Tag Archives: patients

Advice from a chaplain

These notes are as much for my future self as for anyone else. Tonight I listened to a chaplain at my church talk about hospital visitation. He’s a brother, and I was glad to hear his wisdom. He was speaking mostly to people who would be visiting family or other church members, but I did ask him a few questions afterwards as well. Here’s what I remember.

  • To find out what people need, just ask: “Hi, I’m Ben. How can I serve you today?”
  • The most important thing is to be available and be flexible. It’s important just to go visit, and if all they need is a glass of water, bring them water. If they tell you to leave, then leave. If they want you to stay and talk, then stay and talk.
  • If a patient is unresponsive, talk to them. You can talk about the game on TV, items in their room–keep it light.
  • Be aware of what people need. Beyond just asking them what they need (first bullet point), you might ask open questions.
  • Be open to share your faith if they ask, but otherwise, just be there for them.
  • As a physician, it’s perhaps most important to be able to break bad news gracefully. Tell them the news succinctly. Express sincerely that you are sorry for their loss. Pause briefly in case they need something, and then get out of there.

People like people

There must have been at least ten of us all crowded into her room. She seemed very sick, and she probably would have rather kept sleeping. I felt bad waltzing in with my classmates to startle her, but our attending physician didn’t seem to care.

“How are you feeling today?” He said it cheerfully, as if he were seeing an old friend for the first time in awhile.

She whispered that she was feeling a bit better than yesterday. A few of us said hello, and she nodded slightly.

The doctor asked her to lean forward. She did so–painfully–and he moved her gown aside to expose her back. One by one, we placed our stethoscopes over her lungs and listened for a few moments while she breathed. By the time it was my turn, she seemed more alert.

“That’s a pretty shirt, sweetheart,” she said to one of my female classmates. The girl was a little surprised, but she smiled and thanked the old woman. Our attending physician then began explaining what we were hearing–I think he had a chest x-ray and some other data on the computer, but I wasn’t really paying attention. The woman had woken up a bit more, and she was now curiously looking around the room. She seemed relaxed.

“Okay?” said our physician.

My classmates nodded that they had understood whatever he just explained, but I was watching the old lady, who was now reaching across her table for a small plastic bag full of Dum-Dum Lollipops. She picked it up, and extended her the bag with a smile, the IV lines dangling from her forearm.

“Want some candy?”

We all smiled, and a few of us took a lollipop. As we walked out, the lady settled back into her bed, and she seemed more peaceful than she’d been before.

I’ve seen this often. Unless they’re very ill, people who are at first tired and sick often perk up when a troop of medical students walks into their room. I don’t think they’re startled; I think they just like company. People like people–strangely, it took me until college to realize this. So for the past few years I’ve been trying to talk to strangers and new people, because everyone seems to appreciate the attention. I’m not very good at it yet, but I’m getting there.

“The second is this: You shall love your neighbor as yourself. There is no other commandment greater than these.”

And the scribe said to him, “You are right, Teacher. You have truly said that he is one, and there is no other besides him. And to love him with all the heart and with all the understanding and with all the strength, and to love one’s neighbor as oneself, is much more than all whole burnt offerings and sacrifices.”

And when Jesus saw that he answered wisely, he said to him, “You are not far from the kingdom of God.”

Mark 12:31-34

[Just FYI, none of the patients I talk about are real–they’re composites of various patients and people I’ve met over the past four years or so.]

Me. A timid, white-coated kid with fake patients

No, no, I should use a deeper voice to sound more authoritative…

“Hello. My name is Ben, I’m a second year medical student. Today I’m going to ask you a few questions about your problem. I’ll also conduct a physical exam, and then I’ll consult with my attending physician. So, why did you come to see us today?”

Maybe that was a little too formal? And when should I ask the patient his name?

I was sitting in bumper-to-bumper traffic, practicing to myself. Today in school I had to see three “patients”. These patients are actors, and when the interaction is over with, the actors stop acting and offer us criticism on our communication skills. My number one criticism from all three patients?

Lack of confidence. An uncertain demeanor. A little timid.

Last year, when I did this same exercise, the patients said I performed swimmingly. The difference between one year ago and today is that for the past year, I’ve been constantly cramming knowledge into my head. Last year, I was full of self-confidence for one reason: no matter how much thinking I did, I just couldn’t think of any reason why I might be wrong. Now it’s entirely different. The more thinking I do, the more and more I doubt my initial impressions.

But patients don’t want a timid, uncertain doctor, and this kind of doctor won’t give patients the comfort they need when they’re ill. I may have an exquisite line of reasoning. I may be friendly, professional, and composed. But somehow, I need to convince the patient that I do, definitely, beyond any shadow of a doubt–know what I’m doing.

Of course, I won’t really know what I’m doing for another six years. Eventually, I’ll make accurate, lighting-fast diagnoses without even lifting a mental finger. Eventually, I’ll back up my confidence with competence. Until then, I guess I’ll just have to fake it.