Lamenting for our Patients

“Don’t get too close,” was a phrase I often heard roll off my mother’s tongue while cleaning the kitchen after dinner. Whenever water failed to faithfully disappear down the hole, blocked by some mass of mashed potatoes, mom would have us all stand back and turn it on. If for some reason we were feeling particularly disobedient that day, we might attempt to see the destruction for ourselves, but this action was always immediately met with a stern, “don’t get too close.”

As I began my studies in medical school, I was surprised by how my professors instructed me to “respect” my patients using the same language my mother had used about the garbage disposal. I was bludgeoned with abstract ideas about a hollow empathy, and if I dared to suggest bonding with the patient, my comments were met with “don’t get too close.” Yet keeping my distance didn’t seem to resonate at all with what I had been taught growing up about comforting those who are suffering. When I was sick my mother did not leave a tray of soup and toast at the door; she held me in her arms. It seems to me that when the physician-patient relationship is more robotic than loving, something has gone awry.

Medicine is a privilege. People invite you into their lives and share with you secrets that they wouldn’t dare tell their spouse. People come hurting, broken, and weary. Medical school has taught me that what people want is a good mechanic. Someone who, when the bumper falls off, can efficiently and professionally put it back on. No crying or handholding is necessary. Is this really what patients want? When the patient has laid bare his soul before the physician, is the appropriate response to just a place a few sutures? In his book Stations of the Heart Richard Lischer answers these questions, at least for himself.  “At this point, we would have welcomed the human touch – some crumb of the acknowledgment that, even though he was the doctor and our son was the patient, we were at least capable, all of us, of a common sorrow, no matter how differently it was expressed. But then perhaps it was unfair to expect a professional to summon any emotion comparable to what we were feeling. Did we really need the oncologist tears to get us through this meeting? Or was there a mercy in these uninflected sentences?  Perhaps he knew we were less likely to collapse under an evenly distributed weight. What did you want, I later asked myself, the clinical assessments or a biblical lament? I wanted a lament.”[1]

As a Christian physician I am responsible to the Lord for being competent in my craft, but there will be many patients whom I cannot fix. As a medical community we should open our eyes to the idea that there can be hope and healing outside of a physical cure. A lament is an acknowledgement that my heart breaks upon hearing all of the pain and suffering that you have and will endure. A lament is laying our valid concerns and pain at the feet of the Lord of all, begging him for answers and to act. I believe this is what patients want. They want a hand on their shoulder showing a common sorrow, and a glance toward heaven asking “Why?” What does it look like to do this well, with both religious and nonreligious patients? I don’t know, but I do know that not trying is not the answer and neither is, “Don’t get too close.” Maybe in cracking the door of our soul, we can bring some healing to the patient, and to ourselves as well.

[1] Lischer, Richard. Stations of the Heart: Parting with a Son. New York: Alfred A. Knopf, 2013. p.46

Andrew Miller is a fourth year medical student at UNC Chapel Hill and a 2016-2017 TMC Fellow. He is hoping to incorporate his year of studying theology at Duke Divinity School into his future career in pediatrics.


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