Helpless. That is how I felt when my mother found out she had a fibroid the size of a cantaloupe living in her uterus. In my role as a medical student I might have dismissed the finding as nothing serious, telling my patient, “Don’t worry, it could be much worse.” But as a loving son I was not quite as cavalier. At first my mother resolved to ignore the fibroid, hoping it would shrink or go away on its own. It didn’t. Instead, it grew larger until eventually it pressed against other organs in her pelvis, producing a variety of uncomfortable symptoms. She gritted her teeth through bleeding, urinary frequency, and excruciating pain—until the night uncontrollable bleeding rushed us to the emergency room. It was there she realized a hysterectomy was her only option, and the following morning we began calling doctors. At the top of our list was a surgeon touted to be “the best.”
Let me be clear about what I mean by the word “best.” This surgeon was highly respected among doctors, with technical skills that could impress the toughest critics. A legend in his specialty, he had operated on pelvic floors for half a century, served as the director of his department for over a decade, and been written up as a “top doctor” in multiple reputable publications. Patients flocked to him with all sorts of complicated cases, making it near impossible to book an appointment. Luckily, a family friend had an “in,” and we were covertly squeezed into his schedule.
Dead silence permeated the waiting room as my mother and I sat, squirming anxiously in our seats, waiting for the doctor’s secretary to usher us into his office. When the time came, we passed through hallways decorated with numerous plaques and framed diplomas. We proceeded into his office, where we found ourselves captivated by the gorgeous view of the Manhattan skyline from his window. It was clear this surgeon had a stellar reputation with an office to match. This, we thought, was the perfect doctor for the job.
Our awe was disrupted by an accusatory voice: “Why would anyone wait this long to have a fibroid removed?” The doctor entered the room without looking up, his eyes glued to my mother’s chart. My mother grinned sheepishly and began revealing her concerns about taking time off from work, the procedure’s risks, and the terrifying post-op stories she had read online. The surgeon smirked, fixed his eyes on his computer screen, and retorted, “You’re more than welcome to keep suffering.”
“OK,” my mother said, gathering her things. She had heard enough.
In 2010, Dr. J. Kevin Dorsey, dean and provost for the Southern Illinois University School of Medicine, delivered a commencement address in which he told the graduating class that as future doctors they would be judged not based on their medical knowledge or technical prowess, but on whether patients feel they care. “I ask only one thing,” he told the graduates, “When a patient comes to you needing something—care for them like you would care for your parents, your siblings, your children, your best friend.”
Two weeks after deserting our highly coveted appointment with the hotshot doctor, my mother had an abdominal hysterectomy under the care of someone else. Unlike the other, this surgeon didn’t rush her out of his office, dismiss her concerns, or avoid making eye contact. She chose him because he insisted on explaining her procedure in its complexity, and because he rested his hand on her shoulder while warning her about the difficult recovery ahead. When she told him she was worried about having a scar on her abdomen, he validated her concern and promised to make it as small as possible. When she told him she was worried about being in pain after the operation, he reassured her that it would be managed with proper medications. Ultimately, he didn’t treat her as just another fibroid or a surgery to attack with cold steel. Rather, he honored her as a human being with real feelings that matter.
Dr. Dorsey’s prescription may seem simple, but as a son and medical student, I’ve come to see firsthand that what’s simple is true. Good doctors are those who genuinely care about patients. No doubt they have meticulously scrutinized the pancreatic acini, loops of Henle, and intestinal villi. Some of them can even recite paragraphs from medical textbooks verbatim. But this type of intelligence, no matter how vast, is not what makes them good, certainly not “the best.” What makes good doctors rise above the rest is how they treat patients: they make patients feel like they matter. They have the courage to say “I don’t know” and show concern when delivering bad news. They act no differently than they would if it were their own mother on the other side of the scalpel.
Not long ago I was asked to see a 59-year-old woman with frontotemporal dementia, a condition resulting in progressive deterioration of the frontal and temporal lobes of the brain. “She’s a good teaching case,” a resident told me. Because the disease had already spread to her language areas, she was no longer able to process questions, follow commands, or hold a conversation. She instead laughed at inopportune times and repeated nonsensical phrases such as “glad to know you” and “you have a baby.” After an abbreviated neurological examination and a measly attempt at talking to her, I turned to leave, when I noticed a handwritten card on her wall. “I love you, Mom,” it read. I stopped, suddenly transported to my experience with my mother’s fibroid. I quickly wiped a tear from my cheek, turned back and took a seat at the edge of the patient’s bed. She smiled at me and said again, “Glad to know you.” This time, I took her hand and held it firmly, replying, “Glad to know you, too.” And for the next few minutes I just sat there, listening to her as she mumbled words. Listening and telling myself how truly proud my mother would be.
Robert Spencer is a medical student.
