Got a little choked reading your post. I just got home last night from Sanford Hospital, I had/have a spontaneous CSF leak. Extremely frightening.
Luckily my husband has been in the field and his understanding made this all less mysterious.
Before my husband spoke up the doctor with (stupid) masks just floated over the information of the procedures I would be having. One of my symptoms was loss of hearing which I told them, so they spoke a little louder…still couldn’t hear them. I am just so grateful to have my husband as my advocate. Without him I wouldn’t have known what the hell was going on. Once my husband mentioned he works with Dr. Eddie Chang, (up in your neck of the woods), their whole demeanor changed. All the sudden they had time in the world to talk to us. It worked out good for me, but at the same time I thought of all the other patients who have none of this privilege. It breaks my heart and also makes me mad.
I’m 63, and the thought of you bringing me a glass of water, I know you wouldn’t have a mask, I know you would have taken the time to make sure I understood what was going on, brings a tear to my eye.
I’ve been following you since 2020 and appreciate you very much.
Oh! But please note, nursing staff were absolutely amazing!!!!. Every single one was kind and thoughtful. The very best care ever. The first night I was there about 2 am, I was crying, when the nurse came in the room I stopped, but obviously he knew. He came and squatted beside my bed held my hand and just listened. Like he Had all the time in the world. When he got up he could barely walk his legs were asleep. I will never ever forget his kindness and without giving me medical advice or medication, I felt so much better.
What many physicians seem to have forgotten is that we care for the patient as a whole person. As a doc who has taught residents and students for many years I am always so glad to see their evaluations of my service because the most common thing they talk about is how I interact with the patients in a personal way. The most rewarding thing is not writing orders or making some unusual diagnosis but having your patients feel better partly because you care and let them know it.
The medical industry is plagued by people who mistake authoritarianism for care. Some people do things because it is genuinely meaningful to them; many people do things because it makes them feel powerful.
A simple act of providing patients with a drink or a warm blanket makes them instantly feel better. If you can't provide a cure, as is the case sometimes, provide comfort.
Unfortunately, common sense and kindness is lacking in this new gen. Hate to see it.
Completely agree, Vinay, and thank you for writing about this important topic! We in healthcare are there to care for human beings, and the size or complexity of the task should not matter especially if it takes virtually no time and in actuality provides huge benefit to the well being of the patient. These seemingly small acts of human kindness go a long way toward establishing rapport and engendering the respect of your patient. I think a lecture or two on empathy, common courtesy, and thinking about each individual as your most cherished family member or friend will go a long way toward repairing the damaged image that health care providers have obtained during the last decade or so.
My first Substack comment. Monday I retire from cardiology after practicing 32 years. I have often heard my fellow women physicians complain about being mistaken for nurses and fielding requests for various comforts or questions. Our institution made up badges to go behind the ID badges that said "physician" This whining in my opinion is insane-we are privileged, honored, to be able to help people, to be allowed in their lives. As I have been saying farewell in clinic I thanked each patient for this privilege. Rounding in the hospital sometimes adjusting them in bed is all you can really do! When the conversation ended I always asked the patient if they wanted the door open or closed. That small gesture was to let them know I see them not as a disease but a human being who deserves courtesy. Thank you , Dr. Prasad ,for this Substack which I very much enjoy.
Medicine is a lot MORE fun when we behave as humans when interacting together. I remember hearing a colleague say about me that “a director does not need to be treating patients…” I about fell over. I created my job to spend 75% of my time with patients or I wasn’t going to take it. Damned right we are in customer service! Addiction is a messy part of the field and it requires someone willing to be in the mud right with them to help them up. I remember doing many consults on “frequent flyers” who continually were enabled by their primary team with IV opioids because “telling them I suspect addiction is not my job.” That’s not my job” should keep one out of a job IMO.
I've told the story many times I call it the roach story. An executive was admitted to telemetry at a nearby university hospital. He had a three or four day stay in the same room. He went to the Cath Lab had a stent and came back. In a corner of the room, but highly visible , was a large roach. It was dead. An army of staff, including physicians, nurses, etc. came and went. None of them thought it was their job to address the dead roach in the room. He transferred his care to our group post admit having heard about our heart hospital . He said to me that none of them had pride of ownership and that's not a safe place to be. I told this story at my (premature due to MVA) retirement party because it tells you that everyone is part of the team and if you don't realize that everyone's important you're not a very good physician .
As a medical group we read the book called the Southwest way. Southwest has some issues, but all of us have seen pilots helping load luggage to get to plane up in the air quicker. If you think you have a very limited job description and have no pride of ownership (does not have to be financial ) you're working for a terrible place and you're part of the problem. Healthcare is a team sport. The people that often blame. The team are the ones that need to get off.
and actually customer service gets a whole new meaning when I recognize that the ‘customer’ IS the service . this is my job, to improve not just their satisfaction but their lives, in even just a small way as their physician .
