See Me, Feel Me, Touch Me, Heal Me
By
Leonard Zwelling
Perhaps the Boomer readers will recognize this. It is the key chorus of a critical song from the Who’s rock opera Tommy (1969).
Today I would like to use the words from Peter Townshend in a different manner. You see it is these words that actually used to guide the manner in which physicians approached patients and, for that matter, how patients approached physicians during my training. Happily, it is still used by some doctors including mine.
When I was in clinic, I would SEE my patients. Of course, I would also listen to them, but the sense that used to guide my approach to any patient was sight. I looked at the patient, the person, and determined immediately whether or not I thought the patient was acutely or chronically ill.
The patient came to me to be SEEN. The patient was going to SEE the doctor and he or she meant it. Yes, the patient wants to be heard, but each patient wants to be seen. And as a physician, if I were still caring for patients, I would want to SEE the patient. All of him or her not just his or her face. And surely as a patient all too frequently now, I want to be seen.
Tommy, the Pinball Wizard title character of the rock opera, was also deaf and dumb as well as blind. Let’s hope we doctors are not for most diagnoses can be made from the history relayed by the patient. But you have to listen. You need to ask questions. You need to look and reaffirm what you see with your eyes by listening to the patient’s view of his or her chief complaint.
Finally, the doctor must touch the patient. That’s called the physical exam. I have been impressed that young doctors tend not to rely on the physical exam all that much if there’s a CT scanner next door, but part of building the relationship with a patient is that patient allows the doctor to touch him or her in order to learn more about the physical state of the patient. When a patient allows you to touch him or her and you do so with the skill of a healer, great trust is built.
Seeing and touching used to be key parts of the patient-doctor interaction. I am pleased to say they still are for me and my doctors, but I have also had doctor encounters with me as the patient where seeing and touching were short changed in the press to see a new patient every 30 minutes.
A story. I was moonlighting at the Seventh Day Adventist Eugene Leland Memorial Hospital in Hyattsville, Maryland in the late 1970’s when a young woman presented with upper respiratory tract symptoms. She seemed to have some viral illness, but was a bit dehydrated. As I did with anyone I saw who had a systemic illness, I listened to her lungs and her heart with a stethoscope, an instrument that seems to have become a piece of apparel unused by modern physicians.
She had a loud systolic murmur. I put her through a few simple maneuvers I had been taught and was sure she had the signs of asymmetric septal hypertrophy, a serious cardiac disease that required surgical intervention at that time. I called a medical school colleague serving with me at the NIH who specialized in this disease. He later saw the referred patient and confirmed my diagnosis for himself, and the patient was cared for by him at the NIH. I saw, I listened, I touched.
I hope all the doctor’s senses are employed with each patient that he or she SEES.
See me; Feel me
Touch me; Heal me
It builds trust. It makes diagnoses. It heals.
