Humanism in Medicine
This is a collection of true stories from TU-CA faculty, staff and students. The campus was asked to describe a situation that best exemplifies "Humanism in Medicine". These stories should serve to remind everyone of the importance of a humanistic approach to patients, and to inspire people with real life stories of compassion and tenderness in the healthcare setting.
Audra Lehman, M.D. - TUCOM Faculty Member and Member of the GHHS
I had just returned to work after a beautiful spring holiday. It was a “staycation”, lots of time with loved ones, lots of time in the garden. But now I was back at work taking hospital call, with 15 patients I was responsible for on the Medical-Surgical floor, a couple of ladies laboring upstairs on Labor and Delivery, and a patient arriving in the Intensive Care Unit for me to admit.
The ICU was chaotic that night. Lots of admits rolling in at the same time and the nurses spread thin. My patient was a 78-year-old woman who had a fall. Over the course of her transfer from the Emergency Department to her new bed in the ICU, she became increasingly agitated. The monitor showed premature ventricular beats, and more of them as the minutes passed. I came over to talk to my patient, I’ll call her Georgia, to find out what was troubling her, but she wouldn’t respond to my questions. She was shouting, complaining, calling out to people that weren’t there, and not making much sense at all. The nurse planned to get physical restraints for her, since she seemed likely to pull her IV out.
I don’t know why, but I suddenly decided to change my tack with Georgia. Instead of asking her medical history, I just started telling her about my garden. I leaned in close to her ear, so I wouldn’t have to shout, and quietly told her what was blooming, describing the flowering plants and blossoming fruit trees. I told her about all the visiting birds and squirrels . As I told her how much I love the smell of freesias, I noticed she was gradually settling down. Even her ectopy was resolving. I asked her: “Do you like roses, Georgia? Are roses your favorite flower?”
“No,” she finally said, “I’ve always liked daisies best.”
The ICU was chaotic that night. Lots of admits rolling in at the same time and the nurses spread thin. My patient was a 78-year-old woman who had a fall. Over the course of her transfer from the Emergency Department to her new bed in the ICU, she became increasingly agitated. The monitor showed premature ventricular beats, and more of them as the minutes passed. I came over to talk to my patient, I’ll call her Georgia, to find out what was troubling her, but she wouldn’t respond to my questions. She was shouting, complaining, calling out to people that weren’t there, and not making much sense at all. The nurse planned to get physical restraints for her, since she seemed likely to pull her IV out.
I don’t know why, but I suddenly decided to change my tack with Georgia. Instead of asking her medical history, I just started telling her about my garden. I leaned in close to her ear, so I wouldn’t have to shout, and quietly told her what was blooming, describing the flowering plants and blossoming fruit trees. I told her about all the visiting birds and squirrels . As I told her how much I love the smell of freesias, I noticed she was gradually settling down. Even her ectopy was resolving. I asked her: “Do you like roses, Georgia? Are roses your favorite flower?”
“No,” she finally said, “I’ve always liked daisies best.”
Student Doctor Alison Hench, OMSIII
In the osteopathic world, touch is ingrained so deeply within its students that it becomes second nature. However, in the broad views of health care, this is not always the case.
Recently, the scarcity of physical contact in the medical realm has become more apparent to my naïve eyes. I recently came upon Dr. Abraham Verghese’s TED Talk on “A Doctor’s Touch” and his CNN article “Doctors, listen to your patients.” In both, Dr. Verghese draws attention to the importance of human touch. He explains how patients and physicians are growing further and further apart as technology like CAT scans and MRIs progress. He argues that in this age of technology, the old-fashioned physical exam is still vital. Dr. Verghese also points out how patients can ultimately feel neglected if they are not heard or physically examined. After hearing and reading what Dr. Verghese had to say about the importance of human contact in medical practice, I reflected on a time in my life where I learned this valuable lesson.
In the summer of 2010 I was fortunate enough to participate in Touro University’s Global Health Program. During my time in Shirati, Tanzania, I interacted with patients in the hospital, but it was my time outside of the hospital where I learned about the magnitude of touch.
I spent a significant time working with the region’s leprosy camp. I learned how the individuals living in this facility were turned away by their families due to financial and social burdens. And even though these people were clinically treated and cured of leprosy, the physical manifestations of the disease placed them in a situation where they did not feel accepted. As a result, these individuals had minimal physical contact. I was stunned by how appreciative those affected were when I shook their hands or hugged them. In each interaction, it occurred to me how something as simple as physical contact can be overlooked and even taken for granted in our daily lives. The idea that a person would thank me for offering a handshake or a hug baffled me. It was because of my time with the camp’s people that I understood how important touch is for emotional health. I will never forget this basic truth.
