Three books

“She looks like she can’t breath, WHY CAN’T SHE BREATH?” Sharon screamed at the doctors.

Dr. Julian said, “The patient is going into anaphylactic shock.”

“What does that mean?”

Dr. Edward said, “It means she can’t breath, her throat is closing up, please move.”

The elderly Dr. Edwards was stronger than he appeared, Sharon was shoved to the corner of the room while her daughter struggled for air. “Can you fix her?”

“Mrs. Jacobs, we are doing everything we can, you need to let us work.” Said Dr. Edwards.

The two doctors hovered over the 15 year old girl, injected her with something, then she began to cough and breath normally.

“It appears the patient had an anaphylactic reaction to one of the medicines, we will monitor her for any further adverse reactions both remotely and in person. We will update you if there are changes to her condition.”, said Dr. Julian.

“What, what does that mean?”, asked Sharon.

Dr. Edwards stepped forward and gently touched Sharon on the shoulder, “It means she should be fine now, she had an allergic reaction to one of the medicines, but we got her straightened out. We will keep an eye on her and let you know if anything changes.”

“Oh, okay, thank you Doctor”, said Sharon as she went to sit by her daughter’s bed. The two doctors left the room.

----

In the hallway, as the two doctors walked, Dr. Julian pulled ahead of Dr. Edwards. “Boy, slow down, I’m old. Now where did you learn your bedside manner?”, asked Dr. Edwards.

Dr. Julian slowed down to match Dr. Edwards’s pace, “I do not understand your question sir.”

“Your bedside manner, the way you talk to patients.”

“Our patient was non-responsive and in anaphylactic shock, I did not speak to her.”, said a confused Dr. Julian.

“Our patient was everyone in that room, the girl AND her mother.”

“I apologize sir, but I believe you are mistaken, our patient is Peyton Jacobs. I evaluated Peyton Jacobs, I treated her and the hospital will be billing under her name, so she is our patient.”

Dr. Edwards stopped walking, Dr. Julian stopped as well, “Do you seriously feel that way? That the mother is not part of this equation?”, asked Dr. Edwards.

“I don’t see how the mother fits into my diagnostic evaluation of the patient.”

“Oh boy, we need to talk. Come to my office after your shift is over today.”

“Yes sir, of course, I will see you then Dr. Edwards.”

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*knock-knock*

“Enter”, said Dr. Edwards.

“You wanted to see me sir?”, Said Dr. Julian.

“Yes, yes, come in.”, Dr. Edwards motioned Dr. Julian to the chair in front of his desk, “have a seat Robert.”

As Dr. Julian sat down, he looked around the old doctor’s office. There were bookcases full of books, turn of the century medical equipment, medical journals, and even what looked like unbound manuscripts. The things this old doctor must have seen in his 50 years of practicing medicine, simply amazing. How many consults must he have done, how many peers asked him to review their work? Dr. Edwards was a legend and Dr. Julian knew he was fortunate to be paired up with him.

“Are you enjoying looking at my collection?”

“Yes sir, your body of work has been extensive. I was very pleased when I discovered I would be paired up with you as my mentor.”

“Ah yes, the mentorship program. You know, that program is something I asked for at this hospital for doctors like you Robert.”

“Doctors like me? In what way do you mean sir?”

“Oh, we will get to that. For now, I want you to look at these two items.” Dr. Edwards pushed a box wrapped in brown paper, with a file on top, towards Dr. Julian.

Dr. Julian grabbed the file off the top and opened it….it was his employment file. “Sir, I’m not sure I’m supposed to be seeing this.”

“Well why not, it’s your file.”

“Yes sir it is, but there are teacher ratings in here that are supposed to be confidential.”

“Oh hogwash, those teacher ratings are what I want to talk about. Please turn to page 3. You will see you have been rated highly under knowledge, analytical skills and aptitude; however, your compassion scores are among the weakest I have ever seen.”

“I don’t understand, I am compassionate. I treat my patients with the utmost care. I am sensitive to their religious preferences, I engage with them regarding their treatment, I…”

“You don’t care about them.”

“I…I….”, said Dr. Julian.

“It’s not your fault Robert. Having compassion isn’t something we are born with; it develops over time. You are a gifted doctor, a brilliant doctor, but we need you to be a better person so that you can become a great doctor.”

Dr. Robert Julian stared at his mentor. Was he a bad person? He didn’t think so, but obviously Dr. Edwards thought differently.

“No Robert, I don’t think you are a bad person; I can tell by your expression that that is where your keen intellect has led you. No, not a bad person, but a person who compassion doesn’t come naturally to. Your peers…. they are not as gifted as you on the diagnostic approaches, correct?”

