How can I remain distant when I’m looking deep inside people in places nobody has been before? How can I remain detached when delivering a mother’s first baby, saving a brother’s sister, or helping a child’s grandfather die?

Apparently maintaining a safe distance from patients will help my objectivity, limit favoritism, maintain clear sexual boundaries, and prevent exploitation. But patients today don’t want professional distance; they want professional closeness with a doctor who has a big heart and a great love for people and service in a clinic where people feel warm, nurtured, loved and important.

And I want to be that kind of doctor.

The truth is: I can’t always stop patients with heart attacks from eating bacon double cheeseburgers. I can’t always stop smokers from smoking. I can’t always stop little kids from dying.

I can’t always cure, but I can always care — and kiss my patients.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears.

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  • Rginsberg2

    Thank goodness for docs like Pam!!!!!!!!!!!!!! Aren’t we ALL within the “boundaries”??

    • PamelaWibleMD

      Thanks Riginsberg2 – more and more doctors are breaking through professional distance to be authentic and real with patients.

  • Dave

    Agreed. I’ve always felt that objectivity and distance crap was simply a way that the unfeeling physicians among us could justify their lack of compassion. Brava to you for marching to the beat of your own drummer.

    • PamelaWibleMD

      I never understood the reasoning behind hiding one’s true self from patients. They are looking for a human connection. Aren’t we all?

      • Bruce

        You have somehow transcended a pattern which is endemic in our culture, and I hope more will learn to follow in in your footsteps. I don’t think, in the main, any reasoning at all is what is behind the dogma of “professional distance”, and of patient intimidation. I think that emotion is behind it — specifically, the emotion of fear. A lack of integration of reason and emotion is endemic in our culture, so that many people fear emotions — e.g., medical institutions managers fear the emotions of their patients, and fear their own emotions; they fear that, if emotions are not suppressed, “things will get out of control”. The injustices/contradictions of our social arrangements amplify the possibility that, indeed, long-suppressed emotions, building-up, if released suddenly, when the limits of the mechanisms of their suppression is breached, will, at first, “get out of hand”, until reason and emotion can become more integrated, and until emotionally [and rationally] intolerable injustices are redressed. But this will only happen if reason fails to do ITS work in healing our social — including medical — injustices, and leaves that work to emotion alone.

        • PamelaWibleMD

          I asked a new patient why she had come to see me rather than keeping her other family doc. She explained that he put her on antidepressants for depression and she felt uneasy going back in for a follow-up visit. I asked why. She explained, “I can’t discuss my emotions with a doctor who doesn’t have any.”

          We need to be fully human to practice medicine. That may include hugging, kissing, crying with patients.

    • PamelaWibleMD

      I actually think there is a connection between physician suicide and professional distance. We were never supposed to be robotic zombies. We are feeling, loving human beings who happen to be physicians.

  • ninguem

    A hot doctor.

    Plants a kiss on the guy’s forehead.

    And he’s on oxygen.

    I hope you’ve checked your fire extinguisher.

  • May Wright

    What you said, exactly.

  • PamelaWibleMD

    Reductionist medical model can be very hard on the soul. Many graduate medical school with PTSD. A tragedy.

    • Bruce

      And Reductionism is an epidemic and rampant cognitive disease throughout the present Human Phenome, not just in the medical field!

      • PamelaWibleMD

        It is!

  • PamelaWibleMD

    Exactly. How can we experience healing if both parties are behind a wall or facade? The more vulnerable I am with my patients, the more vulnerable they are with me.

  • PamelaWibleMD

    And great that we expose the next generation of physicians to happy healers . . .

  • PamelaWibleMD

    We are one human family. Why not love our patients?

  • Suzi Q 38

    BRAVO, Dr. Wimble.
    You are exactly what many patients want.
    A physician who cares.
    I wish you practiced medicine near me.
    When I am sick, I need a doctor who cares and listens, not one who can’t wait to dump me and my health problems on someone else.

    You have achieved what many could only dream about: A job that they “love.” People who they love to work with.

  • Bob Branch

    This is real medical health reform. We now have high priced, low compassion care. Time for a change.

    • PamelaWibleMD

      Real health care reform happens from the inside out, not the top down.

    • Bruce

      I have never before seen it said so well — high price, low compassion health care!

  • http://www.CommunicatingWithPatients.com/ Edward Leigh, MA

    Early this morning, my mobile phone alarm rang. After turning off the alarm, I checked my email. I looked over the article titles of my recent KevinMD email. As soon as I saw this title, without looking at the author’s name, I knew who wrote the article — Pamela. So refreshing. So inspiring. So wonderful. I hope what Pamela has is catchy — every physician needs to catch this way of caring! Keep up the great work! Happy holidays, Edward “Eddie” Leigh, MA

    • PamelaWibleMD

      Original title: Why I Kiss My Patients

  • Suzi Q 38

    Good for you, never be ashamed of admitting that.

    I think that so many of the doctors are taught to put up a “wall” between them and their patients, that they rarely get to enjoy their patients or jobs.
    This could lead to a long, unhappy career.

    • PamelaWibleMD

      And leads to physician depression and suicide. . . We lost 3 physicians in our town in just over a year.Both men I dated in med school died by suicide. We lose over 400 physicians per year in the US to suicide – that’s the equivalent of an entire med school gone.

      • Suzi Q 38

        So sad, doctor.
        I am sorry for your loss. I am glad that you have chosen to practice medicine differently.

        • PamelaWibleMD

          Here’s a map of ideal clinics where docs are attempting to get back to the basics of the patient reltionship. http://www.idealmedicalcare.org

  • Suzi Q 38

    You are so lucky.
    Unfortunately, doctors like her are so few.

  • edwinleap

    Fantastic outlook. Thank you! I hope you get to speak to medical students sometimes.

    • PamelaWibleMD

      I do!

  • Frank Lehman

    I have never had any desire to be kissed by my physician.

    • PamelaWibleMD

      Well, I don’t force myself on patients. I usually wait for them to ask for a hug. Then I surprise them with a kiss. xoxo

    • Suzi Q 38

      Maybe you did not need the kiss of friendship and health.

      In my youth, I have had a couple of doctors try to kiss me, LOL.
      Unfortunately, not for the same reasons. Awkward. In their defense, I was personable and friendly.

      I would not have minded a physician like Dr. W. “planting” a kiss on my cheek. Most of her patients know her, have a good relationship with her, and expect such affection and warmth.

      In France, Spain, and other countries, this would not be unusual.

      • DoubtfulGuest

        Whoa, that is not cool. Kisses and hugs have to be optional! You should be able to be personable and friendly…you didn’t owe them anything more. Yes, Dr. Wible cares what her patients want so it is okay.