The power of touch is all encompassing and as Dr. Verghese puts it, “the power of the human hand can comfort, diagnose [and] bring about treatment.” Moreover, touch teaches acceptance and nurtures the physician-patient relationship. Although it may be second nature for osteopathic physicians and students, we must not forget how vital touch is to our profession and the wellbeing of those we touch.
Dr. Abraham Verghese’s TED Talk “A Doctor’s Touch” can be found at http://www.ted.com/talks/lang/eng/abraham_verghese_a_doctor_s_touch.html
And his CNN article “Doctors, listen to your patients" can be found at
http://www.cnn.com/2011/10/02/opinion/verghese-doctors-touch/index.html?eref=mrss_igoogle_cnn
Recently, the scarcity of physical contact in the medical realm has become more apparent to my naïve eyes. I recently came upon Dr. Abraham Verghese’s TED Talk on “A Doctor’s Touch” and his CNN article “Doctors, listen to your patients.” In both, Dr. Verghese draws attention to the importance of human touch. He explains how patients and physicians are growing further and further apart as technology like CAT scans and MRIs progress. He argues that in this age of technology, the old-fashioned physical exam is still vital. Dr. Verghese also points out how patients can ultimately feel neglected if they are not heard or physically examined. After hearing and reading what Dr. Verghese had to say about the importance of human contact in medical practice, I reflected on a time in my life where I learned this valuable lesson.
In the summer of 2010 I was fortunate enough to participate in Touro University’s Global Health Program. During my time in Shirati, Tanzania, I interacted with patients in the hospital, but it was my time outside of the hospital where I learned about the magnitude of touch.
I spent a significant time working with the region’s leprosy camp. I learned how the individuals living in this facility were turned away by their families due to financial and social burdens. And even though these people were clinically treated and cured of leprosy, the physical manifestations of the disease placed them in a situation where they did not feel accepted. As a result, these individuals had minimal physical contact. I was stunned by how appreciative those affected were when I shook their hands or hugged them. In each interaction, it occurred to me how something as simple as physical contact can be overlooked and even taken for granted in our daily lives. The idea that a person would thank me for offering a handshake or a hug baffled me. It was because of my time with the camp’s people that I understood how important touch is for emotional health. I will never forget this basic truth.
The power of touch is all encompassing and as Dr. Verghese puts it, “the power of the human hand can comfort, diagnose [and] bring about treatment.” Moreover, touch teaches acceptance and nurtures the physician-patient relationship. Although it may be second nature for osteopathic physicians and students, we must not forget how vital touch is to our profession and the wellbeing of those we touch.
Dr. Abraham Verghese’s TED Talk “A Doctor’s Touch” can be found at http://www.ted.com/talks/lang/eng/abraham_verghese_a_doctor_s_touch.html
And his CNN article “Doctors, listen to your patients" can be found at
http://www.cnn.com/2011/10/02/opinion/verghese-doctors-touch/index.html?eref=mrss_igoogle_cnn
Student Doctor Pierce Stewart, OMSIV
While there are myriad ways to care for patients, I have been most inspired by those physicians who approach their work guided by the principles of humanistic medicine.
A preceptor of mine imparted a valuable lesson about the importance of making difficult procedures less frightening and as comfortable as possible. As an example, one of her patients - a young, previously healthy gentleman - needed an emergency colostomy placed due to severe diverticulitis. Understandably, both the patient and his family were scared about the surgery as well as the prospect of living with a colostomy bag. My preceptor sat on the side of the patient’s bed, slowly explaining what the surgery entailed as well as how the process of recovery and living with a colostomy would look. Additionally, she disclosed that a member of her family had been through a similar experience with the same fears, which noticeably engaged the patient and his family and put them at ease. The doctor’s humility taught me the necessity of treating patient care as a collaborative process focused on establishing trust.
That same preceptor once told me that if it ever occurred to me I could perform a procedure better, I should then stop and restart accordingly. She proceeded to redo part of a surgical closure that, while adequate, could be improved upon. Her demonstration of both integrity and excellence was obviously inspiring, as well as daunting in setting such a high standard. Ultimately, I take comfort in this way of practicing medicine, as it assures that an unwavering commitment to excellence continues to be fostered in my training.
