Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 306

Improving Education 295 bodied here extraordinary nobility and idealism in an era when these virtues are increasingly rare. Some of these doctors wanted more spiritual connection, but felt they could not attain it. The positivistic scientific medical model led some to shun ambiguities, mysteries, and inchoate subjective experiences. Steven said, ‘‘I wish I were more spiritual,’’ but he remained skeptical. In- creasingly, evidence-based medicine spreads, valuing only the objective, the objectifiable, and the measurable. Medical training itself wounds in ways that can callous and distance doctors from patients, rather than heightening sensitivity and warmth. The threat of disease and death can also overwhelm doctors, who then minimize, avoid, or deny their injury, rather than acknowledge, embrace, and grow from, it. Yet concurrently, the benefits of these physicians’ own experiences with illness are not unalloyed. I do not mean to be a Pollyanna, touting the benefits of disease on medical practice. Clearly, personal illness can affect one in both good and bad ways. Empathy often, but not always, increases. At times, these doctors lost patience with those whose medical problems seemed comparatively minor, but who nevertheless com- plained, and failed to adhere to effective treatments. Most doctors did not go so far as to rebuke patients as did Nancy (e.g., saying, ‘‘You have the ability to make yourself better, and I don’t’’). But many of these physicians shared her irritation. They realized, too, the limitations of their field—for example, that medical knowledge does not wholly alle- viate pain. From side effects such as nausea and weight gain, to pain and discomfort from lumbar punctures, biopsies, and feeding tubes, physi- cians often underestimated how much they harmed their patients. Doc- tors may tell patients, ‘‘Don’t worry, this procedure won’t hurt,’’ or ‘‘will hurt only a little,’’ or ‘‘just in the beginning,’’ or ‘‘the scar will be noth- ing,’’ ‘‘this is routine.’’ Yet at times, such statements are simply untrue. These physicians are then giving false information. Hopefully, these narratives will encourage physicians to optimize as much as possible the time they do have with their patients. Even if they have only ten minutes with a patient, doctors could often be more sensitive. Physicians should at least be made more aware of the limitations they confront—from patients’ perspectives. Healers need to realize the im- pact of their constrained time and resources—how patients at the other end of the stethoscope see their treatments and providers.