Dancing to the Rhythm of Care: Where Science and Humanism Meet

Below is the original version of my medical school personal statement; a version I had to delete because I felt it was too raw and potentially offensive. In hindsight it likely wasn’t, so I want to publish this for my readers in order to illustrate the importance of trust in the physician-patient relationship. With trust in medicine at an all-time low, we as individual clinicians must rise to the challenge of communicating well, valuing the mental framework of an individual, and bringing care to their place. The latter bit is what I see as crucial, it is in the place the patient is; their social life, their culture, their community, that care can happen.

As I sat in the living room of a patient we’ll call “Ms. M,” I felt a familiar feeling of frustration when she said, “I’m not having a stroke. You just want my money.” With her daughter witnessing an episode of unilateral weakness, it definitely wasn’t about the money — she needed to go to the ER. After all, recent position statements at the time firmly recommended transport for all patients with any report of stroke-like symptoms. Though I was a paramedic with 5 years of treating patients, this posed a unique communication challenge.

“Ma’am can you explain to me why you think that?” My inquiry was meant to explore her values and connect with her.

“Well, all the paramedics I’ve had demanded that I go to the hospital, but I just don’t have the money.” This was common in my semi-rural county.

“This is serious. If you still refuse, I still want you to go to the ER with family.” The patient’s daughter nodded in agreement. After much deliberation with her daughter, the patient agreed to be transported. Enroute her stroke symptoms resumed, her body becoming paralyzed on her left side. My skills came alive as I stabilized her airway, administered oxygen, started another IV, and prepared to intubate if needed. An hour later, she received the clot busting drug TPA, making nearly a full recovery. Advocating for her with evidence-based practice saved her life. Looking back, I wonder what the outcome would have been if I had assumed that she was just stubborn and misguided.

This is a 911 call I hope to remember until my last neuron decays. Looking back, I was in a state of burnout, utterly exhausted, and feeling like I had little to give my patients. What made me stay in her living room? It was me digging deep to the foundations of this career: humanism. The belief that science is only as good as its ethical applications. While I had the tools and the knowledge, Ms. M had the most important thing of all, trust. Without acknowledging that, assuaging her fears, and eliciting her daughter’s help, there was little chance for a good outcome.