A preceptor of mine imparted a valuable lesson about the importance of making difficult procedures less frightening and as comfortable as possible. As an example, one of her patients - a young, previously healthy gentleman - needed an emergency colostomy placed due to severe diverticulitis. Understandably, both the patient and his family were scared about the surgery as well as the prospect of living with a colostomy bag. My preceptor sat on the side of the patient’s bed, slowly explaining what the surgery entailed as well as how the process of recovery and living with a colostomy would look. Additionally, she disclosed that a member of her family had been through a similar experience with the same fears, which noticeably engaged the patient and his family and put them at ease. The doctor’s humility taught me the necessity of treating patient care as a collaborative process focused on establishing trust.
That same preceptor once told me that if it ever occurred to me I could perform a procedure better, I should then stop and restart accordingly. She proceeded to redo part of a surgical closure that, while adequate, could be improved upon. Her demonstration of both integrity and excellence was obviously inspiring, as well as daunting in setting such a high standard. Ultimately, I take comfort in this way of practicing medicine, as it assures that an unwavering commitment to excellence continues to be fostered in my training.
Student Doctor Jennifer A. Tran, OMSII
The resident explained the case in time with my staccato heartbeat: “three-year-old, 911 trauma, helicopter transport. Doesn’t look too great.” I followed him into the Resuscitation Room, nervous but excited about observing my first trauma case. The room was filled with doctors, nurses, and one technician who said, “Abandon hope all ye who enter here.” Despite his warning, I was optimistic and I thought this was where I wanted to be. Jim, the attending doctor, walked in and announced, “They’re here.”
The paramedic team brought in a lifeless little boy atop of a yellow-taped gurney; he was wearing a pair of green shoes.
“Good afternoon everyone,” the EMT said cheerfully, his tone unharmonious with the predicament. “We’ve got a three-year-old boy run over by a truck in a shopping mall parking lot. Been trying to find a pulse. Intubated. Pressure’s 70 systolic. Attempting CPR since arrival.” He continued to list more numbers and the room clamored with suggestions, questions, and rebuttals. After five minutes of countless ideas, the room stood still. “Does anyone else have an idea?” Jim asked and silence followed. I stood still, terrified of what would come next. “Alright,” he sighed as he peeled his bloody gloves off, “Time of death 3:40pm.” He threw his gloves into the trash, and the staff followed his exit. The floor was trashed with gauze, smeared blood, and plastic. I took one last look at the little boy and my heart cried.
I walked out the ER doors and ran down the stairs, collapsing onto the last step of the basement stairwell. I tried to make sense of everything I’d seen. I thought I could be a doctor so I could help others, yet I did nothing but watch a little boy die. I knew that as a student there wasn’t anything I could do, but no explanation could alleviate my broken spirits. I had no connection with this patient, but I was crying as if I’ve known him my whole life. What was I doing here? I couldn’t do this anymore; I couldn’t be a doctor; I couldn’t stand still. I needed to tell Jim how this dream to become a physician was a misguided ambition. After my sobbing subsided, I used my hands to lift myself from the last step of the stairwell and headed back into the ER.
Catching Jim at his desk, I shamefully lowered my head and said I needed to tell him something. A patient screamed behind us, but no heads turned. Jim groaned and gestured toward the screaming. “She’s hopeless,” he explained. “Can you do me a favor and check on her?” He frantically walked away before I could say no. Her curtain was open slightly; I could see a mess of frizzled hair in a dark corner. As she continued to scream, nurses charted vitals, residents phoned CT scan orders, and ER volunteers scurried to clean gurneys. No one wanted to deal with her. Slowly walking towards her bed, I wanted to flee but I took a deep breath and followed her screams into the dark.
She was restrained to her bed, screaming incoherent phrases and reeking of alcohol. I tried to introduce myself over the cacophony, but her cries kept escalading. Feeling even more helpless, I started to walk out only to hear her say, “I can’t do this anymore,” reminding me of something I had thought earlier. I grabbed a few tissues and sat on her bed, trying to wipe her tears. I moved her hair away from her face and soothingly tried to calm her down. Standing still beside her bed, I told her about my helplessness and my attachment to the small green shoes dangling lifelessly atop a yellow-taped gurney. I told her how I dreamed of becoming a physician to help humanity, but how I felt so helpless as I watched a little boy lose his life. And soon, only my voice was audible. She stopped crying and placed her hand over mine, as if to comfort me. Her grey eyes looked into mine, giving me a small smile. I left her room with more hope than what I had coming in.
At the end of the day, I passed by the Resuscitation Room and peaked inside: sheets folded, floors spotless, and a familiar pair of green shoes hidden in a distant corner. The room was cleaned and refreshed. Hope changes the way we see things, whether it’s us empathizing with patients or a patient comforting us at a time of loss. Someone who the world deemed as hopeless gave me hope, a humbling reminder of the innate compassion resonating within the human condition. “You wanted to tell me something earlier?” asked Jim as he walked by the room. My eyes lingered over the green shoes pushed against a corner.
