Patients are not stereotypes

Perhaps one of our greatest assets and strongest detriments in medicine is our ability to look at a patient and make a quick, thorough assessment of his or her condition and state of distress. Certainly, a good clinician is able to triage and provide greater quality of care in the emergency room if he or she can use the intangibles of a patient’s presentation to provide them better quality of care.

However, more often than not this skill set carries over into judgment of a patient’s character or personage to a level that actually disrupts our ability to provide patient centered care.

She has been in here ten times this month, she must be pill seeking.

Look at how disheveled that family is, what are those parents thinking.

He is morbidly obese — there is no chance he will listen to any health maintenance advice I give him.

I know this family, nothing that I say will convince them to adhere to their treatment plan.

Nothing has struck me more during my brief, 12-month foray into the medical field than the limitations that are placed upon us by these snap judgments. Indeed, I have caught myself making these decisions and assumptions repeatedly.

I can recall the eccentric patient who seemed to have difficulty in speaking yet was a high commander and special operations member in the military. The patient receiving palliative care who seemed so weak and fragile while lying on the bed, yet he came from an incredibly successful boxing career. The reticent young girl who seemed ready to disregard any and all physician advice, but who in reality was terrified by the implications of her menstrual cycle disruption.

I am barely a quarter of a way into my medical education, and I already am so struck by the detriment that quick judgments could have on my ability to be an excellent clinician in the future. How easy is it to forget that patients are not stereotypes, that people are certainly more than the sum of their parts, that patients fit into boxes just as frequently as diseases obey the “rules.”

All of these observations have convinced me of the fact that empathy is more than saying I’m sorry for your loss at the right time.

Empathy is more than trying to understand a patient and walk a mile in their shoes. Empathy is in many ways, a practice of exclusion. Empathy is the solemn refusal to let the quick assessments that have guided so many of us in our careers thus far determine how we treat a patient. Empathy is walking into each and every patient’s room with a commitment to see them as nothing more than a person with hopes, dreams, and aspirations that likely mirror many of ours. Empathy is giving our patients the benefit of the doubt, trusting them to understand their own pain, and then asking them to trust us enough to heal it.

It’s a relationship of mutual trust and understanding. A relationship that begins with each of us who practice medicine in any way walking into the room, smiling, and reminding ourselves that the person sitting in front of us is, quite simply, just that: a unique person.

Kathleen McFadden is a medical student.

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