Sitting with a patient: The least practiced communication skill

In a voice confident and ringing with anticipation, Mr. A explained with meticulous detail how he determined which approach shot to hit to the second green on the Black Course at Bethpage State Park.

Only ten minutes earlier, when we first met, Mr. A had been weary, his face drawn, and his speech so quiet that the sound of the aortic balloon pump keeping him alive made it nearly impossible to hear his words. Now, we were sitting together on his bed, geeking out over golf.

When my grandmother was caring for my ill grandfather, she had expressed unflagging confidence in his physician. As a young doctor-in-training, I was hungry for insights, so I had asked her what qualities she saw in him that made her so certain about him.

Her answer: “He talks to us. He sits with us. He takes time out of his busy day to let us know that he cares.”

Sitting with a patient — how simple. Yet it is among the least practiced communication skills for doctors. This, in spite of the fact that research shows it can make a big difference in patient satisfaction.

My grandfather passed away not too long after that discussion. And even though some evidence seemed to suggest it was the fault of the physician, my grandmother’s confidence didn’t for a moment waver through his dying days.

I was instructed to prepare Mr. A for emergency cardiac surgery that evening. The attending surgeon had been traveling, and the plane had just landed, so we knew the operation would be in the next hour or two. At first, I stood at the foot of the bed, chart in hand, diligently filling out paperwork. But in time, a discussion started about the activities Mr. A had enjoyed prior to the onset of his heart issues. Golf, golf, golf … hmm. Me too, I told him.

We spent the next hour talking about each and every hole on the Black Course, and the incredible amount of strategy it takes to walk off feeling like you deserved a seat at the 19th hole. The Black Course is famous in golf circles, especially for those of us from Queens or Long Island, and we each had experiences and ideas we were eager to share.

Just as we finished discussing our 18th hole strategies, the aides came to wheel Mr. A away. He asked for two things. First, he wanted me to assist in the surgery to watch over him. And second, he wanted to play the Black Course with me when he was better.

“Deal.”

I assisted in surgery that evening. The procedure went well — technically. But at the end of the procedure, Mr. A’s heart didn’t have the strength to start pumping on its own again.

I stayed with Mr. A that night until he was brought downstairs to the morgue. I then stayed with his family and shared things I remembered from the hour-long discussion I’d had with him before the surgery. “We wondered why dad thought you were one of the best doctors around, even though you’re only an intern,” they told me.

Exhausted, scared, and wondering if I could ever again go through the death of someone I let get inside my head, I left the hospital. My golf sticks were always in my trunk, so I decided to go to the second hole “on the Black.” Using the advice just gifted to me, I hit the best approach shot of my young life.

I left the ball there as a parting tribute to Mr. A.

Howard Luks is an orthopedic surgeon who blogs at his self-titled site, Howard J. Luks, MD. This article originally appeared in The Doctor Blog.

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