“I did,” I admitted, “But I figured it out.”
The paramedic team brought in a lifeless little boy atop of a yellow-taped gurney; he was wearing a pair of green shoes.
“Good afternoon everyone,” the EMT said cheerfully, his tone unharmonious with the predicament. “We’ve got a three-year-old boy run over by a truck in a shopping mall parking lot. Been trying to find a pulse. Intubated. Pressure’s 70 systolic. Attempting CPR since arrival.” He continued to list more numbers and the room clamored with suggestions, questions, and rebuttals. After five minutes of countless ideas, the room stood still. “Does anyone else have an idea?” Jim asked and silence followed. I stood still, terrified of what would come next. “Alright,” he sighed as he peeled his bloody gloves off, “Time of death 3:40pm.” He threw his gloves into the trash, and the staff followed his exit. The floor was trashed with gauze, smeared blood, and plastic. I took one last look at the little boy and my heart cried.
I walked out the ER doors and ran down the stairs, collapsing onto the last step of the basement stairwell. I tried to make sense of everything I’d seen. I thought I could be a doctor so I could help others, yet I did nothing but watch a little boy die. I knew that as a student there wasn’t anything I could do, but no explanation could alleviate my broken spirits. I had no connection with this patient, but I was crying as if I’ve known him my whole life. What was I doing here? I couldn’t do this anymore; I couldn’t be a doctor; I couldn’t stand still. I needed to tell Jim how this dream to become a physician was a misguided ambition. After my sobbing subsided, I used my hands to lift myself from the last step of the stairwell and headed back into the ER.
Catching Jim at his desk, I shamefully lowered my head and said I needed to tell him something. A patient screamed behind us, but no heads turned. Jim groaned and gestured toward the screaming. “She’s hopeless,” he explained. “Can you do me a favor and check on her?” He frantically walked away before I could say no. Her curtain was open slightly; I could see a mess of frizzled hair in a dark corner. As she continued to scream, nurses charted vitals, residents phoned CT scan orders, and ER volunteers scurried to clean gurneys. No one wanted to deal with her. Slowly walking towards her bed, I wanted to flee but I took a deep breath and followed her screams into the dark.
She was restrained to her bed, screaming incoherent phrases and reeking of alcohol. I tried to introduce myself over the cacophony, but her cries kept escalading. Feeling even more helpless, I started to walk out only to hear her say, “I can’t do this anymore,” reminding me of something I had thought earlier. I grabbed a few tissues and sat on her bed, trying to wipe her tears. I moved her hair away from her face and soothingly tried to calm her down. Standing still beside her bed, I told her about my helplessness and my attachment to the small green shoes dangling lifelessly atop a yellow-taped gurney. I told her how I dreamed of becoming a physician to help humanity, but how I felt so helpless as I watched a little boy lose his life. And soon, only my voice was audible. She stopped crying and placed her hand over mine, as if to comfort me. Her grey eyes looked into mine, giving me a small smile. I left her room with more hope than what I had coming in.
At the end of the day, I passed by the Resuscitation Room and peaked inside: sheets folded, floors spotless, and a familiar pair of green shoes hidden in a distant corner. The room was cleaned and refreshed. Hope changes the way we see things, whether it’s us empathizing with patients or a patient comforting us at a time of loss. Someone who the world deemed as hopeless gave me hope, a humbling reminder of the innate compassion resonating within the human condition. “You wanted to tell me something earlier?” asked Jim as he walked by the room. My eyes lingered over the green shoes pushed against a corner.
“I did,” I admitted, “But I figured it out.”
Student Doctor Catherine Sperling, OMSIV
It was my first day on the IM service. I had heard stories that this particular IM attending was intense, a bit intimidating and a great teacher. Immediately upon meeting her I was struck by her intensity and passion for teaching but also her kindness and sincerity. The fourth patient we were to see of the day was a woman with end stage pancreatic cancer. As soon as we entered the room the doctor was in quiet, full alert to the patient. The attending walked in speaking kindly to the patient letting her know she had arrived. Then she knelt next to the bed, bent close and spoke softly and lovingly as if the patient were her own mother. She stroked her hair gently. The love and kindness was palpable. Just standing in the doorway from a distance, I was moved to tears. She asked her patient how she was feeling, if her pain was controlled and if she has seen her family today. After a few more minutes, she said good-bye and promised to return later that day and then tomorrow, but feel free to call her before then if something comes up.
