Monday, November 9, 2009


I have an unusual practice. All I do is listen to cancer patients and their family members in support groups. I don’t diagnose or treat; I only listen. Generally I hear praise from them about their healthcare. Sometimes I hear criticism. When these people complain, though, it’s never, never, about medical technology. It's uniformly about human interaction.

“All I see of my doctor is the back of his head while he enters data into his laptop,” one said.

“How is it,” another asked, “that we can put people on the moon but we can’t send a fax across town?”

“They lost my chart,” marveled another, “simply lost it.”

“I’ve been going to this medical office for six years, and the receptionist still doesn’t know my name.”

“The doctor didn’t asked me how I wanted to handle this, just made a surgery appointment.”

A friend summed up all complaints, I think, when she said of her hospitalization, “I was poked and probed and ultraviolated, but never touched.”

In the old days, maybe the 1960s, the medical examination room held only a doctor and a patient and the pain and suffering and intimacy and hope that emanated from their transaction. Gradually, third parties—insurance companies and government agencies—invaded the room and pruned it of emotion. What had been a temple became a factory. The examining room, once an existential crucible, the very nucleus of healthcare, devolved into a sterile counter over which a “provider” passes a product called “healthcare” to a “consumer.” That bothers me enough, but what totally shivers my timbers is that we stood by and allowed it to happen.

So when we finally get to talking about what “health” actually means, let’s consider including responsibility, the skill of paying attention and then acting accordingly.

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