This episode was during my elective time in India in the late winter of 2017. It was a patient-centered learning opportunity for students around the world who has an interest in medicine. I was excited about this because of my earliest clinical exposure to patient encounters as a medical student. I was excited to meet the patients, talk to them, and help them despite the uncertainty and emptiness in my mind. I was uncertain as to what I should do to make them feel better and how I could make a bond of trust and empathize with them. I observed my attending physician, Dr. RB, interact with patients during morning rounds and in outpatient care. I observed Dr. RB spending over an hour after each patient, taking a detailed narrative history from them and digging deeper into the patient’s life, the adverse consequence that brought them to seek care, looking for medical cues, picking a very tiny detail in a history that would just be ignored by any physician in a busy OPD. This instilled in me more confidence and encouragement to learn deeper about a patient’s life.
I was more fascinated when I got more exposure to patients and listened to their life stories, their survival, triumphs, and failure, their perspectives, and social life that influenced what they are and how they are functioning. The wonderful moments were spent with the patients, their family members, and their well-wishers. Being able to respond to the suffering of human fellow with empathy and listening to their comments, answering their concerns. Here are some of my interactions with patients.
1. A middle-aged man admitted to an ICU with an acute asthma attack was ventilated and developed hospital-acquired pneumonia after a few days. His son was very concerned, and while sitting outside praying for an early recovery, he used to ask how his father is responding to antibiotics every day. When will his ventilator be weaned off? How is his pneumonia? Is he taking food? I listened to their query and concerns and tried to answer those. After a 28-days of long hospitalization, when he got discharged, his son and the patient said, “After interacting with you, it was like someone was there who was listening to the concerns and explaining things so clearly about my health which made a sense of hope that I can recover back. May God bless you for your help, and please keep this care and dedication for your patients forever; they really need it.”
2. One day, I was following up with patients in ICU and examining the patients. Suddenly an elderly patient called me from the back and politely asked me, “Dear doctor, I am feeling very cold and not able to tolerate this air conditioning. Can you ask someone to cover my body with a blanket?”
I replied, “Sure, sir, I am doing this for you.”
While after covering his body as I was going back, he whispered again and said to me with surprise: “Doctor, I didn’t think a doctor would help to cover me with the blanket. I am so happy that you did. Thank you so much!” He continued to ask me: “Would you mind if I share my problems with you?”
After I nodded happily, he started getting emotional and shared his life problems and concerns with me. Before I finished the conversation and left him, he said, “May God bless you, doctor!”
3. A 50-year-old lady was admitted to the ICU with an altered sensorium after several times of severe vomiting. Soon after gradual recovery, the patient was transferred to the floor. One afternoon, I went to encounter her, and at the end of the interaction, she said, “Hey doctor, I am not feeling happy here. Nobody cares and looks after me as much as I would get at home. I have been asking for a shampoo packet, a toothbrush, and toothpaste since the morning, but nobody has responded back. Can I request you to bring this for me tomorrow morning?”
Next early morning, I went to a shop far from the hospital and bought them for her. The untold expression through her tearing eyes after giving all those taught me that medical care needs to be more human-centered. The lady was again admitted to the emergency department a few days after discharge with the same complaints, but nobody could save her this time, and she died.
After all the interactions with the patients and their family members, and knowing their life stories, struggles, social life, concerns, their expectations in the care, I must admit and quote from one of my elective fellow Madhava Sai Sivapuram:
I still remember the day Dr. RB said everyone can learn medicine it is just understanding in a simple way, and from that, my way of looking at medicine has changed. And the part I learned from him is that to explain about the disease to patients or kins irrespective of their educational background in the most simple way possible and sometimes patients himself understands what he had to do.
Being a survivor of congenital heart disease and after closely interacting with patients and experiencing their life perspectives, the meaning of life, and demands from the health care team, I learned our approach to patients should not be limited to just naming them as subjects, case number, bed number, tagging them with just a disease. Rather, we need to appreciate empathy for our human fellows, and the care should be more human-centered that meet their full requirements. This demands not just medical care but cares that a human would expect from their son, brother, sister, wife, or family in any adversity of life.
Vivek Podder is a physician in Bangladesh.
Image credit: Shutterstock.com
