First Posted at Educate the Young on 4/7/2014
Kim Oates MD has been a regular faculty member at the Telluride Patient Safety Educational Roundtable and Summer Camps, which is no easy accomplishment given he travels to this remote Rocky Mountain town all the way from Australia. Kim, who is a pediatrician by training, is a medical educator to the core, and is now Emeritus Professor, Director Undergraduate Quality & Safety Education, Clinical Excellence Commission in New South Wales. The following is an excerpt from a piece he wrote on kindness in healthcare for theRoyal Australasian College of Physicians, recently reprinted in the Medical Journal of Australia. Please feel free to share with colleagues. The entire abridged piece in MJA can found by clicking here.
Way back in my intern days, it was unusual for consultants to talk with their “public” patients…The hard stuff was often left to us — the interns, young people with minimal life experience, an overwhelming workload and no training in the gentle art of communication.
At my teaching hospital a time was set aside once each week when family members could come to the hospital foyer, page the intern and ask questions about their loved one’s condition. In my third month after graduation I assisted at a laparotomy on a fit, active 54-year-old man who presented with a hard lump at his umbilicus. The laparotomy showed widespread cancer with multiple metastases. The surgeon closed the wound. There was nothing to be done…It was my job to tell his unsuspecting wife when she came to the foyer to ask about her husband’s operation. I told her the truth as kindly as I could. Her eyes welled up with tears. So did mine.
Afterwards, I felt embarrassed about my show of emotion. Why couldn’t I be “more professional” like my consultants? I wondered if I was really suited to do medicine. Later, I realised that it may have helped her. She may have seen that even though the news was bad, I cared…In subsequent years, as a consultant, my eyes would sometimes moisten when I had to tell a parent that their child would not survive. And sometimes it happened when I had the pleasure of giving unexpected, but joyful news.
Was this behaviour “unprofessional”? Or is there is room for families, junior doctors and medical students to realise that we, the more senior doctors, do care? To realise that there is more to it than striding the narrow catwalk between aloofness and over-familiarity, that there is a place to show humanity and that it is not unprofessional to let people know we care…
…Of course, there are some professional boundaries which we must always respect…these well accepted boundaries are different from really caring about our patients and doing something about it…We don’t have to take off our compassion, or our ability to show it, when we drape a stethoscope around our neck. The need for doctors to be professional is not synonymous with being emotionless. There is more to this than just being nice to people. It is about being kind. It also has implications for the quality of patient care…
Powerful recommendations — listen to patients; model transparency; model trust; keep on learning.