Outside the room Dr. Shwartz told us the patient was on hospice and likely didn't have much longer to live. She asked, "Do you think doctors continue to see their patients more or less when they get put on hospice?" Someone answered more. "Actually less. There is this fear of death and feeling of failure that doctors feel when a patient
is dying. Or that once the patient is put on hospice the doctor feels they have nothing to offer any longer. When it is the opposite. Sometimes the best thing a doctor may do is just hold their patient's hand and show they care. Once a patient is put on hospice we shouldn't just abandon them because we are uncomfortable. We should continue to be doctors to them, even if the treatment options are just pain control and showing kindness by showing up."
Outside the room Dr. Shwartz told us the patient was on hospice and likely didn't have much longer to live. She asked, "Do you think doctors continue to see their patients more or less when they get put on hospice?" Someone answered more. "Actually less. There is this fear of death and feeling of failure that doctors feel when a patient
is dying. Or that once the patient is put on hospice the doctor feels they have nothing to offer any longer. When it is the opposite. Sometimes the best thing a doctor may do is just hold their patient's hand and show they care. Once a patient is put on hospice we shouldn't just abandon them because we are uncomfortable. We should continue to be doctors to them, even if the treatment options are just pain control and showing kindness by showing up."
Tami Hendriksz, D.O. - Faculty Advisor for the TU-CA GHHS Chapter
When I don the lenses of “Humanism in Medicine” and think back through all of the experiences in my life, the one that stands out the most for me occurred prior to my medical career. It is the one experience that continues to affect my daily interactions with my patients, their families, medical students and other health professionals. It is the reason that I chose osteopathy, and served as the ultimate driving force behind my medical career.
As I child I always knew that I wanted be a doctor. I specifically knew from a very young age that I wanted to be a pediatrician. I loved the sciences, I was fascinated by the human body and mind, and I always had great compassion for children. During my undergraduate years I took all of the steps that one takes to get into medical school. During that time I began talking to practicing physicians. Each one of them advised me not to go into medicine. They were unhappy about the way that the large insurance companies had taken over – they had less time with their patients and received less compensation. I was shocked. Here were people who were able to do the work that I had always dreamed about, and they were miserable with it – telling me one after the other not to go into medicine.
I had a small personal crisis and decided after taking the MCAT to take some time off. I moved to South Africa to stay with my parents for a while, and then returned to the states and got a job as a special education teacher for severely emotionally disturbed teenagers. Then my world was turned upside down. On June 1, 2001 my sister was diagnosed with Acute Myelogenous Leukemia. The diagnosis came as a complete surprise to us. We didn’t have any family members who had cancer, we knew very little about leukemia, and my sister’s symptoms had seemed so benign – she was tired all the time, her gums were bleeding when she brushed her teeth and she had a very long period. If anything we thought that maybe she was depressed or had the flu – leukemia was nowhere near our layman’s differential.
My sister spent the majority of the next 6 months in the hospital receiving rounds of chemotherapy. I spent the majority of my free time right next to her. During that time I got to know a lot of the medical personnel. I became my sister’s advocate and spokeswoman. I took detailed notes of the medications that she was given, her blood counts, the procedures that she had. I also realized that medicine was still my passion, my life calling. It was during this time that I had a conversation with a doctor – a conversation that would forever change the pathway of my life. He saw me in the hallway and asked “how’s your sister doing?” I began to give him a list of her recent procedures and blood counts, and he interrupted me. “No, how is your sister doing – emotionally, mentally? How does she feel about all of this?” I stared at him, dumbstruck. In all of our time in the hospital not a single person had ever stopped to ask about my sister, the person. I told him that she was depressed – life as she had known it had been taken away from her so abruptly – she had no sense of normalcy. I also told him that he was the first person to ever ask about that – about the human behind the disease. He told me that he was an osteopath – and that osteopathic physicians were trained to look at the person as a whole and to treat them accordingly. My mind was made up then & there. I wanted to become an osteopathic physician. Soon after that conversation I began the application process and the following year I started at TUCOM.
To me, that experience exemplifies “humanism in medicine”. The ability to see and to treat the person as well as their disease process; To remember that hiding behind all of that pathophysiology and fascinating medical science is a human with emotions, thoughts and dreams. I encourage all physicians and medical students to keep this on the forefront of their minds. In medicine the most fascinating and stimulating cases for the physicians tend to be those that involve the most brutal and rare disease processes. They are the ones that are the most traumatic for the patients – it is very important that physicians and student doctors take time to remember the person behind the ailment, even as they are intellectually stimulated by these exciting diseases, traumas and syndromes.