        One of my specialists hugs me on special occasions — once to congratulate me on some good news, and once when I was feeling particularly cruddy. This started after we’d known one another for awhile. I feel kind of stronger afterward, almost like he transfers a little of his own health to me. :) I don’t think he loses anything…I hope not. Everyone knows him as a warm, approachable doctor. He still comes across as being completely professional and appropriate.

      • PamelaWibleMD

        In Argentina no patient makes it out of the office without two kisses from their physician. One on right cheek. One on left. Wish that were the standard greeting in the USA.

        • Suzi Q 38

          I wouldn’t mind, either.
          I receive similar kisses from my students from various countries. Yes, Argentina….Brazil, France, Italy, Egypt, Iran (females rather than males in the middle East)….I am sure there are others.

          My students from China and other parts of Asia…just the younger women. The older generation no, and no kiss from the males. A handshake instead of a kiss and a warm smile is as good as it gets, LOL.

          • PamelaWibleMD

            Why don’t Americans kiss each other more?

          • Suzi Q 38

            I am not sure why.
            We hug if we know each other well. Kiss?
            maybe if we are related or very close friends.

            I remember the first time as a teacher receiving kisses on BOTH cheeks from two new female students.
            One was from France, and the other was from Iran.
            The “ceremony” of it all…sigh. Heartfelt and beautiful, as if the moment of affectional friendship had great importance…right then.
            As if to say: “STOP whatever you are doing, teacher! I am here to greet YOU.”

          • PamelaWibleMD

            That is so beautiful. Ah, an experiment on the horizon. I think I’ll try greeting others with a kiss this week. Such a beautiful way to live.

          • Suzi Q 38

            Yes.
            I will admit when I took this job years ago, I kept the distinction of instructor and student.
            Then, about a year ago, I had to have my C-spine surgery….came back a different person.
            It started with two quiet students from China.

            The wife could speak English, and her husband only spoke Mandarin. In her broken English, she struggled to tell me this: “He wants to be your friend.”

            I decided that I was going to “break down the wall” that existed invisibly. I used to decline invitations to dinner, lunch, and parties.

            Now I find myself saying “yes” more often than I had in previous years.

            I even started taking Tai Chi lessons from one of the students in another class.

            The result??
            Even more students enrolled in my class (60+ in number) and a waiting list. Sometimes my class is so full that we have to have class outside.

            My point is that this interest in my class did not appear until after my decision to be more “open” to my students.

            My husband and I have gone to some interesting dinners and parties, LOL.

          • PamelaWibleMD

            No need to fear one another. Your story is proof that we can tear down the walls of professional distance.

        • Bruce

          Wow! How much we could gain by scouting out the most loving traditions of all of the cultures that humans have devised worldwide, and then adopting those traditions into our own!!!

          • PamelaWibleMD

            Let’s do it. What loving traditions do you know of besides the greeting kiss?

          • Bruce

            I’ve encountered many such loving traditions, in perusing books on anthropology, in viewing OPB documentaries on other places and other times, etc., but none of them come back to mind here and now — I’m going to start keeping a list [New Year's Resolution!]. The overall impression that those experiences have left with me is that people in community look out for each others feelings, and for each others’ morale, and constantly scheme to make each other feel better. And, I think, that is Healing Medicine, and Preventive Medicine, of the Highest Order!

    • querywoman

      I teased my mother after a breast exploratory surgery cause her surgeon had a giant herpes simplex sore under his mouth. I said, “I hope he didn’t kiss you. He’s got a herpes sore.”
      And she laughed.

      • PamelaWibleMD

        Hilarious.

  • PamelaWibleMD

    Which is exactly why doctors and patients need to be the ones leading health care reform. Not politicians, bureaucrats, and “experts.” I led a series of town halls and invited my community to design an “ideal clinic.” We’ve been open since 2005. Check out the details here: http://www.idealmedicalcare.org

  • ninguem

    As the forensic pathologist was being led out by security, he was heard to protest that he had just read a Pam Wible column.

  • Mengles

    You’re very lucky to have Dr. Wible. Hold on to her as your primary care physician as long as you can. It’s very hard to find ones like her.

  • Kerry

    I was one of the lucky ones. Not having been a person that connects closely with a lot of individuals, I had found a few doctors in my lifetime that fit this description that Pamela describes, three to be exact. They had big hearts and a great love for people and made me feel warm, nurtured, loved and important. This was critical for me because I had a history of panic attacks and a general sense of not being ok in the world.
    For 21 years I was treated by one with a familiarity that my senses translated into dependency and LOVE. During a rather difficult period in my life, when I was falling apart, I was receiving treatment from a psychiatrist that fit this same description. Like I say, I was one of the lucky ones until I received a retirement letter from my doctor of 21 years. I was more than a little devastated, my behavior not falling into normal range. To make matters worse, just before I received his letter I had openly allowed my feelings to cross over into unacceptable territory. As I was deteriorating, my psychiatrist, who I grew to trust, admire, depend on, and also LOVE, fired me. That’s when I crumbled completely.
    It’s true, I over stepped “normal” bounds by exposing my feelings. I’m sure my experience would lend itself to more precautionary measures from the medical field in regards to “professional distance”, but from my perspective there was nothing therapeutic about how they coldly disposed of me after establishing such close and intimate
    relationship.
    Eventuallythe label of Borderline Personality Disorder was revealed to me. I still claim that the feelings are real. If I weren’t under so much stress, while having the biggest meltdown of my life, I would have had a much better chance at hanging onto them. Dr’s who read this and who know something about the “dreaded” Borderline Personality Disorder might be shocked, knowing that any person in their right mind would not publicly reveal themselves to have such a “disgraceful” diagnosis such as this.

    • PamelaWibleMD

      Thanks for being courageous enough to share your feelings and pain openly.

    • PamelaWibleMD

      Kerry ~ How do you think things could have been handled differently?

      • Kerry

        Well, I’m still in the process of figuring out just how
        different I am than the average bear, but for me, after being with a medical
        doctor for 21 years it would be nice to hear of retirement plans from the
        doctor, far in advance, so I could have prepared for it. I know that retirement
        letters are business as usual in the USA, but if the doctor patient
        relationship is summed up in a retirement letter then I really do think
        “professional distance” is a very good idea. If, on the other hand, visits are more
        of a personal and friendly nature, with inquiries into personal matters that
        don’t pertain to your visit, then I think more personal endings to such a
        significant relationship could be considered. In my case I realize I muddied
        the water, but I don’t believe muddied waters are that uncommon in these
        relationships. Perhaps I’m completely wrong. The psychiatrist has different
        focus, but intimate nevertheless. For one to dismiss you so abruptly for having
        feelings seems rather contradictive to the field. Adding insult to injury the
        woman psychologist I was referred to claimed that the feelings I was having for
        my doctors were not real. Who can say that one narrative is more real than
        another’s, the one with credentials?

        • PamelaWibleMD

          These are really good points that you make. To end a relationship with a “Dear John” letter seems really weird.

