Thursday, April 8, 2010

From object to subject

It is important to care. To stop, get out of one's own self-involved space and listen, look, experience the world as the patient does. Today some of our residents were berated for just that. For treating patients as routine. For filling out the checklists, doing the minimal required and not truly assessing the patient in her (I'm on OBGyn service) wholeness. It's something physicians get criticized for regularly, but it really takes going against the grain to do such. The way we report cases and approach an individual is indeed depersonalized and sterile. "Patient is 34 year old female complaining of .... G1P0, previous C-section...." I wish I could convey the tone in which it is presented too. Often times it seems that patient is object, rather than subject of the medical conversation. It has been some months since I've been in clinical rotations and I still find it hard to present. Perhaps it's because I have not mastered organizing the systematic process in my head but the fact that I find it hard to separate my inclination to have a connection with the patient from the depersonalized nature of presenting may also be a contributing factor.

Certainly such methods are necessary to highlight the most salient aspects relating to the patient and to prioritize steps for care but to do such and be a provider with whom patients can connect, to me, means existing in two states at once. Without practice, these states can seem mutually exclusive.

A friend of mine, very young person, has cancer and she opted to create an online journal of the treatment course. In it she shared her fear, confusion of navigating insurance and doctor networks, her need to advocate for herself, because sometimes, her doctor wouldn't. As physicians-in-training, our role is not to only treat the illness but to convert that fear into trust, the confusion into understanding and turn the object into subject of our care.
May this one day be innate in all of us.

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