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What a Doctor Does Best

Luciali72x721Lucia Li -- "The good physician needs a clear head and a kind heart."

The couple who walks into the neurology clinic are young and, ostensibly, in the prime of their adult life. The husband, the patient, is ex-army and used to being in perfect health. The consultant, who has already voiced his concerns to us before the patient came in, takes the history and leads the patient through a gauntlet of examinations. These elicit signs which are so classical that even I, the inexperienced student, know what the diagnosis will probably be. The consultant is gentle but firm and hints to the couple that the man’s symptoms indicate the more serious of two possible conditions.

The patient jokes wryly throughout the whole consultation, half using it as a defensive tool against the potentially life-shattering diagnosis. He openly admits that he’s in denial about his situation and expresses dissatisfaction at the blunt way in which his referring doctor told him "when you see something that looks like a blackbird, it probably is a blackbird." So the consultant explains his symptoms to him, helping the patient come to the conclusion himself. At the same time, the doctor tells the couple that he understands the serious ramifications of a certain diagnosis for the patient’s life and decides to withhold the label until the confirmatory scan has been done.

The patient’s wife has done research on the internet and has many questions, especially regarding a very experimental new treatment. This happens to be the consultant’s research interest, and he is able to explain his concerns in simple yet unpatronizing terms.

He guides the patient through the uncharted water of the probable diagnosis, discussing frankly best-case and worst-case scenarios, both comforting and yet imparting no false hope. When the consultation ends, the patient and his wife request that he continue to be their neurologist despite living 3 hours drive away.

As with such experiences, this one embodied all that medicine means to me -– the good, the bad, and the painful. Here was a doctor who was both competent and humane. Who was both scientific and clear in his explanations. Who understood not only the condition, but also the person. Seeing such an excellent clinician at work reminded me of the type of doctor I aspire to be. Medicine will always be defined and advanced by its people and it is always a privilege and pleasure to see one of their best, doing what he does best.

October 5, 2008 in Lucia Li | Permalink

Comments

Multiple Sclerosis?
Lou Gehrig's Disease?
Huntington's?

What were the signs and symptoms?
What was the disease?

Posted by: Thomas | Oct 5, 2008 10:59:15 PM

Ahhhh... you purposely left out the details of the disease to torment the overly neurotic med student!!! Please do tell!

Posted by: BP | Oct 8, 2008 8:17:49 AM

It's great to find these kind of people, though it's not the most common thing. In fact, I've learned more from "bad" examples about how a good physician should NOT be.

Posted by: Flavio G. | Oct 8, 2008 7:28:20 PM

Well, we can all learn from different kinds of doctors: how to treat patients from a good doc, and what must definetly must be avoided from bad practitioners.
In the end everything comes to us, what we learned, forgot and ignored will determine the kind of doctors we'll be, let's just hope it'll all be for the best in the end.

Posted by: Pepe Telich | Oct 8, 2008 8:14:44 PM

Signs?????????????
Symptoms?????????????
How dare you not reveal those????????

Posted by: Saketh | Oct 10, 2008 1:54:51 AM

What is this guy suffering from?
any signs or symptoms you forgot to tell us?
you did this on purpose. hahaha.

Posted by: Alfin | Oct 10, 2008 4:23:24 AM

tht's so true...all of us need great role models to look up to and get inspired.we ought to be grateful at where we are now as we are seeing the best helping other people and teaching us at the same time.

Kok soon,Malaysia,UM

Posted by: Kok SOon | Oct 10, 2008 8:52:04 AM

Hello! I'm a dentist from Iraq, and I have to say that I was really impressed by the way you kept the information confidential...
And yes, I agree with you, we do need to observe 'good' and 'bad' examples to become better doctors/dentists...

Posted by: ledentiste85 | Oct 11, 2008 2:11:04 PM

hello,i'm a medical student from iran
with thanks for sharing your experince
yes,that's exactly as you said
we can say that the way of treating the patients is the most important part of our practice

Posted by: hamed | Oct 13, 2008 12:04:16 PM

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