Wednesday, April 8, 2015

First, Have some charm

The basic tenet of the Hippocratic Oath is "First do no Harm." Doctors are there to help, not cause more damage. Perhaps that needs to be applied not only physically, but emotionally as well. Hence, the title of this post, "First, have some charm."

Someone needs to teach doctors some tact and manners. Not all of them, of course, but it only takes a few bad apples to make the whole bunch seem spoiled. Doctors are smart. Doctors are busy. But doctors are caring for people at their most vulnerable moments and because they are smart they need to remember that, no matter how busy they are.

My husband and I are the first responders for issues involving my father in law. He lives closest to us and that's what makes the most sense. We are happy to do it and he is very appreciative. Our past experience often comes in quite handy because the similarities between managing Maggie's care and managing my father in law's care are astounding.

Maggie as a disabled child was often ignored by the doctors even though she was the patient. Not doctors who knew her, of course, but doctors who didn't, for example those in the emergency room, or young residents when she was in the hospital . They would talk only to me and not even attempt to engage her. Obviously I spoke for Maggie so that was somewhat understandable, but a comforting word or pat on the arm would have been nice, not to mention the courtesy of telling her the plan. They assumed she didn't understand, which was wrong; but even if she didn't understand, take the time to speak comfortingly and engage your patient. Generally I held my tongue because it was easier. I am a big believer in the adage, "you catch more flies with honey."

[Note  all of Maggie's former medical providers just fell over laughing at that. I was not always the nicest person in the world, but I really did let a lot of little things go, so I could save steam for when I really needed to blow my top.]

The same thing happens with my father in law. He too is now disabled, but the issues in this case seems much more age related than disability related.  This morning he was taken to the hospital from his assisted living residence. (He is already back at home and is fine.) Steve actually arrived at the hospital before his dad did. Steve learned from the paramedics that Dad was ok - in fact they didn't think he needed to be transported to the hospital at all. (Separate issue altogether).

Shortly after arrival the young ER doc enters the very small room with my father in law right there awake and alert and probably not even needing to be there. Instead of finding out the situation he immediately starts talking to Steve asking, "How far do you want us to go? what is the plan here?"

 He might as well have said, "are we going to bother with this old guy at all?"

Really doctor, this is where you START? How about a question like, well, sir, what brings you here today? Oh, you can't hear me, ok I will 1) speak up or 2) get the story from your son and then we will decide the plan together. Instead he disregarded my father in law completely and wondered aloud if they should bother to intervene at all.

 Steve brought the doctor out of the room and let him know that wasn't cool, and the doctor said he got that from Steve's body language. That makes me laugh because I can well imagine what that looked like. Eyebrows UP, head cocked, chin tilted just so, arms folded..... We can only hope that doctor learned something from that body language.

Everyone knows the medical system is flawed. This event could have easily been handled at an urgent care site without involving the ambulance and paramedics and the unnecessary expense. Instead the resources are strained to handle this non emergent matter. Then when he arrives at the ER, the doctor treats him like he is not worth any time or effort despite his relative good health.

I wish I had a silver bullet to fix the medical system, but I don't. Fixing the attitudes is easier. Or it should be. Doctors: Treat every patient like you would want to be treated. Every patient, young, old, disabled, sick, afraid, hypochondriac, mentally ill and everybody else.

It's the Golden Rule.
And it's charming.


  1. I am Elizabeth's friend and an occasional reader. I am sorry about the loss of your beautiful daughter first and foremost. And this post? I couldn't agree with you more. Thank you.

  2. Great story. Anyone who has spent any time in a hospital has a similar story, and most cases are much worse than the treatment your father-in-law received. Good that Steve was there to advocate. But what if the patient doesn't have an advocate? How can we pass this on to medical schools?

  3. I remember sitting with our son Jeremy at an IEP meeting where all talk was toward me and did not include Jeremy in any way, shape or form. After the IEP was discussed "they" started in saying so many people were bailing on them when a client died that they would appreciate us setting up and paying for some advance funeral plans. Perfect, I have no quarrel with that, they should not be stuck with that, however, could they have not said it in front of Jeremy. We have no way of knowing how much he understands so let us just go with he understands absolutely everything we say. How could that hurt anything? I can hear and understand what you are saying even if you are facing someone else. Some people even know how to talk to more than one person. Oops sorry, that is my rant! Just wanted you to know I get what you are saying. Your cousin, Jennifer Silva

  4. Sister, don't get me started -- especially given that I have far less tact than you.

  5. Sorry your father-in-law had that experience today -- have you thought of writing this up and submitting it as a perspective to a medical journal? My mom is a doctor and speaks about the need for this kind of training for doctors often. I think your natural humor and also passion/authenticity for the subject is incredibly compelling. If I edited a medical journal, I'd print it. :-)

  6. Im in the medical field and I applaud this post. I guess I never notice enough because we are in the billing office and I dont have a lot of patient contact. But latel with my Mother I have seen really careless ER docs and nurses and they seem insensitive to her most of the time. Yeah shes got dementia but you can still treat her like the 80 yr old lady she is and not talk over her or around her like she is nothing.


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