Tuesday, September 11, 2012
"Ann" had a serious liver disease. She knew that without a liver transplant, she would die. There were doctors in Boston who would perform the surgery, but there was a problem. Ann was a Jehovah's Witness and according to her beliefs, she could not accept blood products. Liver transplants require multiple blood transfusions. Without those transfusions, they could not do the operation.
Some of Ann's family and friends urged her to go ahead and get the operation, but Ann steadfastly refused. She was young and didn't want to die, but she believed in the Jehovah's Witnesses and didn't want to commit the "sin" of accepting blood products. As her family physician, she wanted my advice. I am not a Jehovah's Witness, but I told her that the operation would save her life, but cause her to lose her soul. After a few weeks, we helped her get admitted to the Hyder House in Dover, a wonderful hospice facility, where she peacefully passed away in the loving arms of her family and her church family. She kept her soul.
In today's world, many of us are willing to trade our souls for fame, wealth or even a political cause that seems so right at the time. Rarely are we confronted with the difficult choice "Ann" had to make - thank God. We doctors are able to treat the body most of the time, but true healing comes when we treat the soul as well. That's not a new idea. In fact, that idea is as old as the teachings of Hippocrates, perhaps even older than that.
Most health care workers (physicians, nurse practitioners, physicians' assistants, nurses, physical and occupational therapists) are in health care for just this very purpose: improving the health and quality of life for their patients. In today's business model of medical care, the act of "soul-mending" is not easy to come by. We often "sneak it in" to our care with small gestures such as volunteer community programs, financial contributions, a hug or a house call. It not only gives our patients comfort, but it makes us feel better, too. We do it quietly, thoughtfully and caringly even though it may not be the most politically correct thing to do. We do it because often it is the most humane thing to do.
Treating the soul takes time and can rarely be done in ten or fifteen minute increments. As we turn more and more to for-profit medicine, we compromise our ability to heal the body and lose our ability to treat the soul altogether. There is no medical code for mending a broken soul. There is no business model for a non-passionate, caring hug. Yet, that often becomes more important than the prescriptions we write or the referrals we make.
As the health care debate continues in this campaign season, we need to think about those aspects of our health care that are most important. We want access to our doctors, but we want our doctors to treat us as individuals, not as cogs on an assembly line. We want our care to be affordable, which often means that we need to make reasonable judgments with our doctors about what tests are truly necessary and which tests can be deferred or delayed. Lastly, we want our care to be continuous ¿ preferably with the doctors we choose. We want to keep our health care with our doctor even if our job or insurance changes.
Good health care treats the body and the soul. Surprisingly, it is often less expensive than the "for profit" business model because it is built upon the relationship between doctor and patient. "Ann's" choice not to pursue further medical treatment because of her religious beliefs saved the health system tens of thousands of dollars. "Ann" was not just my patient, but she was my friend and I will miss her. She died too young, but she died at peace with herself and at peace with her God. In the end, I guess none of us can do much better than that.
Hyder House is a hospice facility in Dover and truly a treasure to the Seacoast community. I have no direct or indirect connections with Hyder House, Seacoast Hospice or Beacon Hospice, but I would urge any reader so inclined to make a donation to this important facility. You can contact them at: Hyder House; 285 County Farm Road, Dover, NH 03820. Telephone: 603-740-8500.
James Fieseher MD, FAAFP