Hold on just a minute

In the breast pocket of my white coat, I carry the beat-up business card that a patient gave me. Every month or two, when I bend over, the card falls out and I remember one of the most remarkable conversations of medical school:

Me: “What do you do for a living?”
Him: “I’m a ninja.”

He was not joking. I was not in the psych ward. It turned out Mr. P was a martial arts expert and professional fighter. I’m not sure if he was an actual ninja – he wasn’t wearing black pajamas or a gold butterfly medallion – but the exchange helped me understand why he may have come into the hospital with a sudden loss of consciousness. More important, it helped me understand why my patient seemed surprisingly unconcerned about his potential head injury and eager to return to his dojo and Shaolin wine. We spent a few minutes talking about his work, his training regimen, and how a ninja likes laid-back Portland life. I don’t know if the conversation helped him feel more comfortable or better understood, though I hope it did. I do know that it made my day wonderful.

“What do you do for a living” is pretty standard small talk. But my med-student brain is so often distracted by checklists of symptoms and fears of missed diagnoses that it’s surprisingly easy to forget to ask patients about the less-pressing but more fundamental non-medical parts of their lives. The oversight hurts them and me. Patients need to know that their caregivers actually care about them as people, not just collections of organs and disorders. It’s not just polite conversation. The contact will almost certainly make patients feel better emotionally about their visit and may help them feel better, physically. And I need to feel connected to the people I’m working with every day – that bond is, for me, the best part of medicine. Many of my most meaningful medical school memories flow from the times I’ve taken a few minutes to make small talk and hear about the challenge of travelling around the world blind, the terror of storming the beach at Normandy, the tragedy of watching your father kill himself, the joy of celebrating 65 years of marriage.

This Valentine’s Day, OHSU is inviting students, nurses, doctors and other caregivers to spend five minutes asking at least one patient what makes their life meaningful, what they enjoy, or just what they do each day. This Just 5 Minutes initiative, part of the Gold Humanism Honor Society’s National Solidarity Day for Compassionate Patient Care, aims to remind doctors what is most important in medicine – not the saving of lives, but the lives themselves. It’s a chance for all of us to get more meaning from medicine. And, if you’re lucky, you might meet a ninja.

2 responses to “Hold on just a minute

  1. Andy – very glad you are asking patients about what is meaningful. As a patient it is extremely important to me that my physician knows me and what is important in my life. Someday I will be incapacitated. I will need my physician to be my advocate in making decisions that will affect my quality of life. If he/she does not know what is important to me they, as wonderful as they are as clinicians, will not be the advocate I need. My physician knows that running and being physically active is important to me and that I will follow an excruciating physical rehabilitation to be able to stay active. If he/she did not know that a less desirable outcome may be chosen in that emergency. Thanks for understanding how knowing what is important to your patients affects the choices and recommendations you make for their care 🙂

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