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Suffering

2015-02-18

Patient suffering is the most difficult thing that doctors have to deal with.  Most of the time, we don’t deal with it.  We just try to avoid it.  But when we connect with a patient one on one, we cannot avoid the suffering.  Think about how it feels to suffer.  That is the thing that makes disease intolerable to us, suffering.  We try our mightiest to avoid or relieve suffering, especially our own.  When a patient reaches for a Vicodin, it is because of suffering (it may not be physical pain, either; it may be “psychic” or mental pain.)

Here is a quote from an article in yesterday’s New York Times (NYT):

“But now, reducing patient suffering — the kind caused not by disease but by medical care itself — has become a medical goal. The effort is driven partly by competition and partly by a realization that suffering, whether from long waits, inadequate explanations or feeling lost in the shuffle, is a real and pressing issue. It is as important, says Dr. Kenneth Sands, the chief quality officer at Harvard’s Beth Israel Deaconess Medical Center in Boston, as injuries, like medication errors or falls, or infections acquired in a hospital.”

The article goes on to list several types of incidental suffering, usually caused by medical workers: poor communication is one.  “Blurting out, ‘Oh, you have cancer’ can cause suffering.”  Loss of a personal valuable item can make a patient suffer, such as when a nursing aide misplaces (or even steals) a patient’s wedding ring.  Losing one’s sense of privacy can hurt, such as when a patient overhears others discussing their illness.

Another form of suffering is just waiting.   Having to wait for a late appointment when you are sick, or busy, or just tired can make you suffer.   Waiting to get treatment when you know that you have a serious illness can make you suffer.  Imagine learning that you have cancer, that it is growing, that it will eventually kill you, and then having to wait two weeks to get a treatment that you have been told is lifesaving.

The NYT also references an article in the New England Journal of Medicine that is titled, “The Word that Shall Not be Spoken.”  The word is “suffering” because it so well covers all the aspects of illness that are painful in any way.

We avoid facing suffering in many ways.  We can deny it, stall it off, or just wall ourselves off from it.

One doctor mentioned in the article learned that he could reduce suffering dramatically and gain patient satisfaction just by “slowing down and listening” to them, “answering their questions.”

Of course, spending more time with a patient usually helps them, but there is only so much time and there are always so many patients.  The doctors (and nurses) are constantly being bombarded with conflicting demands on their time and on their attention.

The most difficult part is that when you are closely connected to a patient and watching them, the feeling of empathy with them can make you feel just as sick and depressed as the patient is.  That can cause suffering for the doctor, which when multiplied by so many patients in a day, can be truly draining.

The article can be found at: http://www.nytimes.com/2015/02/18/health/doctors-strive-to-do-less-harm-by-inattentive-care.html

 

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