‘I love your pajamas’ — how health care is personal

Anyone wading into our great national debate about matters of health care and money soon realizes how quickly the issue can become personal.

When I say “personal,” I refer not to unhealthy partisanship, though there’s plenty of that, but to strong feelings of those on the giving and receiving end of medicine and medical care.

Those personal connections can be a good thing, as an experience I had about a dozen years ago reminds me.

At the end of a long day, my partner and I, along with a pair of resident physicians, were making rounds. Our final patient was a once-healthy 59-year-old woman with recurrent ovarian cancer.

A CT scan earlier in the afternoon found a worsening of the fluid buildup in her chest, and I explained the pros and cons of two treatment options.

Shannon (not her real name) was attentive and asked appropriate questions. She was a successful businesswoman, used to assessing options and making logical decisions. After 30 minutes of discussion, we agreed to place a catheter and resume chemotherapy.

As we prepared to leave, Molly, a second year obstetrics-gynecology resident, smiled at Shannon and exclaimed, “I love your pajamas.” I looked back at the multicolored satin pajamas and thought they were indeed pretty. I also noticed how Shannon’s expression immediately changed from contemplative to wide, bright smile.

While the rest of us looked on, Shannon explained to Molly that the pajamas were a gift from her daughter who was coming to visit from Chicago that evening. Molly then explained that pajamas would be more useful than a nightgown, should a chest tube be needed. They conspired and agreed that Shannon’s daughter should buy her some more pajamas.

Although I was supposed to be the educator that day, we finished rounds with me acquiring more knowledge than I imparted.

Most physicians feel that we are caring, compassionate and attentive. But the fact is, matters other than direct patient care – such as electronic medical records, other paperwork and teaching – may detract from what we trained to do.

Since that afternoon with Shannon, I have tried to follow Molly’s lead. I will ask who is responsible for the crayon drawing taped to the head of the bed or inquire about the flower arrangement or framed family portrait on the bedside table. I may even compliment the out-of-control grandson playing with the bed controls.

Where once I was reluctant to ask much about my patient’s life outside medical care, I have proven that I am trainable and can still learn. That said, I still haven’t exclaimed, “I love your pajamas!”

This experience reminded me to never lose sight of the fact that, for all the science and statistics of health care, medicine involves essential connections to people – to patients.

As they make decisions involving money and access to health care, I’d encourage our leaders in Washington and Topeka to remember that as well. And to follow a guiding principle for doctors: First, do no harm.

This story was originally published January 31, 2018 at 4:02 AM with the headline "‘I love your pajamas’ — how health care is personal."