I cannot tell you how grateful I am for this piece. I wish you were in every hospital with every patient. My 93 year old mother died in the hospital a few weeks ago. Her care was horrendous. Only 2 of the nurses showed the slightest care or humanity to my mother. The doctors were even worse. Completely detached and apathetic. I would run from nurse to nurse begging them to come help my mother to the commode or help her into a more comfortable position. They would say, “I’m busy right now.” I would then run to the doctors’ room, where I’d beg them to come help her or to get a nurse to come help. They’d give me a bored, blank look and say, “I’m not her doctor. Who’s her doctor? We’ll let her doctor know.”
The entire experience was a dehumanizing nightmare. She died with people “caring” for her who couldn’t have cared less. They seemed more like sadists.
I dread someday having to go to the hospital myself. Or my husband or our children. It’s like going to the DMV, except that we’re much more dependent on doctors and nurses.
Thank you! I bar tended my way through college. I firmly believe that it has made me a much better physician. I listen more and feel I can "read" people better. When I was in medical school, we had simulated patient encounters. One of the criticisms I received was, "it looks like she is sitting in a bar talking to them." I still take pride in that "criticism".
Oncologist for over 30 years. Most of my encounters are just that, encountering folks with stories to tell. A 15 minute visit can often turn into a fun (yes, fun!) time with a patient with whom I share laughs. It’s highly therapeutic, for both of us.
Agree, we have lost our humane approach to medicine.
Yet maybe it is a consequence of modern medicine, in which you get trained only to take care of the reason a patient was admitted for and send to another specialist for any question beyond your speciality (mostly for forensic reasons, not to say laziness ;). On the way, a lot of costs are generated.
Example? A patient from a retirement home for whom I had recommended a brain CT scan went to hospital because of a urinary tract infection a few days later; when asked to do the scan there the answer was „not our job, we just get paid for treating the infection“ and she was sent back after several days…
This article couldn't be more timely, I was just in the ER as the patient a few days ago and I was so desperate for a glass of water. (Not waiting to be intubated btw) I asked every person who cycled thru my room for some water and the exact same response was given "Ill tell your nurse". Lol!! I'm just like WTF???
An OB RN coworker of mine was in an antepartum room when the fetal monitor started showing severe distress. An OB was walking by and she called “I need help in here!” and he said the patient wasn’t on his service and kept walking. By the time the “right” OB arrived, it was too late to save the baby.
Got a little choked reading your post. I just got home last night from Sanford Hospital, I had/have a spontaneous CSF leak. Extremely frightening.
Luckily my husband has been in the field and his understanding made this all less mysterious.
Before my husband spoke up the doctor with (stupid) masks just floated over the information of the procedures I would be having. One of my symptoms was loss of hearing which I told them, so they spoke a little louder…still couldn’t hear them. I am just so grateful to have my husband as my advocate. Without him I wouldn’t have known what the hell was going on. Once my husband mentioned he works with Dr. Eddie Chang, (up in your neck of the woods), their whole demeanor changed. All the sudden they had time in the world to talk to us. It worked out good for me, but at the same time I thought of all the other patients who have none of this privilege. It breaks my heart and also makes me mad.
I’m 63, and the thought of you bringing me a glass of water, I know you wouldn’t have a mask, I know you would have taken the time to make sure I understood what was going on, brings a tear to my eye.
I’ve been following you since 2020 and appreciate you very much.
Oh! But please note, nursing staff were absolutely amazing!!!!. Every single one was kind and thoughtful. The very best care ever. The first night I was there about 2 am, I was crying, when the nurse came in the room I stopped, but obviously he knew. He came and squatted beside my bed held my hand and just listened. Like he Had all the time in the world. When he got up he could barely walk his legs were asleep. I will never ever forget his kindness and without giving me medical advice or medication, I felt so much better.
What many physicians seem to have forgotten is that we care for the patient as a whole person. As a doc who has taught residents and students for many years I am always so glad to see their evaluations of my service because the most common thing they talk about is how I interact with the patients in a personal way. The most rewarding thing is not writing orders or making some unusual diagnosis but having your patients feel better partly because you care and let them know it.
The medical industry is plagued by people who mistake authoritarianism for care. Some people do things because it is genuinely meaningful to them; many people do things because it makes them feel powerful.
A simple act of providing patients with a drink or a warm blanket makes them instantly feel better. If you can't provide a cure, as is the case sometimes, provide comfort.
Unfortunately, common sense and kindness is lacking in this new gen. Hate to see it.
The first order of caring for the patient is to care! Love your comment bc it’s spot on.
Completely agree, Vinay, and thank you for writing about this important topic! We in healthcare are there to care for human beings, and the size or complexity of the task should not matter especially if it takes virtually no time and in actuality provides huge benefit to the well being of the patient. These seemingly small acts of human kindness go a long way toward establishing rapport and engendering the respect of your patient. I think a lecture or two on empathy, common courtesy, and thinking about each individual as your most cherished family member or friend will go a long way toward repairing the damaged image that health care providers have obtained during the last decade or so.
