I spend many hours every day thinking, writing, and meeting about care. Compassionate care. Equitable care. Person-centred care. Diverse providers of care. Care for diverse populations. How to teach for compassionate care. What to teach for social justice-oriented care. Whether curriculum can promote reflexive care. How to get faculty members to prioritize person-centred care. How to get health care institutions to focus on equitable care. What the links are between all of these kinds of care conceptually, rhetorically, ontologically, discursively, practically… I’m getting dizzy just thinking about it all!
One of my strategies when I am confronted with this much academic chaos is to imagine explaining the core of the issues with which I’m wrestling to a student or a layperson.
One of my strategies when I am confronted with this much academic chaos is to imagine explaining the core of the issues with which I’m wrestling to a student or a layperson. I found myself doing just that as I tried to write this blog post. As I rolled all of these ideas around in my head, I kept coming back to something I have been saying for the past few years whenever I start working with a new group of medical students and residents on the Internal Medicine wards.
After we introduce ourselves and talk about technicalities like phone numbers and meeting places for rounds, I always begin by reminding the students and residents that many of the patients we will be looking after together for the next two weeks are not only sick – they’re also old and chronically unwell, and by some physicians’ standards their diseases might not be considered “interesting” or “sexy”. Theirs are not the images used to inspire the public to run or bike or donate; nobody is having galas for the diseases they have and they don’t fit into hospital priority programs. And yet, they are our patients. We have to care about them and care for them as though they are the most important highest-priority patients in the hospital – because they are, because every patient should be, and because we are their physicians.
I remind myself that that patient was once a baby that someone held as I have held my own babies, that someone hugged and snuggled and kissed on the nose and thought was the most perfect, wonderful creature in the world
And then I tell them that I’m going to share my trick with them: that when I have trouble bringing my focus back to the patient, to caring about as well as for the them, to looking past their delerious shouts or their soiled diaper or their wizened body, I remind myself that that patient was once a baby that someone held as I have held my own babies, that someone hugged and snuggled and kissed on the nose and thought was the most perfect, wonderful creature in the world (and what a heartbreaking thing it would be if it turns out that nobody had ever held them like that). I remind myself that someone (in my world, usually a spouse or a child or even a grandchild) may still love them that much – and that even if they have nobody left in the world, I need to treat them as people still deserving of that sort of love.
I’m always sheepish about saying all this, because it seems so at odds with the medical culture in which I trained. And it’s often clear that some of the trainees are trying not to show that they think I’ve lost the plot entirely. But usually there is at least one student or resident who meets my eyes, and smiles, and maybe even exhales deeply – and I know they’ve understood. And as I think of the times I’ve watched them over the next couple of weeks treating our patients with respect, and generosity, and kindness, and even a kind of love, I wonder if I’ve found the core of the issue after all.
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