The Problem with Medicine
Medicine is riddled with issues, and when I say medicine - in this context - I mean any health-helping profession, from energy healing to chemotherapy.
I encounter ONE main issue on the daily, from alternative medical media to interpersonal water cooler talk, and it ain't pretty. So, sit your haunches down and get ready for some frank discussions:
The Issue is 'The' Answer
Everyone and their medical cat is trying to catch your eye; to convince you that their answer is better, faster, stronger, more natural, more cutting edge, more intuitive, more acute, more rooted, or worse - trashing others' solutions.
News Flash
No one has "The" Answer. We don't know why things happen - at least not initially. Whether general practitioners or specialists, we can take an educated guess and cross fingers that we are correct on our assessments and treatments. But unfortunately there is no book with answers at the back, no magic hidden solution. The best we can do is keep unpacking the clues as they show up. If we happen to guess correctly on the first try we aren't smarter, we're luckier. I don't know if you can select for luckiness.
Through trial and error, a plethora of solutions can manage what ails you, but more than likely the big "Why" will be left unresolved. Why you got the flu this summer and not last summer, Why you developed this debilitating condition, Why you didn't catch that tragic consequence earlier - That "why" may never be unveiled. We might be able to trace our way into a cause that seems reasonable, but even then - the solutions are an experiment. We can never really know what will work, for you.
Anyone who claims to have The Answer is either a) inexperienced b) arrogant or c) a hustler. Remember that.
It's not the Vitamin D, or that special herb, or the new drug. Those sure are good to hold on to, and they sure help the marketing pitches, but the real deal is whether or not your physician:
Is educated in a variety of options
- Can allow empathy to infuse reason, without allowing empathy to cloud judgement &
- Will make the final call on a treatment when you don't want to.
Process before product.
Whipsmart Compassionate Care is what I call it.
Whipsmart Compassionate Care shows up when a well-trained physician is:
Courageous enough to say 'I'm sorry,' 'I was wrong', 'I don't know' & 'I need help'
- Kind hearted enough to hold space for both bad news and good news.
- Smart enough to ask the questions that pull out the clues & show you the trail.
Which brings me to:
Clues
The reason that The Answer is so elusive, is because of Clues. We are always working with an incomplete set of clues. Even in a longer meeting, a doctor has no way of knowing that you've been using old copper cookware which led to your toxicity or that your strange lung symptoms might be from pigeons on your balcony. We don't know that your back pain began after your divorce when you started sleeping in a different position or that the buzzing light outside your window is why you are getting migraines. You don't know what we need to know, and we don't know to ask for those intimate details until we get to know you. But build a relationship and you will tell us, over time, all the clues that will help us help you.
If a physician has a hammer and your condition is a nail, they might seem brilliant and unfailing. You may want to tell everyone that they have 'The Answer', but trust me, they don't. Your clues are not the same as someone else's clues. If your condition was anything other than a nail, that hammer would have been insensitive, barbaric, or weak. We can hope that each doctor has more than just a hammer. What about wrenches!? And Chisels! And obviously, Duct Tape.
But even still, sometimes there are no tools in our purview that fit. And that is the unfortunate answer. In that case, the question is: While you navigate the unknown, do you want someone who claims hope in a bottle, or who stands beside you through the medical trials?
"Some [...] will want to hold you like you are the answer. You are not the answer." -Sarah Kay, The Type.
Which leads lastly to -
Vending Machines
Healthcare providers aren't endless supplies of answers. They are not vending machines, where you put money in and get product out. I think we need to stop shaking them like they are vending machines. Medicine is an art that needs mutual compassion between doctors and patients. If we keep putting healthcare providers on the product line, they will inevitably dehumanize your concerns. Physicians are people not products. They need to make an income from their service. They need to be paid for meeting you, assessing your concerns and giving you options - even when they are wrong; even when the diagnosis is unsolvable, even when the solutions are not what you want to hear.
Beyond your current condition, there is a past that your medical team wants to know, and a whole future that they want to be there for.
We are all on the same team and I think we all subconsciously understand that. I've assessed that it's the payment systems that get everyone all up in their grills. Socialized 'free' medicine doesn't give time for connection and high cost fee-for-service care means that visits better be 'worth it'. And so in a worst case scenario, we leave either unheard in the former or over-diagnosed/supplemented/tested in the latter.
There is no good way around this - yet - other than to remind us all, that doctors are humans (experienced & educated humans, but humans nonetheless) working with the knowledge they have, trying to help other humans, and we need to appreciate each other a little more.
The way through good medicine, is and always has been, to use medical experience, dialogue, and humility to unpack clues and offer options.
The best way to do that as a patient is to build a relationship with your physician. Trust them, tell them what you know, and work together through the hard times. (ps. Change Memberships are set up perfectly for this! :)
The value of the physician is derived far more from what may be called his general qualities than from his special knowledge. A sound knowledge of the aetiology, pathology, and natural history of the commoner diseases is a necessary attribute of any competent clinician. But such qualities as good judgement, the ability to see the patient as a whole, the ability to see all aspects of a problem in the right perspective, and the ability to weigh up evidence are far more important than the detailed knowledge of some rare syndrome, or even the possession of an excellent memory and a profound desire for learning. – (John W. Todd, MD 1951)
Whipsmart Compassionate Care, that's what we need more of.