The real medical innovation

by Christina on September 27, 2011

Excellent talk by physician/writer Abraham Verghese about the most important innovation in medicine to come in the next 10 years: the power of touch and the human hand.

He talks about modern medicine’s excellent treatment and attention to the “i-patient” on the computer, while the real patient in the room lies confused, wondering where everyone is and what is happening.

He talks about the vital importance of the ritual of the physical exam, often overlooked in exchange for lab tests and scans.

“The ritual of one individual coming to another and telling them things that they would not tell their preacher or rabbi, and then incredibly on top of that, disrobing and allowing touch… that is a ritual of exceeding importance, and if you shortchange that ritual, by not undressing the patient, by listening with your stethoscope on top of a nightgown, by not doing a complete exam, you have bypassed on the opportunity to seal the patient-physician relationship.

He ends with this beautiful passage about his ritual at his patient’s deathbed:

“I percussed, I palpated, I listened to the chest, I think he surely must have known by then that it was vital for me just as it was for him. Neither of us could skp this ritual, which had nothing to do with detected rales in the lung or finding the gallop rhythm in heart failure.

No, this ritual was about the one message that physicians have needed to convey to their patients. Although God knows of late, in our hubris we seem to have drifted away, we seem to have forgotten. As if with the explosion of knowledge, the whole human genome mapped out at our feet, we are lulled into inattention, forgetting that the ritual is cathartic to the physician, necessary for the patient, forgetting that the ritual has meaning and a singular message to convey to the patient. And the message, which I didn’t fully understand then, even as I delivered it, and which I understand better now, is this:

I will always always always be there. I will see you through this. I will never abandon you. I will be with you through the end.”

{ 1 comment… read it below or add one }

Kim Palmer October 1, 2011 at 12:28 am

Wow I love that….I remember in college loving going to see the nurse practitioner when I was sick because she was so touchy!

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