As a Rule, He Taught Compassion
The other day I shared a crowded hospital elevator with two young doctors--a man and woman--in scrubs. They were discussing an operation. I didn’t want to listen to their conversation, but certain vivid scraps involving intimate body parts couldn’t help but reach my ears--and the ears of other passengers. Then the doors slid open, the male doctor and the other passengers exited, leaving only me and the woman in scrubs.
I waited and debated, then timidly took the plunge.
“Kind of graphic for a public elevator,” I said, trying to sound friendly and mild. She shrugged her shoulders as if to reply: So what else is new?
Egad, I thought, what would Dr. Webster say?
Dr. James Webster was chief of medicine at Northwestern Memorial Hospital in Chicago, where I interned 25 years ago. He was a short, brisk and kind-hearted man who spoke about life and medicine unflinchingly.
That included his mistakes--and, of course, ours.
Over decades, Dr. Webster left his imprint on generations of rookie doctors. Mostly by example. But once in a while he also gave us rules. No, they weren’t edicts. Perhaps they should have been.
The truth is: Most doctors--even young ones--don’t cotton to rules. They prize independence. But Dr. Webster’s rules were different. They were about compassion and respect for patients--universal values in health care at any age.
But first I’d like to dispel any fantasies about Dr. Webster himself. Despite his rank, he was no ivory tower elitist. In his low, raspy voice, he spoke to everyone like an equal, from patients to janitors.
At least once a month, he also staggered into morning rounds, eyes bloodshot, clothes rumpled and stained after finishing an all-night call duty. This grueling routine--overseeing a ward of patients and admitting desperately ill newcomers from the emergency room--was a sleepless torture normally reserved for interns. Boot camp, if you like, meant to toughen us. No senior physician in his right mind would regularly volunteer for it. No one, that is, except Dr. Webster.
He never said why, at his stage of life, he repeatedly endured all-night call. But it wasn’t hard to figure out. As steward of our hospital and its occupants, he wanted to share firsthand what patients--and interns--went through, even in the middle of the night. Incredible. Consequently, when he spoke, we listened.
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Now back to the elevator. One of Dr. Webster’s cardinal rules was not talking about patients or procedures in public, whether in the elevator, the lobby or the neighborhood pizza parlor.
It wasn’t his nature to be mysterious or restrict medical information. So what was his motive? I believe it was empathy. Empathy first for a patient’s right to absolute privacy, even if the patient was anonymous. And empathy secondly for all other human beings within earshot. They too deserved protection from seemingly callous and out-of-context remarks about intimate anatomy, painful remedies, living and dying.
Who can calculate the effect of a callous or alarming remark on a visitor in a hospital elevator? Certainly not your average doctor. After slogging through medical school and hospital training, with all its gore and pain, seasoned doctors approach diseases and treatments largely devoid of personal emotion. It’s a necessary adaptation when you think about it. But it’s hardly the usual human response to fleshly distress.
Medical jargon was also anathema to Dr. Webster, especially if it dehumanized patients. Take, for example, the word “case”--in many medical settings, convenient shorthand to denote an illness. Even a statement as innocent as “In this room, sir, we have a case of pneumonia” would cause him to rasp back: “Doctor, you have a patient with pneumonia.”
Dr. Webster’s final rule stood out because it targeted veteran doctors--and it involved death. When patients died, Dr. Webster wasn’t satisfied with interns and residents notifying their families. He expected senior physicians to also meet with loved ones--even if it meant driving back to the hospital in a snowstorm.
This rule cast our hospital’s gray-haired pedagogues in a new light. Brilliant as some were, I learned, at times they too needed a push to do the right thing.
I still wonder what Dr. Webster would have done in my shoes the other day. Upbraided both offenders on the spot? I doubt it. More likely, for starters, he would have held his tongue and forgiven the lapse, seeing that it was ardor for medicine that inspired the thoughtless conversation in the elevator in the first place.
At the right time, however, I’m pretty sure he would have asked those two doctors to stop by his office for a chat. Because the way he saw it, no one in medicine is perfect--or exempt from compassion for others. And to ensure that compassion, he wasn’t afraid to lay down a rule now and then.
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Claire Panosian Dunavan is an internist and infectious diseases specialist practicing in Los Angeles. Reader comments are welcome at drclairep@aol.com. The Doctor Files runs monthly.
