Every Patient Has a Story Worth Hearing
March 22, 2016
Earlier this year, Canadian newspaper The Globe and Mail commemorated the anniversary of the death of neurologist Oliver Sacks by taking a look at his legacy. The piece, by author Norman Doidge, aptly reminds us that “the world’s most famous neurologist believed that every patient had a story worth hearing.” And indeed, his work proves that “humanity belongs at the heart of medicine.”
In “How Oliver Sacks put a human face on the science of the mind,” Doidge describes Dr. Sacks’ writing over the course of his life, including group of essays he wrote in the year leading up to his death, essays that have since been published in a short collection titled Gratitude. Dr. Sacks, of course, was already well-known as a writer by this point, including authoring Awakenings on which a well-known movie was based. His books and articles had tremendous impact, not just on a Hollywood audience, but on his physician contemporaries. Doidge writes,
“When he died, the surgeon Atul Gawande wrote in The New Yorker, ‘No one taught me more about how to be a doctor than Oliver Sacks.’ This Dr. Gawande gleaned not from working with Dr. Sacks at the bedside, but from reading him.”
Sacks had a mentor, too. When it came to writing about patient histories, as in Awakenings, Sacks gained inspiration from scientist-author, Dr. Alexandr Luria. In fact, Sacks dedicated Awakenings to Dr. Luria. Doidge captures Luria’s response (in quotes) to the book:
With “the advent of the new instrumentation,” technology was getting between the physician and the patient. “The physicians of our time, having a battery of auxiliary laboratory aids and tests, frequently overlook clinical reality.”
This would seem an extreme statement; after all, why must new technological tools lead to a loss of clinical reality? Can we not have both? Can one not enhance the other? And yet, Dr. Luria, according to Dr. Sacks, believed that there was a “conceptual and emotional atmosphere” that came with technology that cast a shadow over the doctor-patient relationship.
We encourage you to read Doidge’s extensive article in The Globe and Mail. In addition to describing Sacks’ scientific and literary work and detailing some of his personal life, it also provides interesting insights into the evolution of case histories. It reminds us that how we tell patient stories is equally as important as the medical details they contain.
He listened not only with a stethoscope, but a poet’s ear.
And when it comes to patient stories, Doidge beautifully describes Sacks’ sensibility as follows:
“Dr. Sacks saw himself as a naturalist, cut loose within the world of medicine, and naturalists love to collect, catalogue, describe and discern, in great detail, the manifold variations in nature. Dr. Sacks was wedded to the proposition that we learn best from a close study of the particular. He hated textbooks, with their generalizations and remote language, and science by committee. He wrote to vivify each patient’s unique experience, often using their own idiosyncratic speech. He listened not only with a stethoscope, but a poet’s ear.”
Physician as poet? Well, physician as skilled and careful listener, anyway. It’s a high bar for the physical exam and bedside manner that’s certainly worth pursuing.
Image Credit: © Luigi Novi / Wikimedia Commons