Putting Patients before Personal Beliefs a Good Lesson to Remember

"If you can't feed a hundred people, then feed just one."
- Mother Theresa

The end of the year always prods me to take stock of my life, think about my experiences, and try to apply what I have learned as a clinician and a human being.

Those of us with the honor and privilege to be entrusted with the care of patients have a special calling and place in society. We have access to the special knowledge and experience about both the physical and spiritual aspects of the patients who rely upon us for their care. It is a heavy responsibility.

I spend a lot of time in the in-patient burn unit, emergency department, and out-patient clinic, and see an endless stream of humanity from all walks of life, and all socioeconomic classes. They all share one think in common - and that is that their lives have been disrupted by an unfortunate injury, usually at a most inopportune time. Traumatic injury and burns cross all lines and demographics.

The holiday season has always been a difficult time for me, especially as I age. I have been blessed with a good education, a great profession, a loving and supportive family, and much success in my professional and personal life. However, I’ve grown more aware of the pain and difficulty in life for many of our fellow human beings, some of it self-inflicted, and some of it just plain dumb luck. It is worse for me this time of the year as the chasms in our society seem to be much more visible to me.

I remember well the zeal and idealism with which I entered the physician assistant profession 30 years ago. Experience tempers a clinician and forces him or her to lower their expectations where their fellow human beings are concerned. I tend to set my patient education and treatment goals lower that I used to, and I find that I’m less likely to be disappointed. I measure success in baby steps, and rejoice over each one taken in the right direction.

All of us have an unforgettable educator that helped to shape our attitudes and beliefs about patients and patient care. Mine was Harold Goldberg, MD, at the Stanford University Medical Center PA Program. I will never forget the lessons he taught me.

We never stop being citizens, or regular human beings. We are from every socioeconomic class, every race, gender, creed, sexuality, and political persuasion. Our experiences and training in life shape who we are, and it is an indelible part of who we are as persons.

As clinicians, we see much every day that challenges our beliefs and world view, and it is tempting to act in a manner that is consistent with our values and beliefs, and not the patient’s.

We had significant, profound, and insightful discussions about medical ethics in Dr. Goldberg’s class, and many times we were left with more questions than answers. That is ethics in medicine. He challenged us to “think different,” and be more patient-centered. One of his famous quotes (and he had many funny pearls gleaned in his years of internal medicine….) was that a physician / PA “…should not try to implement public policy one patient at a time.”

Those of us experienced in medicine and healthcare delivery are a tremendous resource in helping to shape the coming healthcare reforms to better serve our patients. We have to always remember, however, that these are distinctly different activities that rarely, if ever, intersect in a good way. As good stewards of our society and healthcare system, we need to actively participate in both, and understand the distinction between public policy and individual patient care.

One of my favorite quotes is from Robert F. Kennedy, who once said, "Each time someone stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope." That is what we do each day as we try to comfort and care for the sea of humanity presenting for care in our practices and hospitals. Tiny ripples of hope become waves of change as they come together.

My expectations may be lower, but my desire to make a difference in the life of the patient in front of me has never burned brighter. Mother Theresa and I have similar aspirations and expectations. If I can’t cure 100 patients, I can sure try to cure one.

May you all be blessed and fulfilled this holiday season, and thanks for all you do to make a difference in people’s lives.

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