Yo I became a doctor because I wanted to help people. Like “supporting the community” and “doing the right thing,” the idea of ”helping people” can be so vague that it borders on meaningless. And so, having entered medicine with good intentions but no specifics about who or how I wanted to help, I soon learned how hard it really was to help someone.
The truth is that the idea of a sick person coming to see a doctor, being diagnosed and treated, and then leaving cured and satisfied is quaint. These days, patients often come in with chronic problems that we could cure, but can’t. We can make sure our dementia patients take their medications on time, for example, but there is little we can do to treat their underlying brain disease. We can lower our diabetic patients’ blood sugar levels when they are too high, but we have nothing to cure their diabetes itself. And when our end-stage cancer patients come in seeking relief from their cancer pain, we know that even our best treatments will do nothing to stop the progression of their real problem.
And so, early in my career, frustrated with our collective inability to help our patients to the extent that I wished we could, I began playing a game I call “Doctor’s Title vs. Puppy.”
After each patient I saw, I wondered: Would this patient’s problem be better handled by myself, with a decade of rigorous medical training and board certification in emergency medicine, or by a tail-wagging yellow Lab?
I kept a written account. “Medical Degree” would mostly win, but that was hardly reassuring. That it was a close contest at all was somewhat unsettling. Also, that every once in a while I’d end a shift and realize that “MD” had lost out to “Cute Puppy” was a more profound statement of modern American medicine than anything I’ve ever read on the op-ed page. from any newspaper.
The game is effectively this: many of our patients are already well aware of the limits of modern medicine. Most people with chronic illnesses have lived with their problem for years and know their situation better than their doctors. They appreciate our treatments, of course, but ultimately what they are really looking for is simply to feel better. These people want comfort and reassurance. They want to feel cared for.
Dogs are great at this. They lie on our lap and express their affection. They are deeply concerned by what we are feeling. They allow us to tell our stories and are never in a hurry to leave our side. So while they don’t provide breakthroughs and certainly don’t deliver pharmaceuticals, they do provide excellent comfort.
What dogs so readily offer, of course, is precisely what modern American doctors do not. Each year, our system equips us with more drugs to prescribe to our patients, but fewer opportunities to sit down with them and explain how they should be used. Each new administrative initiative brings us more tasks to complete and less time to complete them. Downsizing and bureaucratic demands resulting from corporate control of medicine force us to sprint through the day to accomplish the bare minimum to keep our patients healthy, often preventing us from performing the critical task of simply reducing the speed to listen to them. As a result, we may find ourselves in the curious position of having saved our patients’ lives, only to find that they are still generally frustrated with their experience. More interestingly, we understand that they are not necessarily wrong to feel this way.
And so, having found myself on the losing end of an end-of-shift account for a puppy, I’ve come to appreciate that if I was ever going to live up to my original intention of “helping people,” it wouldn’t be by simply applying the skills I learned in medical school. Providing the right medical treatments, even diligently saving lives, is not enough.
We need to do much more. We need to take back control of our healthcare system from corporate control that has driven so many of our problems out of control. We need to institute safe staff mandates so our hospitals have more doctors and nurses, allowing us to slow down and sit at the bedside of our patients once again. We need and end for-profit medicine that treats patients as bureaucratic boxes that need to be checked, and universal healthcare that simply puts patients first once again. If we’re really going to find a way to “help people,” we’re going to make our healthcare system look a little less like the sterile bureaucratic machine it’s become, and a little more like my dog.
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