“Well sir, I mean who is to say?” Dr. Julian began blushing.

“Ha, ha, well at least your humility is intact, no Robert, they are not as gifted as you are in that area. You are a natural, it comes as easy to you as a duck to swimming. I don’t take on a mentee every year, I only take on the special cases like yours. When a doctor with your skills can be taught to also be compassionate, well, that doctor can achieve true greatness.”

Dr. Edwards looked Dr. Julian in the eyes and said, “the question is, can you be taught compassion? If you can’t, you will still be a good doctor, you just won’t be great. Are you willing to try?”

“Yes sir, I would love to learn anything you can teach me.”

“Good, time to open the box then.” Dr. Edwards handed the box to Dr. Julian, who opened it and looked inside to find three books.

“I don’t understand sir.”

“I know son, but you will. In that box there are three items, please take one out.”

Dr. Julian held up the thesaurus. “This is supposed to help teach me compassion?”

“Excellent first choice. Tell me, do you think the patients we treat have extensive medical knowledge?”

“No sir, not most of them.”

“No, they do not. They grew up learning words like allergic reaction, not anaphylactic shock. So when you are talking to me or a co-worker, feel free to use the correct medical descriptions, but if you want a patient or their family to understand you, use the words THEY understand. That is lesson number one. If they can’t understand you, you can’t listen to their replies. Patients and their families need to be heard. You would be surprised how often they know more than you do about the patient.”

“But sir, how is that possible? How could Sharon Jacobs know more than me about her daughters’ condition?”

“Ah, see, right there, you didn’t listen to me. I said you would be surprised how often they know more than you do about the patient, not the patient’s condition. You can look at test results, but they don’t tell you about the patient, only the patient’s condition. Would it be relevant to you to know that Peyton Jacobs is allergic to eggs?”

“Of course it would, eggs are a component of several vaccines and medicines.”

“Ah, so can talking with a patient or their families alter your course of treatment?”

“Yes sir, I can see how it could.”

“Correct! So they have to be able to understand you, so you can understand them. Please chose your next item.”

Dr. Julian held up a book called Public Speaking 101. “Why do you think that item is in there Robert?”

“To help me relay information effectively regarding a case.”

“No, turn to chapter 1, and read the tittle.” Dr. Julian flipped to Chapter 1 and read “How to speak with warmth.”

“YES, warmth! This chapter is also known as how not to sound like a robot! While you are using your common words to explain the situation to the patient and their families do so with warmth. You could say the patient developed a subdermal hematoma requiring a Burr hole surgery, we expect a full recovery, OR, you could look the patients family in the eyes and say I’m so sorry, there was some bleeding near your daughters brain, this bleeding caused some blood to pool in a tight spot and it was putting pressure on her brain, we had to drill a small hole to alleviate the pressure, but we think she’s going to be fine. Which do you think the patient’s family would rather hear?”

“The second sir”

“Why?”

“Because they could understand more of what I was saying.”

“And because you spoke about their daughter, NOT your patient. One is their child, another is just a name on your chart. Do you understand that there is a difference?” Dr. Julian nodded. “Okay, last item.”

“This is an empty journal.”

“Yes”

“What is it for?”

“That is for you to write down every patient you ever see. You don’t have to write much, but you have to write their first name and one thing that had nothing to do with a test.”

“Why?”

“So that you will remember them, so they don’t all blur, so they don’t become just a number to you.” Dr. Edwards walked over to a bookshelf and pointed to a row of similar journals, and opened one, “These are mine, Cecilia, gallbladder stones, had a freckle on the tip of her nose. Rose, appendicitis, had a laugh that could light up a room.” Dr. Edwards smiled, “She really did you know, have a laugh that could light up a room, never met anyone as happy as her, granted the morphine helped, but still, great laugh.” Dr. Edwards turned back towards Dr. Julian, “I want you to go home and think about what we have talked about it, come back tomorrow and start on your path to greatness.”

“Thank you Dr. Edwards, I will.”

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“I first met Dr. Edwards when he was my mentor at St. Francis. He showed me that to be a great doctor, one had to have great compassion. I have tried to teach this to my students and my mentees, and I hope Dr. Edwards doesn’t mind, but I stole his box of three items.” Some of the audience laughed, “I see I’m not the only one.” Dr. Robert Julian smiled. “Those three items changed my life, and I’d like to think that Dr. Edwards would be proud that I now have my own bookshelf of journals, and they all contain names of people I have treated, not patients, but people. I discovered along the way that everyone truly is unique and special, and they deserve to be heard and remembered. Thank you for allowing me to help honor the greatest doctor I have ever known. He will be sorely missed, but not forgotten, because we will always remember how he taught us to listen and to care.