A Blog About An Asian Medical Student. Yes that's redundant.

Thursday, July 8, 2010

David Poon and the Road to Medical School: The Healing Touch

aka Take Your Kid to Work Day
aka Mothers Know Best


My Mommy is the best doctor I know.

I want to practice like her someday.

And it’s not because I love her like a mother (which is true).

And it’s not because she’s paying for my fast food (which I eat in moderation).

And in particular, it’s certainly NOT because she bought me a gym membership and a personal trainer for Christmas (which I DO NOT NEED).

No, her enduring skill as a physician is something medical school admits is nearly impossible to teach.

She lives for compassion.

That’s a rarity.

See, all my life, I’ve been compared to how similar I am to my Mommy.

No, not because I’m girly.

No, not because I wear her dresses.

No, not because of my high pitched voice.

And I know what you’re thinking, no, not because I like men.

Cause I don’t.

I don’t like men.

I mean as buddies.

But not those kind of buddies.

You know. Those kind.

I like girls.

I just don’t like what girls like.

Such as men.

See, the critical similarity between my Mom and me is due to the fact that I’ve tried to emulate her compassion for all people, her unyielding faith that good begets good.


Lemmie tell you about urinary tract infections (UTI).

This is what happens, usually to female patients, when improper toilet hygiene is practiced. In simpler English, when a girl wipes from back to front, or doesn’t shower well. It’s also pretty common when you don’t drink enough water.

It’s not particularly hard to treat usually, just rehydrate the patient and administer antibiotics.

Seriously though - the most frustrating thing you get to treat on the wards.

There are just so many.

And they are (for the most part) so preventable.

Now medical students, say it with me. You’ve all presented this patient to your attending:

“80 year old female with no significant past medical history presents with 3 day history of symptoms consistent with delirium…”

“Okay that’s enough,” your preceptor says.

“Why?” you innocently ask, knowing EXACTLY why you don’t have to say another word. 

UTI.

The number one reason we get paged at 3am on our Friday night call shift.

Hang the IV, start the normal saline, ask the nurse to administer the antibiotics, don’t forget to thank her in Tagalog.

… and then the patient starts crying.

Oh no.

She’s going to dehydrate herself some more.

Sometimes it’s hard to understand. All of this could be prevented if she just drank a little more water. If the family stayed around and made sure she was clean.

But before you can go console the poor lady, you’re paged for the next 75 year old women who was brought to the ER by her children cause “she didn’t look right.”


See in medicine, the faculties have trouble teaching us patient centeredness because

1)   No one shows up to the non mandatory classes of Patient Centered Care (PCC)
2)   It’s hard to prove that listening to how a grandmother’s son doesn’t visit often enough can shorten her hospital stay. We call it RCT, randomized controlled trials, that are a system of proving if particular treatments work. If it’s not proven, we don’t do it.

I remember telling my Mom about this. I told her

“What can I do! The treatment is simple! There’s nothing more I can do! But these poor women, the problem is at home, no one is bringing them water, no one is helping them bathe, it just keeps happening!”

Yeah yeah, I know, I talk to my Mommy when I have girl troubles. Who doesn’t?

Mom told me this:

“David, these ladies, from what you tell me. They just want someone to talk to. Hold their hand, dry their tears. It’s not the antibiotics that will make them feel better. Talk to them, listen to their problems. They’ll really appreciate it.”

And that is the kind of doctor she is.

It shows – her patients love her.

She won some award for “Hottest Woman in Regina” a few years ago from our local paper. That was fun, though I admit as a son, I have… ABSOLUTELY NO IDEA HOW TO PROCESS THAT IN MY BRAIN.

Regardless, she’s known to her patients for her friendly demeanor, her big smiles, laughs, and hugs, in addition to multiple costumes just for jovial fun.

She loves her work, loves medicine, loves her patients.

There was a custodian working in Regina. Great guy, great personality. Wasn’t a big name, no real status, but needed help.

And that would never matter to Mom. People were people and that was that.

He would become her patient, as would his family later on. They developed a friendship. Not for wealth or popularity. Just because people are people, and people can be friends.