        • DoubtfulGuest

          Kerry, I’m not sure if you preferred only to hear from Dr. Wible about this, but I’m sorry for your situation. I agree they could have handled it much better, especially having known you so long and interacted with you so many times.

          • PamelaWibleMD

            Doctors probably don’t often think of this from a patients’ perspective.

          • DoubtfulGuest

            They really need to consider it– avoiding mixed messages is very important. Also, reminding themselves how hard it can be for patients to share personal information, even though it’s often medically necessary.

            Another good way to handle things is to reassure patients that they’ll continue to care in the appropriate way. (Unless a doctor’s personal safety is at stake, which should of course be handled very differently).

  • Bruce

    “Game Theory” tends to focus on situations where “if I gain, you lose; if you gain I lose” — called “zero-sum games”. But it admits — though also neglects — two more realistic possibilities: negative sum games in which EVERYONE LOSES, and positive sum games, in which EVERYBODY WINS. My diagnosis: Dr. Wible and her co-thinkers and ‘co-feelers’ are working and playing to shift American medicine from a Lose-Lose to a Win-Win “game”.

  • PamelaWibleMD

    Once a doctor asked me to prove that my style of practice works, He wanted my data set. I replied, ” When an 80 year-old woman is hugging me at the end of an appointment and telling me it was the best medical visit of her life, I’m not sure how to graph that.”

    • Bruce

      This one-sided emphasis on quantity — this wanting everything to be expressed as “pure” quantitative data, and “proven” in terms of “pure quantity” — is a symptom of our cultural disease, and a key clue to its cause, and to its cure, despite however often this cultural disease goes undiagnosed as such.

      • PamelaWibleMD

        And how can we ever measure love. Chart and graph affection, ectasy. Some things are best left to mystery.

        Weird (and maybe TMI) example: If I thought about all the biologic activities and systems involved in making love with my partner, I may miss the entire experience!

        • Bruce

          So true! I concede that, in some therapeutic contexts, even in some skills-teaching contexts, the feat of cognitively encompassing the vast organismic intricacies of physical communion could be of service. But I think most of us would also agree that, for fuller, whole-bodily participation in the eventity of human intimate joining, we must enter into a form of direct, sensuous feeling-connection, even into a trance-like state such as ancient traditions like Tantrism so cultivate, where thought-waves cease arising in our minds, yet our awareness waxes into ecstatic unity, beyond the merely generative function of human sexuality, and far beyond its degenerative possibilities of derailment, into its REgenerative dimension.

  • PamelaWibleMD

    On her way out, a new patient said, “I feel like I just got a physical, met with a marriage counselor, and had a spiritual awakening.” Now that’s healing!

    We could all have comprehensive, personalized care, but we resist what we most desire: Intimacy. Doctors and patients both need this from each other. Let’s get real.

    • Suzi Q 38

      I think that even some specialists can benefit from your described methods.

      For example, my GYN/oncologist is a very reserved male.

      When I was complaining about my nerve sensations that appeared after my surgery, he didn’t want to hear it.
      He would be annoyed and angry whenever I brought it up.
      He dragged my referral to a specialist out to 5 months later. I slowly and insidiously declined under his and the neurologist’s care. it took a year and a half of this runaround for a different doctor (who was a champion and cared) to believe me and guess what the problem was. I finally got to have my c-spine surgery just in time to save my walking ability.

      My point is the physician “wall” did not put me in the caring environment that was needed in order to promote honest listening and efficient treatment.

      This negative practice can be detrimental to the well-being of any patient.

      IMHO, he didn’t have to plant a kiss on my forehead.
      He just needed to listen and act on my behalf.

      I “dumped” him ceremoniously, soon after my c-spine surgery.

      • PamelaWibleMD

        So important to stay in a place of love and service when we are together . . .

        • Bruce

          That place is the TRUE meaning of MAGIC!

      • querywoman

        Suzi Q, so many women activists claim we don’t need gynecologists, that they are surgeons.
        Were you really that shocked to blown off after a hysterectomy?
        I’ve known about for years.

        • Suzi Q 38

          Believe it or not, yes.
          I expected him to help me as the sensations came after the hysterectomy.
          No one knows why this came about so soon after the surgery.

          I had to get a consult with a neurologist, and he kept putting me off. I reminded the nurse, and guess what, she forgot. I finally called one of those nurse advocates. I told them that the doctor ANd nurse kept “forgetting” to put through the referral, so could she call them to facilitate this? Guess what? I got a phone call from the neurologist’s office within 3 days.

          I am glad that you have known about this for years. I did not find out about this Kevin’s until the worst had passed.

          Live and learn.

          At least now we can warn others.

          • querywoman

            Research Nora Coffey and the HERS foundation. Tell her! Post there!

            And you were a drug pusher, drug sales rep and didn’t know about common post-hysterectomy side effects.
            We can’t know everything. I should have researched my Medicare D sooner.
            I suspect the trauma of the surgery intensified an existing spinal stenosis problem.

            If you read me on the other thread, I’m going to try to get my copayment on my Victoza lowered to first tier on my Medicare D. Then I’ll get it free or very low cost.
            I bet the drug companies give insurance companies a kickback for lowered tier meds.
            In my case, keeping $34 to $75 a month more means I can call a seven dollar cab home instead of walking home in the dark.
            In a few years, I’ll get a private pension as well as my SS.

          • Suzi Q 38

            “….I suspect the trauma of the surgery intensified an existing spinal stenosis problem….”

            Yes, your guess is as good as mine.
            Not everything in medicine is explainable.

            I will check out Nora Coffey and HERS.

            Thanks.

          • querywoman

            All surgery is stressful. I can’t see how the surgery caused the spinal stenosis. It had to already be there.
            I worked with a young woman who died young of lupus. Her brother had it since he was very young, and then hers came out.
            After the woman’s death, another woman told me that her lupus came out after she took a heroin shot. She had been told to keep it secret, but that no longer mattered.

          • Suzi Q 38

            “…..All surgery is stressful. I can’t see how the surgery caused the spinal stenosis. It had to already be there….”

            I agree. I tried to tell the surgeon that….maybe this was already in me and got worse after my surgery.

            At first the neurologist thought the problem was in the nerves of my legs, so my lumbar spine. After viewing the MRI of my lumbar area, it looked irritated rather than a stenosis.
            Since you’re just guessing here, I am guessing that the surgeon thought his daVinci robot could have irritated some nerves. His delay of care was to protect himself, rather than to get to what my problem was, which was my own existing but unknown stenosis.

            Have you looked at a picture of the trachtenburg position utilized during a da vinci hysterectomy?
            The patient (me) is in a very strange position. My legs are docked way up, and my head is pointed toward the floor.
            One P.A. of the neurosurgeon “stirred the pot” a bit and said that they could have dropped me before, during or after the surgery.
            Any pressure on my neck may have made a present stenosis worse. Just my guess.

