Defending patients from judgments
The patient had no identification on him—all we knew was that he had walked out in front of a car. Then we found drug paraphernalia in his clothing, and from that point on it seemed as if this had become his identification. As his healthcare team, it seemed as if we had gone from knowing nothing to assuming almost everything about him. The drugs told his story for him, and as he was unconscious, he was unaware of the opinions and assessments being made about his character.
I wondered if these assumptions had any impact on the patient’s treatment. He would surely receive the same interventions and medications as anyone else with a traumatic injury—but would his treatment be different in more subtle ways? A different patient interaction helped shed some light on the issue. When I was on a ward round on a different occasion, the team I was attached to visited an unwell patient, and I simply observed her symptoms and noted the treatment started by the senior doctor. The next day, we visited her again, but this time her son was at her bedside. I was touched by the young man’s concern for his mother and his desire for her to resume a normal life. His presence was an unspoken yet compelling defence of her character, and helped me to empathise with her. Thinking back to the patient who had been hit by a car—there was no loving family member there to pull at our heartstrings. He may not have been denied any identifiable component of care, but our duties as doctors go beyond just providing the basics.
If we pre-emptively judge our patients, as I might easily have judged the patient found with drug paraphernalia, we might miss an opportunity to help the patient. If a patient has caused their own suffering, a doctor might show less empathy, and might unconsciously be unwilling to go the “extra mile” if they believe the patient doesn’t deserve such a sacrifice of time or energy. Doctors must protect patients against disease, but must also defend patients against barriers to their care by embracing the things about a patient that motivate us to help them. We must work to ensure that certain characteristics and information we learn about our patients do not dampen our compassion and desire to serve them.Ashley Albert, fourth year medical student
1Mercer University School of Medicine, Georgia, United States
Correspondence to: firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
Cite this as: Student BMJ 2014;22:g2799