When Doctors Become Patients

The Princeton Alumni Weekly published an essay by Robert Klitzman, M.D., "Double Lives," adapted from his book, When Doctors Become Patients. Naturally, it caught my eye. 

Columbia University Medical Center psychiatrist Dr. Klitzman interviewed more than 70 physicians who have experienced serious illness, such as depression, cancer, heart disease, H.I.V., hepatitis or various other illnesses. Then he organized the material into chapters that explored particular aspects of illness, such as "Self-doctoring and Choosing Doctors" and "Disclosures of Illness."

Included are stories of physicians who denied obvious symptoms, took unnecessary risks and didn't comply with therapies. These stories highlight a topic of particular interest to me: The gap between patients knowing what to do and actually doing it. [They also made me realize I'd been too hard on myself for years after a few bonehead moves early on in my survivorship!] 

I have felt a powerful need or desire to use my illness as a platform to advocate for patients. I do it by sharing my View From the Other Side of the Stethoscope with my colleagues, hoping they will listen because of our shared background.

Now I see that mine is a common response. The struggles of these wounded healers led many to devote time and energy to improving the education of other clinicians. Dr. Klitzman furthers this effort with this book, saying, "While I do not know if empathy can be taught, these doctors’ experiences can perhaps be more poignant and compelling to other physicians.”

Comments

[A reader]

Wendy - where can I order your book? thank you for your posts.

[Wendy S. Harpham, MD]

Dear Reader,

I'm glad you are finding the blog useful. You can find information about each of my books and links to Amazon on my website: www.wendyharpham.com

My books are sold by all major online booksellers: Amazon, Barnes & Noble, Borders.

Feel free to e-mail me if you need further information about any of my writing. With hope, Wendy

[Finn]

I love the line at the end of Dr. Klitzman's article that says every med student ought to be forced to sleep in patients' hospital rooms to experience what patients experience. While it's referred to as a joke, it's actually not a bad idea. Most doctors aren't going to experience a major illness during their training or early years in the profession (fortunately), but having students spend 24 hours in a hospital room, wearing a johnny without underwear, eating hospital food, and trying to sleep despite noisy roommates and frequent awakenings for vital signs and morning rounds, would be a simple way to give them a small taste of what it's like on the other side. It's hard enough to deal with when you're healthy; they could then be encouraged to imagine what it would be like if they were in pain, couldn't get out of bed or use the toilet on their own, awaiting pathology results, etc.

[Wendy S. Harpham, MD]

Dear Finn,
I agree. The exercise of "playing the patient role" would be a relatively easy, quick and inexpensive way to sensitize future doctors to the stresses of being a patient. But it would be just a taste. Most of the distress of being a patient comes from feeling sick, vulnerable, dependent and afraid. And knowing that it is an exercise (i.e. they are not really sick) and that the exercise will end in 24 or 48 hours makes even the greatest discomforts far more tolerable.

I tried as best I could to understand the patient experience before my diagnosis. I read books by patients with various ailments. I listened closely to my patients' stories. I even projected what it might feel like if it were me, not Mrs. Smith, diagnosed with, say, leukemia.

Yet when possibility became reality and I was diagnosed with cancer, I kept thinking, "Wow! I really didn't have a clue how awful it is."

Something is better than nothing. I vote for having every medical student go through this exercise. But I'd also like to see a greater emphasis on the art of medicine throughout the rigorous post-graduate training periods of internships, residencies, and fellowships.

You've got me thinking, Finn!
With hope, Wendy