“The last thing Edward did was bring in the groceries from the car. I saw the perspiration rolling off his forehead and I heard him moan, but he didn’t stop to rest. I should have told him to come inside and sit down for a while. The next morning, he was gone”, an eighty-two year old widow said to me the other day in a voice filled with the pain of a secret guilt she had harbored for almost a year.

I stretched my hands out toward her and she put her thin, arthritic hands in mine. I held them gently, careful not to squeeze so hard that I might cause her pain.

“Oh, Mary”, I said, “Edward had hardening of the arteries everywhere in his body. He could have had a heart attack many, many years ago if you hadn’t gotten him to quit smoking when you did twenty years ago.”

Her hands returned my gentle squeeze and she smiled faintly as the tears streamed down her furrowed cheeks.

Today, as I familiarized myself with the medical history of a delightful little preschooler, her forty-something mother blamed herself for the little girl’s speech delays. “With my husband’s first losing his job when the mill closed, and then having a stroke less than a year after that, I just wasn’t there for Hayley to nurture her the way I should have”, she said as her eyes turned red and her voice grew faint.

“Look at this wonderful little girl”, I said. “See how she waits for her turn to speak and see how engaging she is with Autumn and me, even though she’s never been to our office before. She exudes a sort of gentle confidence that comes from being loved and cared for. It seems to me you have done a wonderful job with her, in spite of all the challenges you’ve had to deal with.”

“Thank you”, she whispered as she bit her lip, turned her head toward the ceiling and closed her eyes.

I am often reminded of the power of a physician’s words and the role our patients put us in of advisers in matters that go beyond diagnosing and treating illness.

A doctor, as the word “docere” was originally used, is a scholar and teacher, and the office we hold in the conscious or subconscious minds of many patients is like that of a priest or a judge.

We need to be aware of how a single, careless word or even our body language can hurt or undermine a patient’s hope or confidence. And we need to use our words and the authority some of our patients grant us as a kind of surgical instrument that can cut away festering doubts, fears or guilt. We have the power to ease suffering by wisely accepting and judiciously exercising that power. It is our responsibility to use it when that is what our patients need.

4 Responses to “Absolution”

  1. 3 meyati October 16, 2015 at 6:58 pm

    The doctors that I have now are like you. Reading your articles has inspired me to keep trying. Sometimes there are misundertandings, and some things are worrisome. My current PCP took me in and my BP was 190/100 and up. I was on the wrong thyroid dosage, and she was willing to work on it. Several others just wanted me to take BP meds. I really appreciate the kindness and care that my current family doctor has for her patients.

  2. 4 atlantajje123 October 19, 2015 at 3:19 am

    My husband entered Emory University Hospital March 1, 2014 and was diagnosed with cellulitis. His blood work showed a white cell count of 800 – down from 8,500 24 hours and he became completely non responsive while in the ER. A young and tired resident (never go to the ER on a Friday night) admitted him and neglected to diagnose his condition (sepsis), the ER nurse didn’t administer the Sepsis Tool, and the hospital night nurse neglected to read the hospital doctor’s STAT orders for antibiotics. My husband went into septic shock and died. I blame myself for bringing him to a teaching hospital where resident “practice” on patients. My husband had a concierge doctor and numerous specialists. None of them would coordinate care or even pick up the phone to consult each other. He didn’t have cancer or heart disease. He died of poor medical care. That’s endemic in our medical system. We went through many medical errors including the one where he lost his life. Honestly, I wouldn’t believe anything a doctor says.

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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