Healing Hands

I have the privilege of working with third- and fourth-year medical students from Western Oregon University in Lebanon, Oregon. The school has a Lifestyle Medicine track which fits very well with my new specialty, Obesity Medicine. I enjoy demonstrating to them in very practical ways how I work with patients in the areas of nutrition, activity, sleep, and stress management to improve health and if possible, avoid prescribing medication. The work is energizing, and I love it.

Each student brings a unique set of strengths. I am always impressed by their intelligence and well-rounded experience which gives me hope for our future. In addition to their stellar academic achievements, they have accomplished near Nobel prize winning research or joined the Peace Corps or traveled the world or some other amazing or incredible thing which did not even come into my view finder when I was their age.  I wonder if I could make the cut in today’s competitive med school meat market. To be sure medical school and medicine have changed.

When I was a medical student, all I did was study. I went to every class, listened to every lecture, bought every note from the note service whether it was worthwhile or not, spent every Friday in the cadaver lab going over and over anatomy, and consequently, stunk like formaldehyde which made it impossible for me to go out because it would take the whole weekend to wash that acrid  stench from my pores. Who had time for travel or research or bathing, really? When I was on call, I’d try the Crash Cavern, a huge pitch-black room filled with bunks stacked three beds high. It was impossible to sleep, beepers going off incessantly and in irregularly irregular rhythms akin to atrial fibrillation so my brain couldn’t make it white noise. People snored, and loudly. Or they did other things. All this to say, sleep eluded me. I invariably ended up searching the corridors of the hospital wards for an empty room and dozing at least a few moments on a hospital bed or in the cot in the corner hidden from Nurse Cratchit’s view. Not every nurse was Nurse Cratchit, but there was always one.

I remember an Internal Medicine rotation at Houston’s Hermann Memorial, rounding on an elderly African American woman who had been admitted with an exacerbation of heart failure. Her lungs were filled with fluid and she struggled for every breath. She talked slowly and in spurts, “Good mornin’… Chil’… how is… the worl’… treatin’ you…t’day?”

Though she struggled she was at peace. I sensed a sacred presence in the room as I approached her lying there in the bed, despite the irreverent red lights and screeching beeps coming from the monitors snitching on her lack of normal vital signs. But there was no monitor for the spirit in her, the inner strength that exuded her small frame. I could hardly bring myself to invade the sanctuary of her personal space. Yet I felt compelled to know that space.

With my right hand I placed my stethoscope softly on her left chest over her heart and steadied my left hand delicately on her right shoulder. A serene smile unfolded across her entire face like a gentle wave on the ocean shore. “You have healing hands,” she said, her eyes closed as her warm breath exited her slight body.

In my youthful naivete, I did not know what to think or how to respond. I suppose I felt a sense of pride. I took her hand and thanked her. I quickly completed my exam and exited the room to finish my rounds for the morning.

Now that I am teaching medical students, I realize my patient was not reporting about my unique abilities as if I possessed some supernatural power as a rookie medical student. She was declaring something over me. It was a kind of prayer or a commission even.

“You will have healing hands,” she was praying as a hope for my future.

“You! Have healing hands!” she was admonishing me as a necessity for the challenging work to come.

“You have healing hands,” I said to the most recent medical student I hosted as she practiced her osteopathic skills on one of my willing patients. And as I said it, I realized just how far adrift I had gone from this original calling. In the recent years I could see how I had allowed the evolving institution of medicine to give way to busy-ness and crowd out the real vocation of medicine which is healing. The pressure of RVUs, Meaningful Use, Medical Home, CCO, ACA, MACRA, USTSPF, have basically stripped away time spent with the patient and the physical exam and therapeutic touch. Stop the world (of medicine) I want to get off!

And so, I find myself going rogue, at least for the foreseeable future. I am not sure what this new venture is going to look like exactly or where it will lead, but I am confident it will be way different and closer to my patient’s hopeful, prophetic commission than I have ever come. Healing hands are essential as a physician and I intend to discover them again.