Healthcare rituals and medical technology
Picture the following doctor and patient interactions from my time as a practicing physician.
Patient A. Every few weeks, I get a momentary stabbing pain right here on my chest. It feels like an electric shock.
Dr. Abelson. Already knowing the symptom does not represent anything serious, I listen to the heart and lungs, palpate the abdomen and check knee reflexes.
Patient B. Sometimes my stools are little and hard. You know, just like a rabbit’s. I have noticed this for 20 years and it has not changed.
Dr. Abelson. Already knowing that the symptom does not represent anything serious, I listen to the heart and lungs, palpate the abdomen and check knee reflexes.
Patient C. Ever since my wife died 3 months I have trouble sleeping. I am worried that I have a serious medical problem.
Dr. Abelson. Already knowing that the insomnia stems from grief, I listen to the heart and lungs, palpate the abdomen and check knee reflexes
After years of being drawn to listen to the heart and lungs, palpate the abdomen and check knee reflexes I felt engaged in an ancient dance. In most cases, these assessments contributed little to my knowledge about a patient’s physical condition. Going through the routine, I felt a subterranean kinship with witch doctors and shamans.
At one point in my career, I felt compelled to learn about ancient healers. I discovered they all had something in common: ritual. Rituals mark the transformations occurring with significant transitions such as birth, death, birthdays, confirmations, bar mitzvah, etc. Listening to the heart and lungs and palpating the abdomen represented an important ritual in applying human touch to transform worry into acceptance.
In a remarkable 18 minute TED (“Technology, Education, Design”) video entitled “A Doctors Touch,” author and infectious disease specialist Abraham Verghese describes the power of the human hand to touch, comfort and diagnose. (Click here to view). Verghese paints a vivid picture of the everyday health care ritual of patients baring their souls to physicians and then disrobing to allow a physician to observe them, touch them and make a physical and emotional connection with them. Learning by personal observation, he says, is becoming a lost art.
He tells the story of a woman with breast cancer who left her local physician to go to a large specialty center, only to return to her home town physician for her care. When asked why she returned, she said that nobody touched her at the large specialty center.
“We seem to have drifted away,” says Verghese. “We seem to have forgotten, as if in the explosion of knowledge, the whole human genome mapped out at our feet, we are lulled into inattention, forgetting that the ritual is cathartic to the physician and necessary for the patient, forgetting that the ritual has meaning and a singular message to convey to the patient…I will always, always, always be there. I will see you through this…”
There is no doubt that significant advances in diagnostic testing have given us important tools to improve care. But has our reliance on it come at a price?
What do you think? I’d love to hear your thoughts, so please feel free to comment. We encourage a free exchange of ideas but, as always, we reserve the right to remove comments that make personal criticism or attacks on individuals or specific businesses.