Lately, I have been struck by how frequently patients say to me just how much they appreciate the time I have spent with them at the end of our visit. They go on. “This was amazing, wonderful. No one has taken the time to listen to me, to really try to understand my problem, to look me in the eye, to examine me, and to explain what you think and how you think I can get better.”
I see all kinds of patients, young, old, in between—and all kinds of problems, too. But they all say something like what I have come to call the “you are wonderful” comment. It also comes to me in my square credit card feedback comments, or cards in the mail, or via email, too. I really appreciate hearing this, but honestly, I am just doing my job as a physician.
What’s going on? Though I’ve felt appreciated throughout my career, I realize the contrast between the way I practice and what I hear and see happening to family, friends, and patients in other medical settings is growing exponentially. I’ve been at this since 1988, and I have seen about 15,000 people over that time. I’ve gotten to know some of them for as long as 30 years. But I’m a stubborn person when it comes to how I practice. I believe in Slow Medicine. I believe it is more important to know the sort of person who has a disease than the sort of disease a person has, and that it takes time to get to know someone. You can’t ever know them fully. People are complex and change through life. I simply refuse to make the kind of changes doctors are being forced to make in todays “health care system.” I see how much trouble it is causing.
Our understanding of disease and illness changes too. The complexity of the testing I can do nowadays is amazing compared to 1988. Mind-blowing, really. But the Practice of medicine occurs at the interface between what I know and can learn from my fields of study and the patient who sits before me. I am the conduit. My mind, heart, and body conduct the connection between my patient and the science of medicine. It’s like a superfast fiber optic internet cable.
I think the degree to which I can be effective has to do with the level of attunement I can sustain when I’m interacting with people. I’m present, paying attention to as much as I can of what I am seeing, smelling, hearing, and feeling, and connecting it with what I know. That of course can contain a lot of aspects: Memories of what I have perceived before as well as what I have read and learned from teachers, books, courses, journals, webinars, discussions with colleagues, patients, and the accumulated experiences of living that I carry in my consciousness.
It’s like any practice. The more you do it mindfully and with the intention of increasing your awareness, capacity, and skill as you go, the better you get at it. There is not really a limit to this kind of learning and living. It’s a simultaneously being and doing- in the space you share- kind of thing.
It’s also how I was taught to practice medicine by my teachers. I didn’t think of it myself. The reason it now seems so rare and strange is that the way medicine is being practiced now no longer resembles how medicine was practiced for centuries. And why have we let that happen?
That is a question for part 2 of this blog. For help with this, I highly recommend Victoria Sweet’s new book Slow Medicine and her earlier work God’s Hotel. These have both inspired me and are helping me find a language for doing my part in the Slow Medicine Movement. It’s a lot like the Slow Food and Slow Church Movements, bringing us back to an understanding of the underlying principles of Health: Mind, Body and Soul.
For me, being wonderful is also fun. As slow as I might look to others as I practice, the high-speed connection I have with my patients, students, staff, and the space we share feels like I’m moving incredibly fast inside a light beam, or surfing down a huge, infinite wave.