            I am sure that they were concerned about malpractice, but in reality, unclear cases are very hard to prove. You could spend several hundred thousand easily and still not prevail.

            On the other hand, no matter what the cause, I shouldn’t have had to get worse before their eyes and not get treatment.
            Why wait until I am in a wheelchair?
            Isn’t the idea to consult your other specialist friends at the hospital to see how bad it could get talk about difficult cases like mine?

            They did nothing of the sort.

          • PamelaWibleMD

            Please share your thought and feelings from a place of peace with those involved. Will help heal many more then yourself and the physicians involved. You’ll prevent others from suffering . . .
            We learn best from our mistakes. I don’t believe we intend to hurt one another. We just get scared. Then we make fear-driven decisions that are really in nobody’s best interest.

          • DoubtfulGuest

            Dr. Wible, Letter-writing is a great suggestion. I hope it’s not meant as a substitute for full explanation and apology from the doctor? A big part of the solution would be doctors and patients somehow getting out from under the thumb of the legal system. Suzi Q 38 could sit down for hours to write a heartfelt letter, but who controls her physician’s interpretation of it?

            Anger can go along with compassion sometimes, and be a great teaching tool as long as it’s used constructively.

          • Kerry

            This is so true, I have poured my heart out in my wirtings, by way of email, to one of my doctors since I have been dismissed. What has been most difficult to live with is the silence that is returned. I realize I have to live with this silence and I also realize that the occaisional writings I continue to write are for my own therapeutic process. I suppose I should be grateful that I’ve not been served with a warrant for my arrest fo email stocking, but if we could have concluded in a different way there would not have to be such long lasting affects.

          • PamelaWibleMD

            We can never control how receptive the other party will be, but it is therapeutic even for the letter writer. Even if it is never mailed. Sometimes it is easier to express one’s feelings in a letter than in person.

            Would be great to have medical mediation – without fear of lawsuits – as the norm.

          • DoubtfulGuest

            “Would be great to have medical mediation – without fear of lawsuits – as the norm.”

            I agree. I’d never sue a doctor…too much like suing a friend or family member, which is unacceptable to me.

            I have a great deal of respect for your work, Dr. Wible. I just think sometimes if we internalize our focus, e.g. on transforming anger, we can miss opportunities to change things for the better on the outside?

          • PamelaWibleMD

            We must fully feel our feelings. Not suppress. Not run away from. Any feeling fully felt (and expressed) changes.

          • DoubtfulGuest

            Agree…I have written several letters to doctors who made serious mistakes with my care. Even anger can be a positive emotion if we’re careful what we do with it.

            It’s just that taking responsibility for mistakes is a natural grown up response. Our system makes it hard to impossible for doctors to do that, even though it would help them AND their patients heal. I would gladly join any effort to change this destructive situation.

          • PamelaWibleMD

            What has the response been from your doctors? Were some receptive?

          • DoubtfulGuest

            One very kind e-mail apology from a doctor who has a similar philosophy of care to yours. She did not harm me very much, though…that award goes to a couple of specialists.

            The one I most need to hear from has locked down, stonewalled me completely. I’ve been fully prepared to have the kind of discussion that would help me let it go afterward, and he should sleep better, too. I said lots of nice things in my letters. Tried to be constructive at all times. They finally sent me a cold, impersonal termination letter, oddly not signed by him, but just from his office. Except for his name on the letterhead with the other doctors’ names in the practice, I wonder how much he really had to do with it (as opposed to an attorney running the show?) This doctor was really great before he made a small innocent mistake with a referral that snowballed into a big mess for me. He covered up the mistake…I never would have been angry if he’d just been honest. Looking back, I think 90% of the miscommunications between me and him earlier were based on his fear of lawsuits. That’s why I want to work on the root cause, instead of just processing my feelings about this.

          • PamelaWibleMD

            I think you should write another letter. Tell him you have no intention of starting a lawsuit, but that you wish to share information that can help him and his office. Make a copy for the office manager and for others in the office if they were involved and then deliver the letters personally and sit down with the office manager and let her know how important this is to you and to the doctor. Have her schedule an appointment with the doctor to discuss. This would bring incredible closure and — healing.

          • DoubtfulGuest

            Thank you…I did that quite some time ago. They won’t let me. They won’t believe anything I say. I think using the word “lawsuit” at all sounds like a threat, even saying “never going to”. It seemed like the elephant in the room, better to just call it like I see it, and explain that I want something different that will help everyone, right?

            Perhaps in my state the lawyers have difficulty with reading comprehension. I’m sorry…this is just very hard for me. I really liked and trusted this doctor.

            Actually, I did not deliver letters in person. I could still try that. You don’t think they’d have me arrested? When I tried to schedule a visit before, they canceled it on short notice.

            Full disclosure: I did try two different complaint processes, but I didn’t think they’d be punitive. (I knew not to contact the licensing board). Also, the only swear word I used in any letter was “snafu”. I was trying to say I understand things happen and we should just deal with it instead of sweeping it under the rug.

          • PamelaWibleMD

            You need to have a human conversation/connection with someone at the clinic. Once you can “get through” to one person it may be easier to get through to the doctor. They can’t arrest you. Wow. I’m flabbergasted by all the fear on both sides. Very counterproductive to healing.

          • DoubtfulGuest

            Thank you. I’ll try to think of a way to do that. I just don’t want to make another misstep that could harm the doctor. I’m concerned that his legal counsel or insurance company might be taking advantage of him and draining him financially. To defend a lawsuit that doesn’t exist! It’s crazy. Thanks for your thoughts and compassion about this.

          • PamelaWibleMD

            No worries. His insurance company is not hassling him. There is no suit to defend. You just want to talk to him.

          • querywoman

            Suzi Q, you post so much here about your hysterectomy and subsequent or co-existing spinal stenosis here.
            You really need to check out Nora Coffey’s site and the HERS Foundation. You will find other women there who have had drastic post-surgery outcomes.
            I don’t know that the hysterectomy itself is that much of an issue for you now. You need better spinal stenosis treatment now.
            Good luck!

          • querywoman

            I think you might do better redirecting some of your time and energy over on Nora Coffey’s site. You should at least get better emotional support there from other women who had hysterectomies.
            It surprised me that you didn’t know about the site, but I get my eyes opened to stuff all the time too.

      • PamelaWibleMD

        How did he behave toward you before your hysterectomy? Was there an abrupt change after you started complaining about the neurologic sequelae?

        • Suzi Q 38

          He was very nice but reserved before and after the surgery. I did not think that was unusual, as he was a surgeon.

          It was when I started feeling the nerve sensations after the surgery and let him know a couple of months later, that he started changing.
          Yes, the change was abrupt.