The man was trying to become an entertainer.

And yes, he did succeed.

Over the years, the man’s music career would blossom.

Of course there would always be the strange phone call I would get at home.

“Hello?”

“Hi David. Can you talk to your Mom for me? I’m starting to come down with a really bad sore throat and I better get it looked at before my show next week.”

“Don’t you just like, eat oregano or something? That’s what Kevin from the Backstreet Boys says.”

“…”

“…”

“You’re really a medical student?”

He has become one of Saskatchewan’s biggest acts, and a tribute artist that makes all aforementioned little old ladies swoon to the front of the stage.

They just have to share the front with Mom – this King of entertainment always keeps tickets for her.  Sings at a lot of our functions too.

Obviously friendship isn’t always in fair-weather.

It’s the dark times too.

I remember a patient of hers who later moved to Vancouver. Dying of cancer, alone without family, he contacted her. Asked her to visit while she was passing by BC.

I’ll never forget how she comforted him as he was dying.

There was absolutely no obligation for her to be there. She couldn’t bill, not that she would want to. She didn’t tell people she was going to do that, she doesn’t’ care about the accolades.

From the goodness of her heart, she is there for a person who needs her.

If they need a hug, if they need a friend. She can be confidant, secret keeper to the biggest cheer in the auditorium. The friendliest face at your kid’s birthday party, or the explanation the family needs at your grandpa’s funeral.

For patients who have no transport – she brings medications to their homes.

For patients who have nothing to eat – she offers whatever she has.

For patients who have no one – she shares her friendship.

For patients who need a hug – she gives a hug.

For patients who need her not only as a doctor, but as a person – she is there.


My Mommy is the best doctor I know.

I want to practice like her someday.

And I never will be able to.

Today…

We live in a world where distrust has superseded benefit of the doubt.

We live in a world where litigation has more weight than compassion, and form filling is more meaningful than smiling.

We live in a world where befriending a patient is considered a conflict of interest.

We live in a world where a grateful person must second-guess himself when offering a free seat to a concert, for fear of looking like he’s bribing his doctor.

This is a world where smiles, laughs and jokes are crushed under pretenses of political correctness.

This is a world where doctors are sued for not ‘catching’ cancer early enough.

This is a world where a doctor trained today who wouldn’t dare go to a private residence to a former patient, no matter how alone. No, the terrible risk of getting sued, even if the doctor didn’t treat the patient at all, is too much of a barrier to allow that sort of kindness.

We are in a world where even seeing your patients outside the wards raises a public eyebrow.

We are in a world that rewards physicians for spending more time with their charts than with their patients. In legal terms, what comforting words are told to the patient are not nearly as important as what was written in the progress notes.

In this world, accepting gifts is considered inappropriate. The cookies that 80 year old woman with the UTI baked you? Don’t take them. You might be seen as exploitative.  

In this world, doctors are afraid to do physical exams on anyone of the opposite sex.

Or same sex, for that matter.

We live in a world where holding a crying patient’s hand can be deemed medically irrelevant and therefore subject the doctor to professional discipline.

I live in a world where if I hug my patient I can be charged with sexual assault.


Nurses call it the healing touch. I’ve heard the Japanese art of reiki is the same concept. The idea is that various forms contact, even if not proven in randomized controlled trials, can somehow make the patient feel better. This includes massage and hand holding, or just spending that extra amount of time at the bedside.

I want to practice like my Mom does.

Hold the woman’s hand when she’s sad, make a friend when you can, cheer my patient when he’s onstage, eat the cookies I was baked, and visit their home when they can’t come to the clinic.

My Mommy is the best doctor I know.

She lives for compassion.

That’s a rarity.

Because how in the world can doctors be like that anymore.

- David

1 comment:

  1. I like to think that if I know the patient well enough they'd be alright with that level of care and I wouldn't have to worry about litigation.

    That said, I'm not going to be seeing too many patients in the future, but that doesn't mean that such physicians can't exist...

    ReplyDelete

Comments!?!?!