I think we often forget in this busy era of the medical industrial practices where we
are, we forget that the very nature of a patient physician encounter is an intimate human encounter.
Increasing technology, the burdens from an electronic health record have a lot to do
with us losing the sense of the fundamental calling that brought us to medicine and the
joy, the sheer joy, of connecting with another human being.
A stranger who is choosing to come and tell us their problems.
The nature of the encounter has to be human, and that doesn't mean that it can't be studied
with the same rigor that we study sodium levels or study responses to antibiotics and so on.
Well, this whole idea of doing this study really came about because my sense is that
that first moment between patient and physician is so crucial.
For many years, I always thought that the moment of washing hands was more than just
washing hands.
It was almost a way to be intentional to remind myself I'm entering into sacred space.
The other thing that I often do as a clinician is I will look at the patient's shoes.
The most striking moment to me when I think this all began for me was working at a county
hospital in El Paso, Texas, and very often walking into a two-bed room, you would see
their feet in the chair where they were seated or on the edge of the bed, and I would see
someone with big fluffy slippers painted orange or colored orange, or I might see bare feet
in shackles with prisoner-issued rubber slip-ons.
And in each case, I was going to approach that patient already with a slightly different
mindset.
An ability to put myself in their shoes before I even got to them.
And so, I think there were little steps along the way, little stories that I had in my mind,
I think all clinicians have, that we wanted to study further.
In the time we have with patients, let's create a little checklist but an entirely mental
one to allow us to get the most out of that moment even though it's challenging.
So this is not meant to be a panacea.
This is not meant to take away the ills of the way we now practice medicine.
There nevertheless needs to be a way to maximize that patient physician encounter.
Not to let it be further in danger of disintegration.
Not to let it just get so vaporous that there's nothing there, and you just check in on a
keyboard and you don't really see a human being.
We know that won't work.
Ian Forster said many years ago in Howard's End, only connect.
That's really what this is all about.
Only connect and how do we help all of us in this profession, in this wonderful profession
with the great opportunity we have, how do we connect?
Only connect.