fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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February 2022

Bystander

I stare straight ahead at the computer screen, trying to blend in with the other medical tools in the room: IV drips, ventilator, feeding pump, chest tube canisters, nurse. I listen to my patient’s mother read to him.

She’s reading from a book my mother read to me many times. Listening to the story sends me back to my childhood. I’m cuddled up in my mom’s arms, in my pink flannel pajamas, in my parents’ warm, familiar bed.

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Dignity in Childbirth

My interest in women’s health began when, in high school, I became aware of the ongoing genocide in Darfur. Learning about that conflict’s impact on women in terms of sexual trauma and maternal mortality opened my eyes to the depths of inequality that women face in the Global South. This, combined with the fact that I’m a first-generation Nigerian-American, led me to pursue a career in obstetrics and gynecology, with a global-health focus.

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Treating a Messiah

It was my very first day of psychiatry rotation in my family-medicine residency at the Baylor College of Medicine, Houston.

This rotation took place at the old Ben Taub Hospital with its unmistakable odor–a combination of drugs, detergents, illness and death. Even if I were taken there blindfolded, one sniff would tell me that I was at Ben Taub.

At any rate, having survived my first seven months of residency, I was feeling a little more confident in my abilities.

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Why Isn’t He Listening?

I was in my third year of medical school, partway through my psychiatry rotation.

“You’re ready for your first mental-capacity consult,” my attending said. I felt excited at being deemed ready to administer this evaluation, which is used to determine whether a patient has the ability to make decisions about their own care.

“The medicine team is confused about this one,” my attending continued. “He’s clinically improving from his COVID infection, but he wants to withdraw from care and has refused physical therapy.

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Never Saw

When I was a child, I never saw my mother unclothed; she always got dressed and undressed in the semidarkness of her bedroom. I caught a glimpse of her bare thigh once, until she told me it was rude to look. If I woke up in the late evening and knocked on the door of our only bathroom, I was admitted to pee only after mother had covered herself with washcloths while reclining in her nightly bubble bath. All I could see were pale, bare shoulders above the bubbles.

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Listening with an Invisible Ear

The eternal goal for those in the medical profession is to accomplish treating, curing, and healing our patients. This has become particularly challenging with so many encounters now limited by Zoom, time constraints, masks, compartmentalization due to specialization, and shared anxiety due to the pandemic. But the challenge is one we must meet. The integrity of our profession depends on it.

I would make the case that listening is the universal medicament—an alchemy that transcends all else in clinical medicine. It is not limited by technical skill but instead is enhanced by the health professional’s willingness to be a witness to the patient’s story.

Here’s but one example: In the 1970s, when I was practicing as a primary-care physician, if one of my patients suffered a heart attack I would ask them, “Why did you choose that day to have your heart attack?”

I was surprised by the insights my patients offered. Virtually all of them who’d suffered a heart attack were trapped in life situations in which they had lost control. For them to be truly healed, they needed help uncovering the biopsychosocial, spiritual, and ecological interrelationships in their illness. This required a profound level of listening that went

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Listening in Music and Medicine

While attending a music retreat several years ago, I had the opportunity to play a piano duet with a more experienced piano player. As we prepared for the recital, it became evident that it wasn’t enough to focus on my part. I also had to listen to what my duet partner was playing in order to make pleasant-sounding music.

Sometimes, when dealing with patients, we get the real “story behind the story” only at the end of the visit or after several visits.

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