          • PamelaWibleMD

            Maybe he felt a sense of failure. Everybody prefers a good outcome. Never guaranteed.

          • Suzi Q 38

            Yes.
            He called me to try to convince me to do the spinal surgery. I had just told the neurosurgeon at his hospital that I was not sure about the surgery, so I needed to go get a second opinion first.
            I guess the phone call was on of a panic for him.
            He found out that I told the whole story to the neurosurgeon, and he finally was called out.

            I could hear the sadness in his voice. He listened to me for about an hour while I told him off for being such a bad doctor the last year and a half. I told him that I was in a wheelchair for long distances (parking lots) and I was scared about my possible future as a quad.

            I told him that his ignoring of my complaints did not help me and made my situation worse.

            I told him that I could not trust him anymore, and there was no worse feeling than having a doctor that I didn’t trust.

            In the end, after I yelled and he listened, a peace of sorts came over me. I realized that he was only human and a scared human at that. He sounded contrite but did not admit fault or apologize.

            You are right, he must have felt a sense of failure in one of the worse ways. He said that the was going to try harder to listen to his patients from now on. He said that he was going home to think about it all weekend.

            Yes, I agree that good outcomes are never guaranteed. I think though, that if the patient needs help, the physician needs to get the patient to the right specialists in a timely manner, to help fix the problem.
            The attitude should be of healing and helping rather than ignoring serious symptoms and delaying care.

            Thank you for your thoughts on this.
            I have since tried to forgive him and move on.

          • PamelaWibleMD

            I am a believer in writing letters to share deep emotions. Write not from a place of anger, but from a place of compassion – for yourself and for your doctors. You never know when your words may change someone’s life forever. Here’s your chance to heal the wounded healer. No doctor wants to injure a patient physically or emotionally. I bet if you are still struggling with this, then he is too. Now that time has passed maybe you can share your thoughts from a place of compassion for him. Which I know sounds REALLY weird, but it will heal you too. He never wanted to hurt you or any of his patients.

      • Bruce

        Here, with your “case example”, we see — VIVIDLY — just how destructive “professional distance” — and HEARTLESS MEDICINE — can be!!!

    • Guest

      retyped elsewhere

      • PamelaWibleMD

        retyped what elsewhere?

        • Suzi Q 38

          I have told my story so many times, but thanks for asking.

  • PamelaWibleMD

    Do you care for friends and family in your current practice?

  • PamelaWibleMD

    Labor of love Marianne.

    • Bruce

      … the kind of labor wherein our true humanity is discovered!

  • PamelaWibleMD

    A physician friend of mine shred an interesting story. During family medicine residency, his program was tracking the success of residents who wee able to get their patients to quit smoking, lose weight, lower cholesterol. He had the best results in his patient panel out of all the residents. He was called into the residency director’s office and reprimanded. he apparently referred less people for cardiovascular studies and was not generating enough income for the hospital.

    • Bruce

      TOUCHE’! Case-in-point!

  • PamelaWibleMD

    When the public demands to be treated with compassion and love, more and more doctors will find ways to deliver it.

  • Bruce

    HERE HERE !!!

    Nobody else can or will do it for us.

    If we want it done, we’ll have to do it for ourselves.

  • Suzi Q 38

    You are probably right about that.
    They did not know what to do.
    Sometimes, people only do what they think is best for any given situation. Just the same, sorry it hurt you. I am sure they did not mean to do so.

  • Kerry

    I found this to be true of my experience as well, with my previous doctors, the vulnerability the connection, or so I thought. But the feelings of Love accompanied and began to overtake me and all of what was taking place while recieving their support and care during a very fractured time period in my life. I needed to somehow find a way to express this love and put in an appropriate frame work, Not knowing how to do this, I tried poems, too many emails, and exposing my feelings. In return, rightfully or not, I was shut out in the worst possible way and at the worst possible time. I won’t be vulnerable or naive enough again to allow this to repeat. Now, I go in, get my blood work done and go home. I’ve learned the hard way, it’s all about proper boundaries. Is this snarky? I’d be lying if I said I had no resentment at all.

    • DoubtfulGuest

      Many people are taught as kids, how to have good relationships AND good boundaries. Some of us stumble through life trying to figure it out on our own. This is very hard but not impossible. I think often the emotions themselves are not the problem. What can harm someone is when expectations are built up around those feelings. Along with what Dr. Wible is saying, good fences make good neighbors. Doctors must uphold *some* professional boundaries in order to do their jobs right.

      It sounds to me like your feelings were based on a genuine positive regard you had for these people after receiving good care over many years. It seems weird to me that they would not try to work this through with you at least once. Perhaps they would have preferred to if only they had more time for each patient. It says something really good about you that you care how these doctors were affected. It is possible to learn from an experience like this and go on to have healthy relationships.

  • Jerry Fenter

    I know there are so many people who need your kind of care and attention from a doctor. Sometimes all a patient needs is to know is that someone actually remembers their name and actually cares what happens to them after they leave the office. For physicians to do this is not impossible, nor does there have to be “distance” between doctor and patient. Doctors should take time to listen and ask good questions. I love when a doctor at least tries to touch or make eye contact when I’m sitting there in a tiny cold room. I’ve been lucky. I’ve had some good ones who had a true insight into who I was and what my interests and fears were. Pam is totally leading the medical profession in the right direction. Doctor’s shouldn’t be afraid to show that they are human and have feelings for their patients and patient’s families or to share their own concerns with patients. Thanks, Pam for not giving up. You’re a star!
    Plus the word needs to get out to patients. Find a doctor who you’re comfortable with and understands that you want contact and understanding from them. If they can’t take time with you for a few minutes why trust them with your medical needs? Change doctors and don’t be embarrassed. Listening and responding should be taught by patients to the new students at medical schools before learning anything else. Have patients explain to doctors what it is we really need.

    • PamelaWibleMD

      I actually brought my patients who were featured as chapters in my book, Pet Goats & Pap Smears, to teach the medical students at the local medical school. A great way to inspire the next gen of doctors. They LOVED it! Brought some of the students to tears. Like this one: http://www.youtube.com/watch?v=CrcnkaRjhus

    • Bruce

      Well said! And, yes, “patients teaching doctors” can be a key to bringing about the change that we want. “Market demand” — in this case, “patients’ demand” — and patients “voting with their dollars” — can work to help move medical care in the right direction, IFF patients are informed, e.g., IFF enough patients come to know, soon enough, that doctors like Dr. Wible ARE POSSIBLE, and not just some utopian fantasy.

      • PamelaWibleMD

        I once wrote an article on ideal medical care for a respected family medicine journal. It was rejected because it was “too utopian in concept.”

        • Bruce

          Ugh! And this, despite the fact that you have PROVEN “ideal medical care” to be realistic, by making it real, for years now, as have other physicians, many of them inspired directly by you!