My first Substack comment. Monday I retire from cardiology after practicing 32 years. I have often heard my fellow women physicians complain about being mistaken for nurses and fielding requests for various comforts or questions. Our institution made up badges to go behind the ID badges that said "physician" This whining in my opinion is insane-we are privileged, honored, to be able to help people, to be allowed in their lives. As I have been saying farewell in clinic I thanked each patient for this privilege. Rounding in the hospital sometimes adjusting them in bed is all you can really do! When the conversation ended I always asked the patient if they wanted the door open or closed. That small gesture was to let them know I see them not as a disease but a human being who deserves courtesy. Thank you , Dr. Prasad ,for this Substack which I very much enjoy.
Hope those filling your spot are as kind and considerate as you! God bless your retirement, thank you for your care.
Medicine is a lot MORE fun when we behave as humans when interacting together. I remember hearing a colleague say about me that “a director does not need to be treating patients…” I about fell over. I created my job to spend 75% of my time with patients or I wasn’t going to take it. Damned right we are in customer service! Addiction is a messy part of the field and it requires someone willing to be in the mud right with them to help them up. I remember doing many consults on “frequent flyers” who continually were enabled by their primary team with IV opioids because “telling them I suspect addiction is not my job.” That’s not my job” should keep one out of a job IMO.
I've told the story many times I call it the roach story. An executive was admitted to telemetry at a nearby university hospital. He had a three or four day stay in the same room. He went to the Cath Lab had a stent and came back. In a corner of the room, but highly visible , was a large roach. It was dead. An army of staff, including physicians, nurses, etc. came and went. None of them thought it was their job to address the dead roach in the room. He transferred his care to our group post admit having heard about our heart hospital . He said to me that none of them had pride of ownership and that's not a safe place to be. I told this story at my (premature due to MVA) retirement party because it tells you that everyone is part of the team and if you don't realize that everyone's important you're not a very good physician .
As a medical group we read the book called the Southwest way. Southwest has some issues, but all of us have seen pilots helping load luggage to get to plane up in the air quicker. If you think you have a very limited job description and have no pride of ownership (does not have to be financial ) you're working for a terrible place and you're part of the problem. Healthcare is a team sport. The people that often blame. The team are the ones that need to get off.
Bravo, Vinay!
and actually customer service gets a whole new meaning when I recognize that the ‘customer’ IS the service . this is my job, to improve not just their satisfaction but their lives, in even just a small way as their physician .
I cannot tell you how grateful I am for this piece. I wish you were in every hospital with every patient. My 93 year old mother died in the hospital a few weeks ago. Her care was horrendous. Only 2 of the nurses showed the slightest care or humanity to my mother. The doctors were even worse. Completely detached and apathetic. I would run from nurse to nurse begging them to come help my mother to the commode or help her into a more comfortable position. They would say, “I’m busy right now.” I would then run to the doctors’ room, where I’d beg them to come help her or to get a nurse to come help. They’d give me a bored, blank look and say, “I’m not her doctor. Who’s her doctor? We’ll let her doctor know.”
The entire experience was a dehumanizing nightmare. She died with people “caring” for her who couldn’t have cared less. They seemed more like sadists.
I dread someday having to go to the hospital myself. Or my husband or our children. It’s like going to the DMV, except that we’re much more dependent on doctors and nurses.
What has become of us?
Thank you! I bar tended my way through college. I firmly believe that it has made me a much better physician. I listen more and feel I can "read" people better. When I was in medical school, we had simulated patient encounters. One of the criticisms I received was, "it looks like she is sitting in a bar talking to them." I still take pride in that "criticism".
Oncologist for over 30 years. Most of my encounters are just that, encountering folks with stories to tell. A 15 minute visit can often turn into a fun (yes, fun!) time with a patient with whom I share laughs. It’s highly therapeutic, for both of us.
Agree, we have lost our humane approach to medicine.
Yet maybe it is a consequence of modern medicine, in which you get trained only to take care of the reason a patient was admitted for and send to another specialist for any question beyond your speciality (mostly for forensic reasons, not to say laziness ;). On the way, a lot of costs are generated.
Example? A patient from a retirement home for whom I had recommended a brain CT scan went to hospital because of a urinary tract infection a few days later; when asked to do the scan there the answer was „not our job, we just get paid for treating the infection“ and she was sent back after several days…
Humility, Compassion, Gratitude. The hallmarks of great spiritual leaders. And happy people. The ego is a speed bump on the path to enlightenment.
This article couldn't be more timely, I was just in the ER as the patient a few days ago and I was so desperate for a glass of water. (Not waiting to be intubated btw) I asked every person who cycled thru my room for some water and the exact same response was given "Ill tell your nurse". Lol!! I'm just like WTF???
An OB RN coworker of mine was in an antepartum room when the fetal monitor started showing severe distress. An OB was walking by and she called “I need help in here!” and he said the patient wasn’t on his service and kept walking. By the time the “right” OB arrived, it was too late to save the baby.
That person should be kicked out of the hospital. Disgraceful!!
Heartbreak and infuriating.