In the past the physician was a medical father figure,accepted into the family and dispensing empathy and compassion. There was an emotional connection with their patients and a bond was formed based on respect and a sincere caring attitude. Today everything has changed. Rarely do physicians spend more than fifteen minutes with a patient in the doctor’soffice. A shift in the concept of service has occurred with doctors attempting to suppress emotional involvement with their patients so that their reasoning ability is not influenced by emotions. Hence, the article in MEDCITY News posted on Feb. 13, 2013 by Deanna Pogorel, where a handwritten condolence note from a doctor was sent to the surviving husband whose wife died in the emergency room of breast cancer. In the note, the female physician explains this was the first such note that she had written in 20 years. The doctor states in the note “Our encounters are typically hurried and do not allow for more personal interaction. However, in your case, I felt a special connection to your wife, who was so engaging and cheerful in spite of her illness and trouble breathing.”
This note struck a chord in over 2.1 million people and1,300 of them left comments, many from those who have also lost parents and many from doctors as well. One physician wrote, “They don’t train us how to deal with the human element of our job very well. Most react by developing a deep callus over their hearts. Some of us are downright evil in how jaded we’ve become…” Another physician writes, “I pray to God when I make it as a trauma surgeon, I do not become desensitized to the sometimes inevitable loss as of life of my fellow man or woman, nor desensitized to the joy of saving or helping to improve the quality of life of my patients.”
How sad that in our world today this simple act of a treating physician writing a handwritten note to a family member following the death of a patient creates such an outcry for more of the same compassionate care. I believe the problem lies within our U.S. system of training of our doctors and nurses. In research for the book Soul Service: A Hospice Guide to the Emotional and Spiritual Care for the Dying (Balboa Press, 2013), it came to light the only 8 U.S.medical schools of the 122 we contacted and none of the 34 top U.S. News and World Reports nursing programs had mandatory training in the areas of emotional, spiritual and palliative care to the dying. Today’s doctors and nurses are not acting out of malice but ignorance of how to connect with their dying patients. If the medical and nursing schools had mandatory required coursework on subjects like the psychology of terminal illness, how to deliver a cancer diagnosis, how to treat cancer pain, when to refer to hospice, how to address a patient’s spiritual needs or how to tell a family that their loved one has died there would be a significant improvement in the quality of terminal care.
From his statements in The Wall Street JournalsTheWeekend Interview, eminent bioethicist Leon Kass comments on the Dangers of a World Increasingly Indifferent to Matters of Human Dignity. He says about real human dignity,"You see it in the way nurses treat people who come in for chemotherapy. You see it in the way a great hostess treats a handicapped guest, helping him without causing him embarrassment. You see it in the way people come close to where there is human suffering and are not put off by the horror but do what is humanly necessary."
His voice lowered almost to a whisper, he adds: "You saw it in Boston. Some people fled to safety—others rushed to the danger."
We all need to consider working at a deeper level of service in our relationships with others to strive not only for dignity but for compassion and not repress that which can be one of the most rewarding of our human experiences.