          • PamelaWibleMD

            This was earlier – back in summer of 2006. They just could not believe how low my overhead was. Office rent $280 per month, for example.
            Their response: “Malpractice cost, office rent, and per patient cost/reimbursement do not seem market based. TThe numbers do not seem realistic, and the overall tenor is too Utopian in concept.”

  • DoubtfulGuest

    No problem…I also don’t want to be jumping in with too many opinions. I’m trying to help, but please don’t let me step over YOUR boundaries, either. I’d be happy to edit my comments if they are not helpful, so just let me know if you’d prefer that.

    Sock folding…referring to living with someone and doing the everyday stuff that people do in relationships, I suppose?

    Yes, that would be hard to see a psychiatrist and not be able to discuss feelings. It seems that the health care system has largely moved away from talk therapy even though many, many people find it helpful.

    I wonder if it’s an option to see a different psychologist about this? Someone else might handle it more compassionately. They would not encourage the feelings, but they could help you talk through them in a better way. Instead of telling you they are “not real” they could help you understand more about your emotions, where they come from, and what you would really want out of a relationship. Also, I wonder if this woman psychologist you’re currently seeing would be open to a different type of discussion than you’re having — if you tell her you’re uncomfortable with what seems like negative judgment coming from her. In my experience, the word “uncomfortable” translates very well with mental health professionals. They seem to understand it easily and be more open to what you’re saying.

  • Bruce

    Exactly!

  • Bruce

    Here Here!

  • Bruce

    You said it, so well!!!

  • PamelaWibleMD

    Thanks Geoff! So honored to be a part of your life. . . .

    In fact, can’t think of anything I’d rather do than be invited into my patients’ lives at their most vulnerable moments. A true honor.

    • Bruce

      Spoken like a true healer!!!

  • PamelaWibleMD

    Honesty and sharing ones true feelings openly is the first step to healing. No blame. No self deprecation. We are always allowed to feel. That makes us human. Never hide from your feelings. Any feeling fully felt changes.

    • Bruce

      Amen! And yes, what an insight! Feelings have a logic of their own: experience a feeling fully, and it transforms into a new feeling, leading us forward in the healing that we need, step-by-step.

      • PamelaWibleMD

        Exactly! And no need for high-tech intervention. It’s so simple really.

  • PamelaWibleMD

    We need to be human and integrated in all of our work environments – especially human services.

  • PamelaWibleMD

    The part that surprised me most is how EASY it is to deliver what patients really want. More than anything, patients just need a HUMAN BEING who is BEING HUMAN.

  • Michelle Mudge-Riley

    I love reading stories about physicians who love practicing medicine. I wish I would have enjoyed practicing as much as you, do, Pamela! And I love that you do it “your” way. Your patients will benefit on so many levels.

    • PamelaWibleMD

      Young physicians need to be exposed to older docs who love their jobs. I believe we lose so many students because they never find mentors who can help them see the beauty in our profession.

  • PamelaWibleMD

    Always available by cell. And as soon as I can dig the foot of snow off my front stoop, I’ll be able to get around again.

  • PamelaWibleMD

    Hey is the magician-physician a gastroenterologist in Oregon? I think I know him.

  • PamelaWibleMD

    Yes. Start with chapter 52 – A Tale of Two Testicles. Or watch the video:

    http://www.youtube.com/watch?v=UG-NaDVMer8

  • PamelaWibleMD

    If anyone would like to attend a retreat on how to love medicine again – next one is May 6-9, 2014. Learn more on my webpage.

  • PamelaWibleMD

    Interestingly, some (especially elderly) patients do go to the doctor for social reasons. Some of their conditions are fueled by loneliness and despair.

    • Bruce

      We humans are social to our core. Yet, today, we live in a society that incarnates an extremity, an apogee — in all of human history — of social alienation, of estrangement, of the dissolution of human community, an apogee of human isolation and atomization, in which even the nuclear family — let alone the age-old extended families of yore — is not holding on, is increasingly dissolving, into people living singly, and often deranged thereby, like “rogue elephants”.
      Because of its nature, the medical sector is increasingly flooded by the consequences of this unsustainable historical extremity.

      • PamelaWibleMD

        And primary care has become the social safety net when all else fails.

        • Bruce

          Yes — inevitably — the refuge of last resort!

      • Geoffrey Koerner

        Brilliant observation, Bruce! I’m glad I’m not the only one perceiving the cultural implications of 21st century American culture – and seeking to preserve human connection. Rock-on, dude!

        • Bruce

          Geoffrey — thanks for your appreciation, and know that it is returned, likewise, from me to you! Rock-On!

  • PamelaWibleMD

    It is! Sharing our love with others is a very simple way to heal. And it’s bilateral. The doctor also feels great after the visit.

  • PamelaWibleMD

    Thanks Allen. Caring is a mindset. And loving is a way of life. I still submit ICD and CPT codes while caring and loving. It’s not one or the other.

    • Bruce

      Yes — not EITHER / OR, but BOTH / AND!

  • PamelaWibleMD

    Compassion is our natural state. Med students begin their training with a high level of compassion. Then they are taught to be “professionally distant.” The cure is professional closeness. It’s okay to be authentic, real, and even love your patients.

    • Bruce

      Amen!

  • PamelaWibleMD

    Beautiful and timely sentiment.

  • PamelaWibleMD

    wow

  • PamelaWibleMD

    They key is not to become jaded. Most med students and residents become cynical a few months after beginning their training. We need to be courageous enough to ask, “Why?”

    So often we chose pessimism over optimism. Being surrounded by cynical doctors who are stressed out does not help matters. We need to start caring and nurturing each other so we can pass that care on to patients and our families.

    How can we give care if we don’t first care for ourselves and our colleagues?

  • Bruce

    I couldn’t agree more — let that radiance shine out!

  • Bruce

    Such dishonest prioritizing of money-seeking over everything else is always an ulterior motive, one that corrupts whole societies, but is especially ulterior in the healing professions. I hope that you are in a position to call this physician on this fraudulent overcharging — charging the full physician’s rate for service by a much less highly trained employee.

  • Bruce

    I couldn’t agree more!

  • Bruce

    I think that your idea of promoting more collective feedback from patients to doctors about the quality of their care is an excellent one: make it a regular practice to invite patients to address doctors, and participate in Q&A sessions to answer doctors’ questions about that care, at doctors’ retreats and other conferences. I also think that such practices would also help to foster a climate in which more one-on-one, doctor-patient “magic” moments, such as the one(s) that you recounted, would occur.

  • Bruce

    I AGREE!!!

  • PamelaWibleMD

    Healing happens when we are fearlessly real with one another.

  • Bruce

    Thank you, Geoffrey. I realize that we also need to get “Big” right — like intercepting exoliths [comets, asteroids] before they slam into our Earth, but, just as much, we need to get “Small” right too!

  • Bruce

    DITTO !!!

