Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Life for patients and their families is so much more than data

James C. Salwitz, MD
Physician
October 8, 2013
Share
Tweet
Share

One of the first things I teach medical students is to be aware that they have arrived in a bizarre land.  The strange things they see, the disturbed experiences they have, the weird stories they hear, are like noting else in life.  I advise students to stay in touch with their feelings, to note what shocks, frightens, or embarrasses them.  Remember those emotions now, because as doctors learn their craft they learn to control those reactions. They create order from confusion, and the wild world of medicine seems to make sense.  However, for their patients, first entering the healthcare maelstrom, it will always be chaos.

Much of the practice of medicine is about organization and structure; using data and measurement to apply scientific principles to variant biology.  From the simplest concepts of height, weight, and blood pressure to the esoteric study of molecular cancer mutations, we change the “sick old lady,” to a “78 year-old female with acute respiratory desaturation (89%), from nonischemic cardiomyopathy (32%), exacerbated by a normochromic normocytic (82) anemia (8.3), from chemotherapy (V58.1), with congestive heart failure (428.0), induced by saline resuscitation (1500cc) treatment of neutropenic (0.8) sepsis (103.4), and shock (88/47); in Room 4, Bed 1, 5N.”

Medical care demands we digitize the “old lady.”  This process makes analysis, decision-making and treatment possible.  Each number is in its place, each box checked and tabulated; all is calm and well. The problem is we fool ourselves into believing that we have forged from disorganization a global order that applies to the whole person and family.

The reality is that while we may sterilize a part of each person’s life, that part we call medicine, we can never sooth the chaos.  Confusion, variation, originality and endless change are what make human beings special.  The scientific model cannot be applied to all experience or to the global reaction to illness. If we expect objectivity and structure, simply because we have organized health events, we fail to appreciate the complexity of our patients and will universally fail to give the best in health care.

Life for patients and their families is so much more than data. It is soaked in abstract ideas, dysfunctional decisions, social influence and emotion. Why did I deserve this? How will the cancer effect and change my relationships, my marriage, my children?  What about my job, what will I do to make money or to justify my worth?  Who will mow the lawn? Has god deserted me? Am I so altered that I am no more?  With the loss of strength, how I will I express or share passion?  How beautiful is the sunset!  What about suicide?  Will my family “catch” the disease?  What will tomorrow’s, tomorrow, bring?

Life is myriad.  Cancer is chaos.  To think that the superficial organization of medical care brings universal calm is to believe that putting a top on a boiling pot quiets the seething waters inside; the kettle looks neat, quiet, but the metal grows hot and will, in time, boil over. The  “lady,” is also a grandmother, church secretary, struggling artist, world traveler, friend, union shop steward, lover and is surrounded by family, neighbors and even enemies.

We gain from recognition that there are major limits in the application of clinical structure.  Doctors must accept that what happens to their patients is much more than can by typed into a history, physical, diagnosis and treatment plan.  Physicians must be sensitive and vigilant to the labyrinth that is their patient’s lives and how it affects them and therapy.  It is not just writing a prescription.

Perhaps more important, every family and patient need to learn that, as in the rest of life, chaos is normal.  Every patient and family enters the medical arena with all the variation, strength and weakness, which has been their whole life.  Disease inflames that history and adds new layers of change.  No journey is a straight line.  Each person is different and each day a new unstable experience.

Life is not neat, digitized, or organized.  Life is strange and messy.  That is what makes life hard, but it is also what makes it wonderful.  Disease, cancer, is part of that chaos, increasing the intensity.  That is normal, healthy and to be expected.  It is a tough journey, but we can make it.  Moreover, just maybe, that is what makes life worth living.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

Prev

Technology should not define medical education

October 8, 2013 Kevin 1
…
Next

What if exercise counseling came in prescription form?

October 8, 2013 Kevin 19
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
Technology should not define medical education
Next Post >
What if exercise counseling came in prescription form?

ADVERTISEMENT

More by James C. Salwitz, MD

  • Each line on the radiology list is a patient’s line in the sand

    James C. Salwitz, MD
  • The broader mission for hospice care

    James C. Salwitz, MD
  • Is the medical profession at its end?

    James C. Salwitz, MD

More in Physician

  • The unseen cost of detachment in radiology

    Dr. Yesu Raju
  • I thought success was a destination. Then I became a doctor.

    Ryan Nadelson, MD
  • How subjective likability practices undermine Canada’s health workforce recruitment and retention

    Olumuyiwa Bamgbade, MD
  • Why judgment is hurting doctors—and how mindfulness can heal

    Jessie Mahoney, MD
  • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

    Olumuyiwa Bamgbade, MD
  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • How oral health silently affects your heart, brain, and body

      Charles Reinertsen, DMD | Conditions
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • How oral health silently affects your heart, brain, and body

      Charles Reinertsen, DMD | Conditions
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Life for patients and their families is so much more than data
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...