.:. The Human Connection .:.

Salam ...

I'm not intended to update my blog in the middle of upcoming examinations await me. But after reading an interesting article linked by one of my friends at the facebook wall, I can't help myself but to write something regarding it. And to add the spark, it's something I just experienced a day before.

Here are some excerpts from the article. It's about the doctor-patient relationship ...

“Place the diaphragm of your stethoscope here,” the Irish doctor was saying. “Start at the base of the heart and move down to the apex.”

He listened quietly. “Ma’am, take a breath in, and breathe out and hold it.”

I felt like an oddly invisible prop: part artist’s model, part one-night stand, heard but not seen. At first nobody made eye contact or spoke to me, a situation that evoked the universal vulnerability of patients: exposed, invisible, dehumanized.

* * * * *

The fourth student who strode to my chair was a guy I remembered from a cardiology lecture I’d attended at the outset, taught by Dr. Katharine Treadway. He’d sat up front and answered her toughest questions, brimming with enthusiasm and brains. I had found myself rooting for his medical career. Now he listened, smiled at me and said, “Awesome!”

That broke the ice. At last I was a person, not a prop.

The next student opened with “Hi, how are you?” When she finished, she said, “Thank you very much!”

* * * * *

Again, some of the students spoke to me, while others did not. One let his hand linger too long on my shoulder as he thanked me and turned to walk away: creepy.

Another remained stony-faced as he fumblingly examined me, never saying a word: really creepy. So inept was he that I decided not to lean forward, thus making my heart more difficult for him to hear. (Doctors who don’t earn the trust of their patients, by the way, are more likely to be sued in a malpractice claim.)

* * * * *

“Hi, my name is Ben,” he said with a warm, professional smile as he looked me in the eye and shook my hand. I was instantly at ease.

Ben moved with natural confidence, as if he had been practicing cardiology for decades. While listening he closed his eyes, the better to hear the subtly separate click between the two heartbeats.

He made such a vivid impression in person — kind, compassionate, smart, capable, intuitive — that when I later played back our exchange on my digital recorder, I was surprised that his soft voice had barely registered. At the end of the session I asked him why he wanted to be a doctor.

“I had an experience in the hospital with my mom, who passed away,” he told me. “That’s when I realized what I wanted to do.”

* * * * *

The third group seemed to have picked up a few pointers. The doctor in charge not only called me by name, but rubbed her hands and the stethoscope to warm them up, which the students mimicked. They greeted me at the start and thanked me at the end.

Before beginning, they explained where they would be placing the stethoscope and why. And they listened to my heart intently, for longer stretches — one fellow for 5 minutes 25 seconds: a lot of listening.

Feeling like an acknowledged human being, I was more apt to adjust my posture for them and inquire whether they had heard what they were listening for. I wanted to meet them halfway; I felt I owed them a good click.

Still, it was not until the 18th student — the last — that someone bothered to ask my first name. She told me hers and shook my hand. How wonderful it felt to finally say my name, to be heard and seen.

* * * * *

Pardon me for the long 'excerpts'. I think I should write it down rather than just post the link. HERE!

As for me myself, yesterday i had gone through the osce exam for internal medicine. The exam went quite well. For this exam, I was told to greet patient first before doing any of the questions requested. Not like the previous osce surgery in which I wasn't emphasized onto it. It's like - Assalamualykum. Ezayyak, 3ammel eh? Ana duktur Basyir, momken ana kashf 3aleyk? (Assalamualaikum. How are you? I'm Dr Basyir. Can I do some examinations on you?) And later on after finishing my examination on the patient, I should recover again any parts of the patient's body in which I uncover before.

For me, it's just a small thing. Not something that I should worried if I forget to do so. Not as much as if I forget the murmuring sound of mitral stenosis. But after the osce exam, I can conclude that the human skill of the doctor-patient relationship is as much important as the knowledge of medicine itself if not more.

In addition to the article above, the previous osce exam has taught me to treat patients as a human being and not merely a subject or a model of diseases. It's true the limited time of exam (even some of my unfortunate colleagues got a very brief time) sometimes made us anxious and eagerly rushing to the diagnosis rather than thinking of making some connections with the patient.

I believe these things can be learned and practiced. Developed by times. And trust me it would only do us beneficial than harm. One of my patient (as if I'm a doctor ... hehe) yesterday even try to encourage me and ask me to calm and think to answer my professor's question. Isn't it a great feeling to see your patient giving you a support in that time?

It was related on the authority of Abu Hurairah, radiyallahu ' anhu, that the Prophet, sallallahu 'alayhi wasallam, said :

"Whosoever relieves from a believer some grief pertaining to this world, Allah will relieve from him some grief pertaining to the Hereafter. Whosoever alleviates the difficulties of a needy person who cannot pay his debt, Allah will alleviate his difficulties in both this world and the Hereafter. Whosoever conceals the faults of a Muslim, Allah will conceal his faults in this world and the Hereafter. Allah will aid a servant (of His) so long as the servant aids his brother. Whosoever follows a path to seek knowledge therein, Allah will make easy for him a path to Paradise. No people gather together in one of the houses of Allah, reciting the Book of Allah and studying it among themselves, except that tranquility descends upon them, mercy covers them, the angels surround them, and Allah makes mention of them amongst those who are in His presence. Whosoever is slowed down by his deeds will not be hastened forward by his lineage."

[Muslim]

Shokran hadhrotak ...