He had three gunshot wounds to the chest and tubes entangled his upper body. The overhead lights exposed the blood and sweat smeared across his chest. Physicians, nurses and trauma technicians cloaked in white shuffled around him, their masks covering most of their faces, revealing only their attentive and observant eyes. They watched with a well-practiced calm as one of the trauma technicians aggressively pumped the man’s chest, trying to start his heart again. He remained still on the white hospital bed. After about 15 minutes of attempting to resuscitate the man, everyone ripped off their facemasks. They left the corpse and went onto their next patients.
Watching from outside of the room, I expected a show of disappointment, some kind of mourning among the staff. But the most I got was someone reporting to a colleague, “They gave up on him.”
This is how it works in the emergency department. People show merely a resigned indifference towards death, if not towards all the cases they see while on the job. Physicians in general adopt this attitude, because it helps them make quick and logical decisions about their patients. And yet, there’s something strange — and almost unacceptable — about a caretaker who reacts to his patients’ deaths with apathy.
Despite being someone who is thinking about going into the medical field, this anomaly has only recently been brought to my attention. Every time I tell people that I do research in the emergency department, they ask me what I see. Everytime I tell them, they say, “I could never do that.” The blood. The mangled bodies. The deaths. And I will admit, when I first got into my research group, I thought I couldn’t either. But I could. It was easy.
I figured that this ability to deal with unpleasant human experiences made me fit to become a physician. But after talking to enough people, I began wondering if my indifference, so similar to that of the physicians I saw working in the ED, actually made for a horrible physician.
The truth is, the average human should not be able to look upon others’ suffering so easily, especially if they want to save their lives. Growing up, my parents, who both work in the medical field, always told me that to become a physician, I had to care about people. And I imagined that if you cared about your patients — or anybody for that matter — it would be hard to talk about their pain casually, let alone walk away from their deathbeds casually. To be so desensitized indicates a partial loss of humanity rather than mental stability.
But it hasn’t always been this way among physicians. In an article published in The Huffington Post by Duke University Professor Allen Frances, Frances pointed out how physicians in the ancient world, such as Hippocrates, were well-versed in the liberal arts rather than the sciences, and thus saw their jobs as physicians through a more humanistic, subjective lens. The concrete and systematic version of science we know today didn’t even come about until long after their time. As a result, they focused on getting to know their patients, not just their patients’ illnesses, and cured them accordingly. In the same article, the author pointed out that a third of US deaths today are due to medical mistakes from physicians who did not know their patient well enough.
This is not to say that if the people in the emergency room had stopped to talk to the man for fifteen minutes, they would have saved his life; he wouldn’t have been able to respond anyhow. However, it is to say that people in the medical field should not hold the wounded at a distance. This detachment has not only led to misdiagnoses, but a disconcerting shift in how healthcare works today.
Rather than meeting face-to-face, physicians and patients now use technology to expedite the process of diagnosing and treating illnesses. An example of this, as discussed in the article “You’ve Got Mail” from The Journal of the American Medical Association, is emailing patients their test results from labs rather than having them come in to discuss the problem. Although efficient, this method also leaves patients alone in their homes — specifically in front of a lifeless and unresponsive screen, far away from anyone who can help them — panicking over confusing medical terms and the possibility of having a life-threatening disease.
Even more concerning is the fact that patients are beginning to accept this streamlined version of healthcare service. With such busy lives, people don’t mind not seeing their doctors when they’re sick. Since entering college, I’ve even had some friends who opt to self-diagnose by using sources like WebMD instead of going to the Health Center.
But at the end of the day, turning the healthcare process into another one-click fix puts lives at risk, despite how convenient it may seem. WebMD can’t know the whole of a college student’s health problems well enough to give them a proper solution. Emails can’t provide treatment or care to a cancer patient, only bad news. And doctors who don’t care about their patients will only do so much before they give up.
The key to changing this unhealthy indifference lies in bringing the humanities back into the practice of medicine, enabling physicians and patients alike to see that there is more to healthcare than pure science and methodology. There is a trusting relationship between the hurt and the healer, one that can only be developed through direct interaction and deep understanding of the other’s pain, whether it be mental or physical.
UCI has recognized this through its initiative for the new medical humanities minor. According to their website, proponents hope to “promote a model of health care that is patient-centered, culturally sensitive and responsive to community needs,” a refreshing and necessary change given the context of today’s healthcare system. Many medical schools are also requiring that their medical students take humanities electives to enrich their understanding of the kind of dynamic they should have with their patients once they start practicing.
Finally, although I talk about physicians in general, there are still physicians out there who still hold their patients’ needs close to their hearts, and who should be treated as examples to anyone that wishes to go into medicine. Just last year, I went to a social hosted by the School of Biological Sciences where a neurosurgeon from the Children’s Hospital of Orange County served as the guest speaker. After summarizing his 20-year-long journey to becoming a doctor, he asked us students if we had any questions. When asked for his proudest accomplishment, he replied with the fact that he still sympathizes with the families he serves. “I’ve gone to too many funerals,” he said. Yet he still works with dying children in the hospital to this day, not knowing if he will see them tomorrow.
I realize, though, that this is what it means to be a doctor. Doctors are supposed to hold their patients’ hands as they walk the thin line between life and death, guiding them towards the safest and most promising path. They are together until the end, regardless of the prospects on the way.
Michelle Bui is a second-year biological sciences major. She can be reached at mkbui@uci.edu.
