Connect 2.0: Healing the Doctor-Patient Relationship

|| Hari Om ||

For those of you who do not know me personally,

 a brief introduction:

 

 I have completed my MD in General Medicine from KEM Hospital in 

September 2020.

I joined Tata Memorial Centre, Mumbai as a Senior Resident in Medical Oncology in December 2020.

This is a collection of my thoughts and feelings that I have imbibed in my Oncology residency. This is a branch that not many are ready to step into. A branch everyone, patients and doctors alike, associates with suffering. But where there is suffering, there is hope. And in the midst of darkness, we appreciate the light even more.

Connect 2.0: Healing the Doctor-Patient Relationship

This blog post is a continuation from something I had written as an MD General Medicine Resident. "Connect" was a concept that I visualized, where doctors and patients get to know each other better as people, get to understand who and what they are, when not bound by health and disease. People, getting to know other people. No hierarchy.

Now, I’ve spent almost a year as a Medical Oncology resident at Tata Memorial Hospital. 

Medical Oncology in many ways differs from the rest of medicine, in that we are not always treating to “cure” and that simply disease control or symptomatic relief are also acceptable outcomes. The branch of oncology is very vast and complex, and as a junior “Senior” resident, there are many questions thrown my way by the patients that I may not be able to answer immediately. Work is exhausting, hours are long and the reading matter is more exhaustive(and exhausting) than I’ve ever encountered before. But all said and done, work is very rewarding.

More rewarding still is the lives we touch and stories we see unfolding in front of us.

 

Most of what I’m writing here is not just about myself, but things I’ve observed from my teachers, seniors and colleagues, and of course our patients

At the end of the day, people are people. Both doctors and patients have the same needs, wants, likes and dislikes as anyone else. True, we are bound together as the sufferer and the healer, but that doesn’t really change who we are as people (or at least it shouldn’t).

Also, we doctors invariably end up spending more time in the company of our patients than we do in the company of our families. If you’re spending so much time with someone, you may as well get to know them well.

 

All it takes is a little conversation. A few sentences more than the basic: “ How many times did you get fever today ?” , or “How is the nausea ? “ . A few sentences that remind the patients that we are human too. A short conversation on cricket, the news, politics, a snippet about the latest Bollywood gossip, or even discussing our favourite singers! All it takes is a moment to form a connection, to provide a topic to discuss, to laugh about. To smile, together. 

 

Here, I feel the initiative lies with the doctor to spark off the connection. 

 

Patients often hesitate to ask questions even regarding their illness, making off topic conversation a distant entity. Once you open the doors, there’s so much more you can learn about each other. In fact, once there is a normal conversation going, people feel more comfortable sharing their problems. People. It is not just patients who can share their problems. We doctors have problems too. And more than that, we have small joys that we want to share as well. Before you know it, you end up sharing tiny bits of each other’s lives. You know that patient X has been staying away from her dog due to chemo, and really misses him. You know that Y is an artist and has promised to show you some of his sketches at the next visit.  You know that the elderly gentleman, bedridden with high fever, is a professor with a mind sharper than Sherlock and looks forward to playing a game of chess with you once his fever settles. Suddenly, you have a tonne of well-wishers for a sports event you are going to as fun, and actually end up winning something! You get the idea.  We share prasad from poojas at our respective homes, and stay in the hospital like a family. 

 

Does that mean that there are no rules to be followed ? Well, not at all.  Particularly for patients on chemotherapy, there are a lot of restrictions to be followed. A degree of discipline is definitely necessary. But discipline is so much easier to digest with a topping of love. 

 

Diagnosis, treatment, planning, cure, control, palliation, decisions: these are all the big things. These are the things we always have covered.

But is Healing in the big things, or is it in the smallest of things?

Healing is visiting a doctor who remembers you by name when you visit after a gap of 2 years. Healing is visiting the person who remembers that you were having problems looking for a job, and asks how that is going. Healing is sitting down with a friend and discussing the places to visit in Mumbai after the treatment is complete.

 

Healing is meeting a patient who tells you that she doesn’t know if she will be well at the end of the treatment, but that you have made the treatment journey a very pleasant experience.

Healing is seeing one more person smiling because you have touched their lives, and they have touched yours. A bond that lasts forever.

 

When we take the time to get to know each other, what is it that we are healing ?

Are we healing the disease: not really, we had that covered with the treatment. What we are healing is Faith. We healing the Faith of the patients; they believe that the person who is treating them is doing so out of genuine goodwill. They know that they are more to us than just an investigation chart, a collage of lab reports and vital parameters. They are living breathing human beings, and the people treating them are human too. 

 

We are also healing our own faith as doctors. Healing our faith in our profession, in ourselves, in our ability to do good. This is very true in oncology, where outcomes measures are very different, but equally true to the rest of medicine. 

The moment we remember that we are humans on both sides of the table, just cast in different roles by health and disease, we automatically step down from the pedestal. 

Not deities to be worshipped, not villains to be attacked when things go wrong. Just people, plain and simple; people just like the patients themselves.

 

True, the hospital is a busy place. The work itself is so much, that this kind of extra-curricular conversation, so to speak, really seems impossible.

 

It is impossible, if you treat it like another task on your To-do list.

·      Vitals

·      Temperature

·      Auscultation

·      Conversation

 

Life doesn’t work like that. 

 

Instead, make this connection something natural, a part of the way you live your life. 

Offer the same courtesy to your patient/ doctor that you would offer to anyone else.

We can be a very caring species, let us be so where it matters most.

A slight shift of perspective, and everything changes. As doctors, we can’t guarantee that the treatment will be pleasant. What we can do, is create an environment where our patients look forward to meeting us, to speaking to us as friends.

 

A few years down the line, you will get a phone call from a person you met ages ago, and you will talk about everything except medicine, everything except treatments that may or may not have been successful. Just a person, catching up with another person, to find out how they’re doing.

This is the most rewarding thing of all. 

 

P.S. The concept of "Healing the Faith" was actually something that was said to me in the context of the doctor- patient realtionship. This was the inspiration behind this blog post 😇 

Here is a link to my previous article: "Connect"

https://arnavht.blogspot.com/2019/03/connect.html

My older blog posts are listed at the top of the page.
If you liked this, do read the others too!

-Dr Arnav H. Tongaonkar ( DrArnavMHT) 

Senior Resident, Medical Oncology

Tata Memorial Hospital, 

Mumbai

 6/11/2021

|| Shree Ram ||.    || Ambadnya ||. || Naathsanvidh ||