After a presentation on Compassion in Medicine (hands up, please — who doesn’t want it?), a man about my age came over to introduce himself. He had been sitting near the back of the conference room with a troubled gaze, as if he were looking for a room with a sliding panel and an ear pressed to the other side.
He had become a physician for the usual hopeful, generous reasons, and for years they fulfilled him. But gradually, like many of us who are not native speakers in electronic records, billing requirements, and productivity demands, he began to feel the mission subverted by outside forces; he seemed to be running full-speed down the wrong road, with predators on his heels.
Nonetheless, breathing hard, he kept up — fighting for medication approvals, filling out multiplying forms, charting diligently. He documented whether there were weapons in the house and if seat belts were worn. He followed alcohol intake, discouraged cigarette smoking, and typed everything into the chart at night from home. He administered a required mental health questionnaire on each visit. All this while running full-speed down the wrong road (in encounters booked 20 minutes apart) was an admirable aerobic feat. But it came at a cost.
One night, an officer called from the local police department. One of his patients had been found dead in his apartment. There was no personal information anywhere in the apartment — nothing in the wallet, no photos on the refrigerator. Finally, someone had thought to check the pill bottles for a prescriber’s name.
“Listen,” said the officer. “We’re trying to learn a little here. You’re his doctor. What can you tell us about this guy?”
The patient had been under his care for several years. Hypertension and diabetes were more or less controlled, fights had been waged and won for higher-tier medications, documentation was in place about household weapons (none), seat belts (always), and alcohol use (rare). But in the face of this question, he found himself startled, then shocked, then stunned. There was nothing to add. He could recall none of the personal details that color a patient’s life in the telling and enrich a doctor’s life in the hearing. It was not for lack of wanting to learn. There had been no time to ask.
What patient doesn’t want to receive compassion, I thought, listening. And what physician doesn’t want to offer it?
“This is not why I went into medicine,” he said.
Elissa Ely is a psychiatrist.