Physician Empathy Can Benefit from Seeing the Patient Perspective

Having practiced cardiology now for over 30 years, I have seen more than a few patients recover from open-heart surgery. However, I have had no direct experience with a child who had to endure similar trauma.

Last December, my granddaughter in Atlanta, was born with a complex congenital heart malformation. She had a temporary procedure in February to keep her from being “blue,” or having low oxygen levels. Although any “minor heart surgery” procedure is a bit of an oxymoron, she did well and was able to gain critical weight until a more extensive and corrective procedure could be done.

That procedure was done successfully on August 26 at Emory Children’s’ Hospital in Atlanta, and the parents were told to expect a one- to two-week hospital stay. The baby did so well that she was moved out of the intensive care unit after two days and sent home on only her third post-operative day. This is on the short end of the expected stay even for an adult undergoing coronary bypass and or valve surgery. To everyone’s surprise, this was nothing short of a miracle.

For my daughter who suffers with OCD, (Obsessive Compulsive Disorder), the hospital stay was a nightmare and she actually pushed for the early discharge. To her, a hospital is a veritable house of horrors where mistakes are the rule, and every interaction with a healthcare person is fraught with errors in judgment and miscommunications. For example, blood must be drawn at 4 a.m.¬¬

“Why can’t they do it later?” she would ask.

“Because the doctors need this information early on to adjust medications before they enter surgery for another six to eight hours,” I answered.

The post-operative echocardiogram took one and one-half hours.

“Why does it take this long?” she asked.

I said, “You are in a teaching hospital, and everyone needs to learn. Complex congenital heart disease surgery is not done in community hospitals where things go faster.”

“Why do they have to awaken her for vital signs?” she asked.

“Because those are the rules,” I would say again, trying to be patient. Her baby was poked and prodded for 84 hours, and my daughter couldn’t escape this perceived medical jail soon enough.

Yet, what is easily overlooked here is the true miracle of rearranging the veins, arteries, holes, and valves of a 16 pound child in under three hours, and then discharged home in three and one-half days.

As a physician and cardiologist, it is not easy to be on the flip side of the doctor-patient relationship. Nurses and doctors often dread taking care of a physician or his family, so I tried to be as unobtrusive as possible. However, the temptation often got the better of me as I asked the critical care unit nurse, “Is that right bundle branch block on her EKG new?” I think being on the receiving care of medicine, and/or surgery, offers a wonderful opportunity to make us more compassionate and empathic caregivers.

The wonders of modern medicine, and the awesome skills of a pediatric cardiac surgeon are nothing short of miraculous. And, oh by the way, the prayers of a multitude of friends and family members didn’t hurt either.

Find out more about David M. Mokotoff and our other Practice Notes bloggers.