Saturday, May 9, 2015

Healing, Fixing or Both?

This was originally written in November 2014:

     One of the profound difficulties that doctors face during their training and practice is that some of their patients, over time, will be physically declining - no matter what the doctors do.  Physicians' goals are to delay that inevitability for as long as possible while hopefully improving a patient's quality of life!  Some conditions cannot be cured.  However, one saving grace that (frequently) accompanies this awareness is the recognition of the value of joining with the patient on their health seeking journey - regardless of the outcome.  It is a privilege, albeit painful at times, to be involved and included in a patient’s most intimate and emotional moments in their lives.  I believe more healing is done in the simple acts of humanity like caring, witnessing and validating rather than ordering and performing labs, tests and procedures. 

     Working with Family Medicine residents has alerted me to the struggle many physicians have at understanding that their healing impact on patients far exceeds their ability to diagnose and treat ailments!   A second struggle is the recognition that healing is what can happen when two human beings share a moment of intimacy.  This aspect of doctoring seems such a contrast to the nitty gritty of Dx and Tx - it requires shifting gears, slowing down, and focusing more on the person who is bringing in the illness than on the illness the person is carrying.  As part of an effort to identify these two gears, I started to generate a list of these contrasts in how one functions as a physician.  See what you think - Add some others in your comments - Share your thoughts about what might be a good (or better) contrasting term for healing.  I used fixing - I thought about curing or treatment - what other contrasts are there for healing?

  • Healing is a process / fixing is an act. 
  • Healing is chronic / fixing is acute.
  • Healing takes time / fixing is immediate - a prescription, a procedure.
  • Healing is providing space and opportunity / fixing is providing solutions.
  • Healing is being cared about / fixing is being cared for.
  • Healing requires trust / fixing requires compliance.
  • Healing is for the person / fixing is for the injury.
  • Healing is for the dis-ease / fixing is for the disease.
  • Healing supports the relationship / fixing supports the diagnosis.
  • Healing is validating / fixing is being cured.
  • Healing is being / fixing is doing.
  • Healing is accepting / fixing is changing.
  • Healing is communal / fixing is individual.
  • Healing is cultural / fixing is biological.
  • Healing is emotional / fixing is logical.
  • Healing is asking / fixing is telling.
  • Healing is curiosity / fixing is labeling.
  • Healing is understanding / fixing is knowing.
  • Healing is listening / fixing is talking.
  • Healing is reassuring / fixing is dismissing.
  • Healing is patient centered / fixing is doctor centered.
  • Healing is: ‘You know what’s best for you.’ / fixing is: ‘I know what’s best for you.’
  • Healing is in the relationship / fixing is in the intervention.

How much healing are you doing when you are fixing?
How much fixing are you doing when you are healing?
What are your experiences - as a patient or as a health care professional?

1 comment:

  1. Useful distinction. Usually when I'm fixing, it's me I'm, or my own anxiety/discomfort, I'm fixing, not the other person at all.

    Looking forward to more on this blog. It's off to a great start.