Assuming the worst

Originally published in The Ottawa Citizen July 31, 2001

In June of 2000 my Dad was hospitalized for some surgery. He related the following story to me that made me stop and think about how we treat our patients and where, perhaps, some of our interpersonal skills come from.

My Dad walked the ward after his surgery whence he came upon an elderly woman near the nurse’s station. She appeared frail having several scars upon her scalp suggestive of old cranial surgery. Tied to her wheelchair by a drape of bed sheeting, he noticed that her right hand was moving. At first he thought these hand movements were involuntary, and yet something did not seem right. He asked the nurses about her but was told that she was demented and was not aware of her surroundings. During this brief conversation he noticed that her hand twitching was more deliberate.

Not a man to accept incongruous answers to observations that demanded a better explanation, he did what any man of science would do, he tested his hypothesis. He approached her and took hold of her hand. He instructed her that if she understood his questions to squeeze his hand once for ‘no’ twice for ‘yes’.

“Do you understand what I have said?’ Two squeezes.

“Can you hear me?” Two squeezes.

“Do you like your doctor?” One squeeze.

“Do you want to sue your doctor?” Two squeezes. (My Dad is also a joker.)

The doctor was skeptical and responded that she indeed was demented. My Dad asked him to take her hand and to repeat what he had done but asking her different questions. Again she responded coherently to each question.

My Dad noticed that the doctor went pale and had a look of horror upon his face. He immediately transferred her to the rehabilitation unit. The doctor asked my father to speak to the other patients on the floor as well.

My father felt “on top of the world” after that incident. He saved a woman from a life of hell, locked inside her body yet fully cognizant of her surroundings and no one hearing her scream for help.

We as physicians can sometimes assume too much. We have all committed this error to varying degrees during our careers. I think we all need a good reminder every so often about how we can effect someone’s life for good or for bad. We at times can be overwhelmed by our workloads and responsibilities that our empathy suffers. We are trying to provide so much to so many in so little time that in our rush to keep up we lose a part of ourselves that made us become doctors in the first place. At times we base decisions upon preconceptions.

My father experienced such joy that it brought him to tears. All of us should keep that feeling close to our hearts. We cannot cure everyone but we can still make a difference to people if we take the time to listen. My father’s simple act of taking someone’s hand changed their life. My father is not a scientist. He has never taken a science course. He sold insurance, drove a taxi, owned a grocery store and is an excellent butcher. He has had to communicate well in all his endeavors. He notices people. We ask ourselves and are asked at times where we learn to be a good doctor. I can proudly say I am my father’s son.

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