Friday, September 17, 2010

On Humanizing Medicine

An excellent opinion piece by Sally Satel, MD, a psychiatrist, appeared in the Wall Street Journal this AM about white coat ceremonies as ways to reinforce the humanistic qualities of medicine. The best part, however, was this perspective:
But the question of whether empathy can be taught—and, in particular, whether a white-coat ceremony is a good means for promoting that virtue—is a matter of some debate.

Judah Goldberg, a young doctor at Chilton Memorial Hospital in New Jersey raises an intriguing paradox. He asks how the white coat can bring doctors closer to the subjective experience of patients when, as an icon of the profession, it is meant to isolate and distinguish them from the lay community.

"To the extent that empathy can be taught through a ritual," Dr. Goldberg told me, "a hospital gown, the common garb of human frailty, would be more fitting than a distancing white coat."
I must say, the thought of everyone seeing each others' posterior sides as they paraded across the stage at such a ceremony did make me smile.

I think that humility as a doctor comes with life experiences: it is difficult to have empathy for a young mother bringing her child into the ER at 2am until you've had a sick child. It is difficult to empathize with a grieving widow until you've lost a parent or loved one. It is difficult to comprehend the anxiety of surgery, until you've been under the knife. It is difficult to comprehend cancer, until you have been so diagnosed.

Once these experiences happen to a doctor, that doctor is forever changed on how they approach patients. These are life's great lessons for doctors. And depite these noble efforts to impart empathy to doctors using this symbolic gesture, no white coat will ever impart humility better than real life.



Gary M. Levin said...

My personal experience has taught me much from the patient experience of acute and chronic illness. Serious illness also affects the entire family with reperucssions.

MD said...

Such an important point - the things which truly change us as physicians are the medical catastrophes that happen in our own lives. These give us a window into "life as a patient" which we cannot get in our training. I happened to post an entry in response to Satel's article as well (White Coats: Can We or Should We Learn Compassion?). Thank you for an insightful post!