Patients can spot the fake: They need the authentic

“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”
– Albert Einstein

“Miracles happen every day; change your perception of what a miracle is, and you’ll see them all around you.”
— Jon Bon Jovi

“The miracle is this: The more we share, the more we have.”
— Leonard Nimoy

It is amazing when things in medicine work just the way they are supposed to —  it’s like a miracle.

When I take an antihistamine, I can breathe, and all the itching and sneezing stops. When I get an injection of local anesthetic, I can touch and poke and pinch to test that it is working — and it is. When I had an operation on my knee, an ACL repair, my knee stability was noticeably restored almost immediately, despite the post-op pain and swelling. I know these things work on patients, because books, observations, and experiences have shown me so. As a surgeon, I get a kick out of operating on acute appendicitis, where often even in the recovery room immediately after surgery, the patient already feels better.

Yet I still marvel when I notice that this stuff is working on me.

I used to worry that as I entered the world of science, and then medicine, I would lose the ability to see beauty, to appreciate and be amazed and awed by the world around me. I worried that the more I knew about the details of how things worked, that I would not be able to see the glorious whole, the big picture, whatever that big picture might be.  Would the biology and chemistry and biochemistry and physics become like a filter on a camera lens, changing the way I would see these things? As I got deeper into this world of science and medicine, and then surgery, I was concerned that the experiences around me might overwhelm or blunt my humanity,  become mundane. Would I  become callous, detached, dispassionate? Would I still feel? Would I lose my faith, whether in people and humanity, or even more?

Thankfully, blessedly, those fears have not been borne out (although admittedly at times feelings and faith have been strained, tested).

On the contrary, my sense of awe and amazement has been heightened by what I have learned in science and medicine, and humbled by the appreciation of what we as scientists and physicians do not know. My appreciation of the beauty around me is not diminished by my understanding of component parts. I am perhaps more amazed now than before that it all actually works, both form and function. More often that not, my faith is boosted not destroyed.

I did not have to worry about not feeling. It is true that it would be hard to be professional and function as a ball of raw nerve and emotion. But it has been important to me to preserve a piece of myself in a space open to the humanity and feeling in my interaction with patients. I see them in critically important times, if not while critically ill, and that humanity is part of the bond and the relationship. They want a doctor, but they also want a real person who not only cares for them but cares about them. They can spot the fake; they need the authentic. There is incredible trust and intimacy in the physician-patient relationship and in that bond, and it works both ways — the only way to get it is to give it. I honor and respect that trust, and the best way I can do that is to give me, a piece of myself.

I appreciate how the patients must feel as they proceed through consultation and evaluation, treatment, procedure and operation, and healing and recovery. Each step of the way brings little bursts of amazement as signs and symptoms yield a diagnosis, as diagnosis leads to treatment, and as healing and recovery progress, function restored as they return to their lives. This is the ideal, and sometimes it doesn’t quite work out this way, despite our skills, despite what we had hoped or planned. The disease or injury may be too much to overcome, or a complication may intervene, function may be diminished from what it was before. But most of the time it does work out, and that is a little miracle.

The little miracles surround us every day. The trick is to keep our eyes open, to notice, and take a moment to let the amazement sink in, and shine out.

Kathryn A. Hughes is a general surgeon who blogs at Behind the Mask.

Image credit: Shutterstock.com

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