Perhaps we should have expected that the contradictory stories about a middle-aged man's heart attack would lead to a vigorous conversation about whether the doctors and nurses or the patient and his wife were right in their descriptions.
The piece by Dr. Leana Wen, an emergency physician, about the man's dissatisfaction with his treatment — despite its success — had been clicked on more than 275,000 times and drawn more than 200 comments, as of Thursday afternoon. On NPR's Facebook page, the story had been commented on more than 900 times and shared more than 7,000 times.
I asked Wen how she felt about the response to the piece. "While I'm gratified that so many readers appreciate the time pressures of working in a busy ER, I am saddened by how many respondents accept that efficiency must come at the expense of humanity," she wrote to me in an email.
"Our health-care system needs to change to bridge the disconnect between what patients need and what hospitals do," Wen continued. "All of us — as providers and patients —need to speak up, and demand a system that values both competence and compassion, and enables doctors to practice true patient-centered care."
What did others think?
One of the most popular comments came from someone with the handle MinJon, who made the case for the patient's point of view:
Great article, thank you. But it's more than providing "simple courtesies," or being "circumspect" to allow for certain personality types (as mentioned in the comments). One's body is the most personal thing we have — it is inseparable from us — and medical treatment can feel invasive. When we are left half-naked and alone (as I have been), we can feel extremely vulnerable. Add to that lack of privacy and being sick and scared, and you have a person who ends up feeling violated, even if they did get appropriate medical treatment. A person who is stressed and scared feels more pain and does not heal as well as someone who is relaxed. Not to mention that just treating someone with care and compassion is the right thing to do. Doctors may be in hospitals every day, but most patients are not, so it can be a very disorienting and stressful experience.
Another commenter named SeaLady took a hard line that put the emphasis on the clinical outcome:
1. Someone saves your life with prompt, effective treatment.
2. You file a complaint against them because they didn't do it politely enough.
(head meets keyboard)
That didn't sit well with Gary Dean, who shot back:
You obviously only considered half of the article as relevant. The point is, no one has to be treated like a clinical object. We are much more than our physical being. A little bit of compassion would have gone a long way in this example. (head meets keyboard)
A self-described health-care insider named joesfk wrote that sometimes the most important information gets drowned out:
As someone who works in health care, communication is [a] huge issue. There are definitely times when caregivers assume you know terminology that you do not, but I also see a lot of situations where a doctor says something, plainly and clearly and repeatedly, and the patient does not fully process the information. I work in the cancer field, so it's understandable that the patient can be distracted by grief/shock, but it makes the responsibility of clear communication even more difficult.
My suggestion to patients: ask questions, take notes, and bring a second pair of ears to visits (preferably attached to a friend or loved one).
What modern comment thread could go for very long without a reference to Louis C.K., the great moral philosopher of our day? Gregory Scott weaves in an anecdote from the comedian in his response to the piece:
I agree with the author's assertion that professionals should remember that there is a person in there, not just a disease. But the need for urgency and speed can be a very circumstantial thing. I've always been treated as a human being by health care professionals during interactions where my life wasn't immediately on the line. I feel I could get over it if I knew later that saving precious moments by skipping the cordiality might have contributed to saving my life. Yes, I want them to break time records even more than they want to break them themselves. The description of this situation reminds me of the comedian Louis C.K.'s bit where he makes a point that we're so jaded by technological advances that we don't appreciate them anymore. He cites an airline flight where they've just started offering in-flight Wi-Fi connection, and talks about a man getting miffed when the connection stops working. He just learned of this amazing service five minutes before, and already he feels completely entitled to it. "Never mind that you're sitting in a chair... IN THE SKY!!!" observes the comedian. It strikes me that this family could very likely have been looking at a 'Dead at 54' headline not so many years ago, instead of appreciating that a tiny balloon inserted through the thigh opened a blood vessel in his heart and had the man working and exercising (and feeling so darn unappreciated) two weeks later. Baby boomers.
For some people, including Terre Vance, Wen's story stuck a personal chord. Vance wrote:
Great article on perspective. My husband just had a heart attack and our experience was similar, except I was kept fully informed and reassured that all was going to be okay. And I was able to be with him until he was wheeled off to the cath lab. We all understand the patient is the most important factor in this situation, but family members need to be cared for also. Knowing what's going on makes all the difference during such a stressful time. It's bad enough you're worrying about the bills, you don't need to be p.o.'d at the hospital and doctors. That type of negativity hinders recovery. Hopefully, hospitals and doctors are all working toward keeping the family and patient informed and up to date with what's going on.