I had just had my second child and I noticed that there was kind of an
abnormal area in my left breast and the imaging workup showed that there was a
about a seven or eight centimeter mass there. I still wasn't that worried. This
is what I do for a living. I diagnose breast cancer. This probably isn't gonna
be my story.
They did a biopsy of the mass and the next day I was back at work waiting
front my colleague to come knock on my door and tell me the results of my
biopsy. Eventually she did come to my door.
She had a colleague with her and I knew the second that I saw the two of them
together that the colleague was there to help her deliver bad news to me.
It was me this time that was getting a cancer diagnosis. I learned firsthand
really what that felt like.
A major part of what we do as physicians involves understanding what's important
to a patient, understanding how a diagnosis or treatment plan is going to
affect that person's life, and being able to communicate why we think that a
certain clinical decision might be the right one
for a patient and for all of those things empathy is critically important.
We do have research to tell us that empathy is important. We know that having
a trusting relationship if the patient is perceiving that trust that then
translates into gains in patient satisfaction, provider satisfaction. It's
associated with better quality outcomes. Listening is at the heart and core of
empathy and then derivative from that is being able to place the patient's
experience in a broader context to more fully understand the implications
of the disease, of the patient's life on their well-being and the well-being of
those around them
Being a patient opened my eyes to a lot of what patients go through but I don't
think that it's the only way you can gain understanding about what it's like
to be in someone else's shoes. I think there is some empathy built into the
character of young physicians as they enter a field that really is a lot
about empathy but it's unfortunate sometimes the system isn't built to
capture that and nurture that in a positive way. Technology is now
interwoven into almost everything that we do in clinical care and I think that
can at times detract from human connection and the interactions that
many of us went into medicine for. There has been over these past decades a rapid
expansion of biomedical knowledge but in some cases that knowledge and the way
it's been applied and the technology accompanying it have served to distance
care providers from their patients. Just as much as we're teaching the biomedical
sciences, basic sciences during the preclinical years and the clinical years
from the medical students, we need to equally be thinking about how to build
their listening skills and their ability to connect to patients, their ability to
build that empathy with their patients. Medical students you know learn how to
examine the patient in their first two years of medical school and then they
arrive on the wards and they find to their dismay I think that the currency
on the wards doesn't revolve around the patient as much as it does around the
computer which and led us to particularly embrace something we're
calling Presence. It's full name is Presense: the art and science of human
connection. And it really is about trying to foster interdisciplinary work in
order to enhance the experience of being human. I have been really appreciating
what presence has been doing for us. A lot has come out of presence, one in
particular is the Presence Five initiative. The Presence Five study is an
initiative that's bringing together researchers from the different
disciplines across Stanford and the School of Medicine and our goal is to
identify specific discrete actions that clinicians can take to be more fully
engaged in the moment with patients. Making a young physician
present is really a matter of undoing a lot of the things that the old
physicians have left them as a legacy but I think we now have a new mandate to
embrace that. Not only is the patient at the center but the human being is also
in the center. My own personal journey opened my eyes to a lot of what patients
go through and I think a lot of the benefit I brought back to my practice
was sharing this story with other physicians or other physicians in
training, other patients. Medicine is not a factory, it's art and a science. It's two
human beings coming together ultimately and one human being is in a state where
they require more than the science. They require compassion, they require
understanding. There's a subtext there we're dealing which is "please help me."