INVISIBLE SUFFERING

My new book, The Bedside Manifesto (to be published within the next month), argues that authentic healthcare reform won’t result from any juggle of its economics, only from reviving its center, the venerable “bedside manner.”

I needed to know what other authors were saying, so read piles of books on the subject, almost all written by physicians. Their titles include words I, too, use, like Relationship, Caring, Listening, and Compassion. Yet astonishingly, they’re almost all about diagnosis: pay better attention to the patient and you’ll diagnose more accurately.

Of course, a proper diagnosis leads to optimum physical treatment, and who wouldn’t call that a good thing? Yet none of these good doctors write about patients’ feelings. What’s the shape of their suffering, regardless of diagnosis? How can they be helped to feel better, right now, before any medical treatment?

The authors who do address patients’ feelings are those who work in palliative care. Here, at the apparent end of life, where diagnosis is no longer paramount, comfort is the priority.

Doctors tend to focus on literature within their own field, where there’s plenty to keep up on. To them, palliative care can feel outside mainstream medicine. In fact, end-of-life specialists lament that in the medical mind, a hospice is only somewhere to go to die. While that’s usually true, it’s more, too, as it offers long-sought comfort. A friend of mine who recently engaged hospice services told me, “Finally, no more chemo that makes me sick. The hospice nurses are interested only in me, not my illness. They hear me and keep me comfortable and as pain-free as possible.”

I’d love to see the hospice ethic extend into mainstream medicine. Why shouldn’t every patient with any condition receive this sort of personal attention and comforting?