When Physicians Have the Power to Sting – or to Support

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Today’s guest author is Carolyn Thomas, a heart patient living on the west coast of Canada, as well as a blogger at Heart Sisters and author of the book “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press, 2017). She’s sharing a personal essay about the influence and power of small gestures in a clinical encounter.

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Last year, I read a compelling patient essay in the BMJ (the British Medical Journal) written by Sharon Roman, a woman who had her first attack of multiple sclerosis at the age of 30. As you can imagine, this means that Sharon has encountered lots of physicians. Those doctors, Sharon observed, hold a unique position in our lives.

After a close friend told her about a distressing encounter with a dismissive physician, Sharon observed:

“Doctors are in a position to sting or to support like few other professionals can, being privy to intimate details and personal history, and knowing things that often aren’t shared with others.

 “I have had the incredible relief of hearing the words ‘I believe you’ - as well as the empowering ‘I believe we can lessen your pain with exercise.’

“Belief is key—but not just for patients. Doctors need to believe that they themselves can sometimes be a placebo and influence a patient’s life.”

Surprisingly, even how a doctor’s waiting room looks - whether dark and dated or chic and expensive – can be where that influence can start.

“When my doctors come out to meet me and show me in, their greeting and broad, sincere smile brightens any room to me,” Sharon explained. “No amount of expensive decor could best that feeling.”

I found myself nodding in agreement as I read Sharon’s words. Some of the most unforgettable medical moments during my last decade as a heart patient have involved what may seem like the smallest of personal encounters.

Consider these examples:

- the cardiac nurse who gently held my shoulder as she walked alongside the gurney wheeling me down a long hallway toward the CCU post-heart attack, and whispering softly: "You're in the right place now, and we're going to take very good care of you here."

- my wonderful cardiologist who has a touching habit of greeting me at each appointment by taking my hand carefully in both of his own.

- Tina, my favourite hospital housekeeper, who after 40 years of keeping patient rooms clean and safe, still prided herself on remembering "her" patients' names, seeing them as real persons, and never as just "the MI in Room 8.”

Describing tiny gestures of kindness and caring like these doesn't do justice to the immense impact of such small moments on patients who are ill or scared – and our family members.

And the good news: each gesture takes no more time during a busy person's normal work day than the dismissive and hurtful conduct experienced by Sharon’s friend.