  • DoubtfulGuest

    I think it’s a disease or syndrome, actually, not a strategy they’re taught in school:

    Stonewall Syndrome:

    1. Symptoms: irrational fear/anxiety, defensiveness, poor coping, unexplained rage “episodes”, AKA “head in sand” syndrome, or HISS.

    2. Signs/presentation: appearance consistent with small frightened forest animal; a rare “slime-ball variant” has been reported in the literature.

    3. Some features of mass hysteria include but not limited to: office staff repeating inane phrases such as “We can’t change the past”, “We just don’t understand what you want”, unreturned phone calls, unrelenting “phone tag”, *crickets chirping* in response to patients’ letters

    4. Treatments: Self-care measures include: Pick up the damn phone and call pt. In-person visits with harmed patients are curative.

    *Asking a nurse who was not involved in patient’s care to call pt. is NOT an effective treatment for Stonewall Syndrome. Not recommended due to risk of exacerbating misunderstandings, i.e. “Clear As Mud Syndrome”.

  • Bruce

    Amen!

  • PamelaWibleMD

    Medicine is an apprenticeship profession. We learn from established docs how to practice medicine so very important to (joyfully) pass the torch. I befriend doctors who want to open ideal clinics. Most doctors just need to know that it is okay to be human and love their patients – and be happy! Here’s one that just opened in Salem, Oregon:

    http://www.youtube.com/watch?v=V_r0bQo4bc

    • PamelaWibleMD
      • Geoffrey Koerner

        Yipee for Lara and her patients! The gowns are so much fun and they double as interior decor, too!

        • PamelaWibleMD

          Yes. Something as simple as a homemade flannel gown can make all the difference.

  • PamelaWibleMD

    R.I.P – my sweet patient in the photo above died this morning peacefully at 7:00 am PST.

    • PamelaWibleMD

      12/10/13 7:00 am. I’ll never forget you . . .

    • Geoffrey Koerner

      I’m glad he died well and that you were part of guiding him onward.

  • PamelaWibleMD

    You have a right to express all your feelings Kerry.

  • Bruce

    Yes indeed!

  • Bruce

    You’re right, they don’t! Late Capitalism is degenerating into Corporatist State Capitalism, a species of “Murder, Inc.”, whose M.O. is “killing people for money”.

  • Bruce

    I think that only a radical change of direction will suffice to pull us up, out of the tail-spin that we are in, spiralling down toward a new Dark Age. I don’t think our health care system can be fixed apart from fixing the larger problems, of which the degeneration of our health care system is just one symptom. I think we need to recognize the necessity of a new increment of human rights and responsibilities. One formulation of this that I have seen is that of the Equitists, at http://www.equitism.org. They identify three new human rights that they want to see recognized in our constitution — “Citizen Externality Equity”, which gives every citizen a vote against pollution by each individual corporation that operates in their local environment; “Citizen Birthright Equity”, which gives to every child born, a trust fund, a completely portable social safety net, whose use by that citizen is regulated, and; “Citizen Stewardship Equity”, whereby self-organized groups of citizens with qualifying business plans, and qualifying democratic self-governance by-laws, can form producers’ cooperatives, competing in the marketplace, and be granted, by a public body, stewardship over plant and equipment that fits their business plan, and for which they must pay a monthly social rent, that helps fund the Birthright Equity trust funds, with equal sharing of net profits among coop members, but unequal, skills-based compensation for work-time. Such ideas aim at creating economic checks and balances, since our political checks and balances are ruined once corporations grow rich enough to prostitute the government — executive, legislative, and judicial alike. They aim to end the growing dictatorship of corporate capital, but NOT by converting it into an even worse dictatorship of state capital ["socialism"].

  • PamelaWibleMD
  • Geoffrey Koerner

    When our time comes close to leaving, I hope we all will be attended to with such deep care and compassion. Though I didn’t know the guy, I hope I’ll be as happy as he looked when I go.

    • PamelaWibleMD

      Yes. May we all pass peacefully surrounded by friends and family who love us. And doctors who are not afraid to leave a kiss on our foreheads. He is waiting in the funeral home for the ground to thaw with a big kiss on his head.

  • Geoffrey Koerner

    High-fives and fist bumps can be good beginnings.

  • Geoffrey Koerner

    Being treated as a human being is a wonderfully worthwhile thing. May she be as blessed as the rest of us have in being Pamela’s patients and friends.

  • Lonnie Stoner

    A good Heart and a Great Friend to All.
    Thank You Dr.Wible.

  • Nancy Bright

    Pamela is my doctor. Even though she is not able to accept the insurance company I use, I would much rather go to her than to my other doctor who is caught up in the system (and Pamela is always willing to trade or work out payments with me). Recently, I tried going to the doctor that my insurance company covers, but I left feeling like I had not gone at all. Expensive tests were prescribed (which I didn’t follow up on since they seemed like an absolute waste of time & money). I did not feel supported in my health and well being, but instead felt like I really didn’t matter. This was not the doctor’s fault, as she seemed like a fairly compassionate human being, but being locked into the system, she could not give me the time, attention, and care I was wanting.
    I LOVE Pamela! I must admit when I first started going to her, I had to get used to the very personal relationship she offered. Having been accustomed to stoic, distant patient/ doctor relationships, it took me back a little to visit with such a warm, friendly, enthusiastic, energetic and open doctor. But she is what we all need- loving, supportive, attentive care to give us ease when we are in dis-ease.
    Thank you from the depths of my heart, Pamela, for creating such a wonderful way to serve. Thank you for sharing and educating others- giving hope to all those doctors whose hearts and psyches need healing from the harsh system they encounter, as well as patients who seek caring, loving support in their most vulnerable moments.

    • PamelaWibleMD

      Ah . . . the solution for all of us is so simple: opening our heart to love ourselves and one another — without fear.

  • Michael Wasserman

    I always felt that my patients were my friends, and I treated them accordingly. Kudos to you!

    • PamelaWibleMD

      Bet you get high marks on your patient satisfaction surveys too!

  • PamelaWibleMD

    What patients really need is a human being who is being human.

  • PamelaWibleMD

    Dr. Kathy Alverez is great! Pass this on to her. We went to medical school together back in Texas about 20 years ago. . . .

  • PamelaWibleMD

    It’s the human relationship that heals – and protects from malpractice suits.

    • Bruce

      That — automatic protection from malpractice law suits — is the best “side effect” of a “main effect” — in this case, medical HUMAN relationships that enable real healing — that I have ever heard of!

      • PamelaWibleMD

        At a risk reduction workshop sponsored by my malpractice carrier, we were told of a woman who had a bad outcome and sought an attorney. He compiled a list of all doctors involved in her case. Before he began the claim process, he presented her with ten names. She reviewed the list and said, “Take them all to court except that one. I like him. He’s my family doctor.”

