Don't forget the patient
Now, I ask this with love, truly I do: Why must some budding doctors -- any doctors -- be trained to be human?
A commentary in this week's Archives of Internal Medicine suggests that med students be offered this handy mnemonic (CAPTURES*) to jog their memories on how to interact with patients:
C = Curiosity/interest
Adopt a warm, sincere, friendly Curiosity or interest about your Patient's personal aspects
A = Appreciate/Admire
Find something to warmly Appreciate or Admire in your patient
P = Point of view
Always try to see things from the Patient's Perspective/Point of View
TU = Touch and Use
Touch the patient and Use other body language (proximity, attention, smile) to show caring
RE = React
React to what the patient says or does and how
S = Support and Stress
Support the patient by Stressing any positive aspects, providing reassurance and hope as much as possible
* = Continue
Continue with this approach in future encounters: When there is more to be accomplished than time allows, postponement and organizing a further appointment will relieve stress and facilitate the relationship.
It's one thing to need this sort of memory crutch to recall all the branches of the carotid artery or the tributaries of the internal jugular vein. "To Zanzibar By Motor Car" is a heck of a lot easier to remember than the facial nerve's branches (temporal, zygomatic, buccal, masseteric, and cervical, btw).
Dr. Ami Schattner of Hebrew University and Hadassah Medical School promises in the Archives commentary:
These simple, easily mastered, and time-frugal techniques, all in the realm of human interaction, can be regularly used to add a sincere humane touch to the beleaguered medical encounter.
Translation: Act like a human and patients will think you are one.
There's a better way.
(Look after the jump for insights from the late poet/psychiatrist Kenneth Gorelick)
I wish instead that med students would all be assigned to read last week's Washington Post obituary of the psychiatrist and poet Kenneth Gorelick, who died of brain cancer at age 67.
Before he died, Dr. Gorelick was the subject of a profile in Washingtonian Magazine. In that story, he hailed the graceful way his own neurosurgeon, Dr. Henry Brem of Johns Hopkins Medical Center, delivered bad news.
"He knew how upsetting this diagnosis was," Dr. Gorelick recalled.
[Dr. Brem] said, "I'm very sorry." It's such a simple thing, but oddly enough, very few doctors say that. They express medical knowledge and professional concern. But it's not the same thing.
In the Post obit, Diane Allerdyce, a former colleague and friend at the National Association for Poetry Therapy described Dr. Gorelick in a way that makes me suspect he was a very good doctor, too. Allerdyce told the Post that Gorelick had,
a very generous spirit, very affable...He was an openhearted person who was unassuming and made people feel completely at home and comfortable. He had an uncanny ability to recognize a person's spirit, their authentic self. He really just met you where you were.
Hard to imagine that insight came from a memorized list.