After a busy day where nothing was accomplished but which seemed like an endless treadmill to nowhere, today is moving more calmly and slowly, and it seems that things are falling in place, at least in terms of my state of mind, although it is likely that nothing is still actually getting done, but then that depends on your definition of nothing. Most certainly the garden is not getting weeded, the laundry is not getting done, and I am not doing accounting work for the office, but these seemingly tangible things are ephemeral in their own way, ephemeral in that although they are concrete accomplishments, they are probably not lasting – they don’t really affect who we are or what we are, nor do they really have any bearing on the true accomplishments of life.
But then, once again, perhaps I am living too much in my head.
Yesterday brought the most recent issue of the NY Review and a package from Amazon. G immediately grumbled at a headline What’s Wrong with Doctors but then that is the kind of thing that always catches his attention, he takes doctor-bashing very seriously, although he will happily indulge in bashing other professions. I of course had to look at saw that it was a review of the new book by Jerome Groopman, How Doctor’s Think. I knew G’s sister was sending us a copy of the book, along with another one she thought G would be interested in reading, so I promptly settled down with it. I was eagerly awaiting the Groopman book as I have enjoyed reading the author’s essays in The New Yorker. The review was interesting. The book was even more interesting, and more balanced and interesting than I think I expected from the review. I need to check the review again, now that I have read the book.
Indeed the book came yesterday as well. I started it at some point after dinner, probably around 9 PM and I finished it this morning. It has been a long time since I have just settled down to read a book without interruption and I truly needed to do this. It was a fabulously productive and calming experience. I stayed up late, after G went to bed, and I did briefly consider whether this was wise because I feared he would wake me early. He did. But after a cup of coffee I was simply ready to curl up in a sunny window and continue reading.
It was a good book and well worth reading. It was not, of course, only about what is wrong with doctors, but also what is right with doctors, and sometimes also about what is wrong with patients. The book is much about how decisions are made, how medicine, or probably anything dealing with such complex organisms as humans and their lives, is not a simple science. There is no correct formula and many times even no right answer, although there way me an answer that is the best one for each individual patient. The book is continuing to affect how I think, and how I interact with doctors. This is an issue now as we deal with G’s current medical issues, but also with my own in the future. I think the book helps me to think about the process, and makes me try to think about how a doctor may be approaching the situation as well as how I as a patient or family member of a patient approach the doctor and how I pursue medical care.
This subject — the idea of how we make decisions, how objective we can truly be, and how our upbringing, our training, our personalities, and our basic assumptions about life color our decisions even without us intending that they do so – is endlessly fascinating to me. It has come up several times in my life lately, not just concerning work and medical care. I think it is something that needs to be pursued further, and probably definitely needs to be a part of the education of those who care for others. But then, as Dr. Groopman says, medicine is, or at least should be, a calling more than it should be strictly a business. And that in the end is where we all have problems and issues with the health care delivery system. Each of us wants to be treated as an individual, to be listened to and cared for. But some part of us also wants rules and statistics, cures and guarantees. Our needs, our wishes, and our demands may not be compatible, and doctors and patients need to find a way to communicate and find their way through this morass together.
