How Medicine is Killing Its Own

On the heels of the painfully sad essay, “What I’ve Learned from Saving Physicians from Suicide,” I just read David Bornstein’s essay, “Medicine’s Search for Meaning” and I am heartbroken. I am heartbroken for physicians and health care providers and I am heartbroken for patients. As we all know, most physicians would not encourage their children to go into the field and physicians themselves are leaving the field. Physicians today face days that are too long, patient interactions that are too short, lawsuits that are defeating even if they are won, and bureaucracy that is maddening.

Bornstein’s essay talks about how the humanity –the very thing that brought most people to medicine — is drummed out of young physicians and how they are subjected to a culture that does not acknowledge the emotional aspect of taking care of patients. Reduced to decision-making robots, where does “care” come into it? What’s the point? It seems that care givers are not even allowed the joy of building a “real” relationship or the ability to express sadness when the relationship encounters problems or disappointments. Are physicians even “caring” for patients anymore?

Care to me, as a patient, and as the parent of a patient, isn’t getting the prescription, or having an operation –it’s what happens between the poking and prodding, if you will. It is the thoughtfulness and compassion that someone expresses to me. It is the emotional context that all of the decision-making takes place within. It is the care giver’s intention for me –his or her hope that I’ll get better, their joy at welcoming my child into the world, their concern over a bad test result. Some of the best “care” I ever received actually had nothing to do with procedures, technical ability or outcomes.

One example that comes immediately to mind: the nurse who put my baby in a stroller.


This simple act did wonders for me –and was so thoughtful and caring that, nearly 10 years later, it still makes me tear-up:

I will never forget arriving at the hospital one morning to visit my less-than-one-month-old son who had just gotten out of the NICU (he had had two surgeries in those first few days and weeks of life and was still on a feeding tube). I had unknowingly walked right past him outside of his room. When I asked the nurse where he was, she laughed and said he was “right there,” pointing to him right outside of the room happily bundled and in a stroller. I stood there puzzled. He was ready for me to take him for a walk in a stroller. It never occurred to me that I could take Owen for a walk in stroller. My fragile child was able to go for a walk! A typical motherly activity! It floored me that I could do this with my child that I viewed as delicate as a glass egg –that we could do this together! Needless to say, I broke down crying –out of happiness and hope. Even though it had nothing to do with Owen’s “care,” in terms of his post-surgical follow-up, etc, it had everything to do with making us a mother and baby, just like everyone else. And, it was the best feeling I had had in a long time. The “care” shown to me by that nurse gave me more faith that we were going to be ok and have a future together than anything else thus far. I was able to see beyond the intensity of that first month and I was reassured and comforted by that.

That’s care, isn’t it?

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