  • PamelaWibleMD

    Amazing actually.

  • PamelaWibleMD

    I often speak to med students and many tell me they have lost their way and that they no longer feel a passion for medicine. This widespread cynicism starts within the first month or two of medical school (and residency). Many students tell me that they are exposed to older docs who belittle their dreams. They are told that family medicine is a dying specialty, that they have to sign on with big groups, that there will be no such thing as a small-town solo family doctor . . etc . . .

    Recently I sat down with a first year med student and . . .

    1) I asked him to tell me about his personal statement.
    (It was a wonderful description of a family doc)

    2) I asked him how much he is paying for his medical education. (50K per year tuition)

    3) I reminded him that he was accepted to med school based on his personal statement. He’s there to learn a skill set that will allow him actualize his dreams. He is not there to be talked out of his dreams.

    So, Erin Martin, remember who you are. Hold tight to your dreams of being the doctor you always wanted to be. Remember: You are paying tuition to become THAT kind of doctor, not to be talked out of your dream.

  • PamelaWibleMD

    I feel most med students are in their hearts humanitarian idealists (somewhere deep inside – some more hidden than others). It is our training that dehumanizes these once bright-eyed students into burned out doctors. It is NOT that we need to teach students to have heart and soul. We need to stop killing their hearts and souls in our training. Many students graduate with PTSD from med school. It is a tragedy.

  • Bruce

    Sheri, I think that, “to turn the beast around”, deeper changes will be required than even just a thorough reform of our medical “care” system. We need to restore our constitutional, political “checks and balances” against the increasing prostitution of our governments — executives, legislatures, and judiciaries alike — to Big Corporate Big Money. But, to do that, the people will have to amend their constitutions — federal and State — so as to install new ECONOMIC checks and balances, via several newly-recognized Human Rights, Human Rights that are necessary to be stated explicitly now if we are to maintain/RESTORE democracy and the rule of law today.

    • PamelaWibleMD

      Doesn’t all of this start with finding ourselves? Rediscovering our hearts and souls? When the people lead, the leaders will follow. How can we legislate love & caring anyway?

      • Bruce

        People finding themselves, rediscovering their hearts and souls, rediscovering the power of love, eclipsing the “love of power” — all these may ultimately obviate “legislation”. But, based upon all human, historical experience that I know, I cannot see that kind of self-conversion reaching critical mass any time soon. Until it does, constitutions, bills of rights, the rule of law, and, yes, legislation, represent gigantic steps forward in human progress, and serve to protect millions — especially defenseless children — including from the kinds of hyper-traumatic experiences that derail whole lives, shut down people’s hearts, and bury people’s souls.

  • Bruce

    Your diagnosis of the disease(s) of our ‘disease system’ is right on the mark — perhaps the clearest, most discerning — and briefest — that I have ever read! BRAVO!!!

  • Bruce

    Why don’t we start adopting the best we can find from other ‘medical cultures’ worldwide? “Best practices” should include ‘best emotional practices’, and ‘best human[e] practices’ in general!

    • PamelaWibleMD

      Yes. We are hyperfocused on technology and we are losing our humanity. Reminds me of the MLK quote: “Our scientific power has outrun our spiritual power. We have guided missiles and misguided men.”

      • Bruce

        I think that you are right about a one-sided focus on medical technology, but I also think that technology is a boon if used with wisdom and heart. I think the cause of the one-sidedness runs far deeper. Medical “high technology” — and high-priced, high side-effects, “high tech” pharmaceuticals — are HIGHLY PROFITABLE, in the short term, for Big Corporations, so that the technology bias is just a special case of the over-pursuit of profit-at-any-cost bias. Re-balancing will require, I think, that humanity wean itself off of the true majority single world religion — in the world today [in terms of the religion that is actually practiced by the majority]: The Worship of Money [of Profit][of Capital], and the sacrifice of EVERYTHING ELSE to this jealous and hungry “God”.

    • Craig Einhorn

      Several years back Taiwan was planning a health care system and did just what you suggested. They sent people all over the world to study health care systems. Their reps in the USA reported back that there’s nothing in our health care worth implementing in Taiwan. In other words they thought we had a lousy health care system and they were right. Now they have one of the best health care systems in the world.

      • Bruce

        Good for the Taiwanese!!! But what a shame, on we who are Americans. Even if Americans cannot always hope to be the best in the world at every single thing, we can surely do far better than this!

  • PamelaWibleMD

    They don’t.

  • PamelaWibleMD

    I kept my soul alive. Cried a lot. I’d rather be in pain from all that I witnessed than to be numb.

  • PamelaWibleMD

    Ultimately we all want INTIMACY (in to me see) and yet we resist revealing who we really are to each other — and to ourselves. It is when we are willing to be real, authentic, and integrated (body-mind-spirit) that we experience healing. All physicians are role models. The question is: what are we modeling for our patients?

    • Bruce

      In your case, at least, we begin to see what a worthy physician role model would look like. And what a wonderful revelation and inspiration it is to behold!

  • Sydney Ashland

    The back story here, is that this man in the photo recently died. He died knowing that his physician truly cared about him as a person. She made numerous housecalls, comforted him when he went on hospice, and was available to him. Pamela did not ignore physical, emotional or spiritual needs of her patient.

  • PamelaWibleMD

    What the world needs now is . . . radical love.

  • PamelaWibleMD

    Comment from Mark (who could not log on):

    Care in medicine is the first treatment, a main treatment, and many times the only treatment necessary. Conventional medicine does not appreciate the power of the mind in healing; or that the mind critically directs immune response, and healing (what does the conventional doctor know of the healing process?) at many levels. When medical treatment is used to support heath and well being with caring rather than be another adverse pressure on it then outcomes will be improved with any procedure or prescription. For a doctor to care for the patient literally improves their health in all ways (there is physiologic reasons for this also (wave mechanics of medicine, see for example “The Quantum Mind” by RM Bergland MD)

    And insurance is not medical care, detracts from it at best; does not save overall medical costs, only adds to them.

    Mark

  • PamelaWibleMD

    Keep the original vision alive. Always be true to your personal statement and the vision you had when you applied to med school. You can be the doctor you always dreamed of.

  • PamelaWibleMD

    It’s all about being human, keeping it real. So simple really.

  • Josephine E. Drew

    Dr. Wible you are my bold, beautiful hero. Thanks for sharing your caring. I also hug and kiss my patients. It is much more rewarding to share in their joys and sorrows than to deny our “physician-selves” such an essential part of our humanity.

    • PamelaWibleMD

      It is the joyful moments that keep us in this profession. Why not experience the pleasure of bonding with our patients?

  • PamelaWibleMD

    Synchronicity!

  • PamelaWibleMD

    Would never happen in Argentina. Some countries are more comfortable with PDA (Public Display of Affection) which is not always sexual. Humans are social animals.

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