WEARING THE WHITE COAT:
REFLECTIONS
Scott C. Williamson, Ph.D.
Scott Williamson, PhD (Professor at
Louisville Presbyterian Theological Seminary)
referring to Dr. Tina Yuan:
“The empathy, the care, the ability to connect with
patients in a minute, I don’t know how Dr. Yuan does
that,” said Scott Williamson, PhD. “Whatever the
forces are that take Tina away from patients are evil!”
I
met Dr. Tina Yuan at her Prospect, KY office on October 28th,
2014. Wearing my pressed white coat, confidentiality agreement
tucked away in a pocket, I arrived promptly at 9:30 a.m. to shadow
Dr. Yuan. She welcomed me graciously. We briefly exchanged the
customary biographical sketches, leading up to the purpose for the
shadowing experience that brought us together on a rainy Tuesday
morning. And then we experienced a problem. Tina had not done
this shadowing thing before and wasn’t sure what she was supposed
to teach me. I had not done this shadowing thing before either and
had no clue what I was supposed to learn. We had no objectives, no
learning goals, no questions to answer, and no expectations beyond
sharing time and space as Dr. Yuan cared for her patients.
Now fast-forward to the Wear the White Coat debriefing dinner
on the evening of November 5th. After a sumptuous dinner, Dr. Bruce
Scott, President of the Greater Louisville Medical Society, invited
reflections from those of us who wore the white coat for a day. Not
knowing exactly what I needed to say but needing to say it with
some urgency, I raised my hand. I intended to say how very good
Dr. Yuan was with her patients. I intended to say that she met with
seven patients in a 2-hour time period, a 30 percent reduction in her
usual pace, because she didn’t want to overwhelm me. I intended to
say that I have no idea how she created such a warm rapport with
patients, and monitored their health, and maintained her sanity,
in ten-to-twelve minute appointments that proceeded relentlessly.
I intended to say that she did not schedule any appointments that
afternoon because she needed to catch up on paperwork. I don’t
remember how many of these things I actually said because I needed
18
LOUISVILLE MEDICINE
to say something else. And then the words came to me, “Whatever
bureaucratic forces take Dr. Yuan away from her patients are evil!”
(This is a serious charge from an ethics professor.)
The story here is: what happened to me on October 24th that
made it so important for me to say that? What did Dr. Yuan do that
morning that held such significance for me? She didn’t do much
in one sense. She did not perform neurological surgery, resuscitate
anyone back from flat-line, or deliver a premature baby. But in a
different sense, by doing what she does every day as an internal
medicine specialist, Dr. Yuan upholds a standard of patient care
that is the bedrock of her profession, a standard of care that is
increasingly undermined by a complex health care system that is
difficult to understand. But Dr. Yuan endures. And she sees new
patients. And she wears the white coat, though she does so less often
these days because she has to schedule any number of hour-long
appointments to complete paperwork, and care for bureaucratic
mandates ancillary to the health of her patients.
It will come as no surprise that Dr. Yuan’s patients were not content to let me remain a shadow. Patient #6 in particular needed to
tell me a story. The patient did not know who I was or what I was
really doing at her appointment. But she consented to my presence
in that private space, looked in my eyes, and told me that she would
have died were it not for Dr. Yuan. Tina looked down. On my drive
home, I found that I needed to say something.
Note: Robert H. Walkup is a Professor of Theological Ethics at the
Louisville Presbyterian Theological Seminary.