It was an ordinary afternoon in my outpatient internal medicine rotation. I prepared to enter a room for a congestive heart failure hospital follow-up patient. I mentally prepared myself. I was going to ask for his hospital records (particularly looking for the echocardiogram), make sure he was started on an ACE inhibitor and a beta-blocker, and ensure he had a follow up with a cardiologist in the coming weeks. “This is going to a simple hospital follow-up visit,” I thought to myself. Little did I know what the next 30 minutes had in store.
Time and time again patients’ words put medicine and my life choices into perspective. I remember when I applied to medical school, the number one reason I wanted to become a physician was to provide health care to everyone regardless of their circumstances. Health care, in my opinion, is a right that everyone is born with because everyone deserves the opportunity to live to their full potential. When I said I believed health care was a right, I think I automatically meant medical care: access to physicians who can perform the necessary history and physical and steer patients toward the right management with diagnostic tests or medicine.
This afternoon in clinic, I came across a woman, Mrs. X, and her husband, Mr. X, who taught me what it really meant to have health care. Mrs. X, maybe in her 80s, told me about her husband’s battle with chronic pain after a motor vehicle accident several years ago and his recent hospital admission for heart failure. After listening to their story and a subpar hospital experience, I simply said “I’m sorry. You seem to be going through a lot lately.”
Her response was one that I did not expect. She said, “I appreciate you saying that. You know compassion is something that still can’t be bought anywhere online. Compassion is free to give.”
At that moment, my definition of health care was altered. When someone asks for health care they are not only asking for medical diagnoses or treatments; they are seeking a person who will understand their struggle through a human connection. Compassion is just as much a right for every individual as is actual medical care. At a time when everything is accessible online and people can buy anything in an attempt to build their happiness, they forget the joy that empathizing with each other brings. Humans are special for this; we have the capability to relate to each other. Electronic medical records, cell phone applications, even electronic blood pressure machines are continuously building distance between two individuals who are meant to communicate and share their thoughts. In a world where we continuously debate what will be deemed a commodity and what will be a human right, as physicians we can only emphasize that regardless of financial or social situations, compassion is a right that all our patients deserve if they’re coming to us asking for help. Mrs. X and her husband had been in the hospital for the past five days, frustrated for one reason and another, and in all the professionals they saw, no one simply sat down and said: “I’m sorry you’re going through a difficult time?”
Mrs. X continued her lesson for me.
“You know our hearts are connected. I’ve been with him for more than 50 years, when he’s in pain, I feel the pain too,” she said.
I smiled and nodded as I saw the tears build up in her eyes. Mr. X had suffered an MVA in which he broke several bones and suffers from chronic pain as a result. Repeatedly, when he is in the emergency room, his pain is dismissed. She said she has been making sarcastic jokes to him (out of pure love) their whole lives, but the second that someone else hurts him, it boils her blood.
“His blood is flowing through my body too, you know,” she reemphasized.
I gave her a soft smile, but I was only masking the disappointment I felt. I was embarrassed. I was a part of the medical profession. It is our profession as a whole failing to judge and cure the ones who need relief from pain. I looked at the patient, Mr. X, and he simply smiled. Mr. X, also in his 80s, sat quietly in his wheelchair looking down at the braces on his legs while she talked. He looked as if he had given up all hope. I believed every word Mrs. X was telling me at that moment. We continuously write off patients as pain medication seekers because we’ve been fooled one too many times. We’re scared of the laws that rule how we practice medicine in case we prescribe too much of a medication. We have failed as a system to put the patient first. We put our legal duties ahead of humane ones.
I know some of what I’m attesting to is simply impossible to practice. For better or for worse, legal ramifications are a major part of medical practice and keeping it in check. However, to sit down and understand what a patient is experiencing is the least we can give our patients. Sometimes it is the only thing we have to offer. Compassion is free; abuse it all you can; there are no negative consequences for using it too much, and best of all: The benefits will always outweigh the risks. Maybe once in a while, you’ll even catch a patient who is suffering from pain that can be controlled and we could be their only hope to a pain-free life ahead.
Nidhi Desai is a medical student.
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