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Good morning all-

Good night, relaxed morning. I've had breakfast (bacon, eggs, croissant with strawberry jam) and cooked bacon for Mom and kids.

Allopathic medicine (me, as opposed to osteopaths and homeopaths) has concentrated on the physical aspects of care for many years. Medicine has made many important and fascinating procedural and anatomic discoveries, instituting new treatments on this basis. All that is good. Surgical outcomes and options are better, medications for chronic conditions are better, testing more complete and less invasive.

What I feel has been forgotten in all this technical progress are the other parts of a person besides the physical- the emotional and spiritual.

During my two hospital stays, I feel I received excellent surgical care (which in a sense is what I came for). At the same time, NOONE asked me in a serious way how I feel, nor did they seem to care about the intensity of my feelings when I expressed them myself. Further, there is essentially no spiritual care of any kind. One of the things I love about St. Mary's and about several hospitals with which I have been affiliated, is their religious affiliation. At St. Mary's there are nuns who make rounds every day, and who visit every new admission. I remember having one of the nuns pray with me when I was hospitalized for a-fib. It was intensely touching and helpful to me.

Some may recall the conditions at Scutari Hospital in the crimea during the Crimean War of 1850. They were scandalously bad- men in open wards, lying on straw mats, 1000 of them ill with cholera, feces and vomit on the floors, grossly inadequate food, contaminated water, inadequate nursing and physician staff.

We look back at such care with horror, and justifiably so. An admission to the hospital was a likely death sentence, and even those who went knew it. The death rate of mothers and infants in hospital childbirth was much higher than in those who delivered at home. 'Only' 30% of surgical patients died.

But that is in essence the level of emotional and spiritual care that we provide now. I'm a 'show me' kind of person. Give me data. In this situation there is a surprising amount of data. Data on prayer are quite conflicting, this because of the difficulties of the character of prayer, and the disconnect between earthly desire and spiritual goals, which may be quite different. However, we have plain scientific data on the effects of anxiety on healing, as well as data on the effects of emotional and spiritual interventions for surgical patients.

While I am grateful for my surgical outcomes, I can not say I feel I was treated well as a person. In an environment where most cases lose money and reimbursements for hospitals are going down, it seems a great deal to ask to consider a patient's needs beyond the strictly physical. One may immediately ask, however, is it also too much to consider their bowel and bladder function? These are not technically related to their surgical or medical care, but we are well past the point of asking people to shit in their beds and change the sheets tomorrow, or whenever the staff feel like it.

Just so I would like to see more emotional consideration of the patient, and a serious assessment of their needs. The nicest thing that happened to me was in the ICU, where they had one nurse for two patients. My nurse came in every hour or so, sometimes more often. I was awake and reasonably comfortable, and she just talked with me, asking me how I felt, etc.

In the movie 'American Beauty', Lester is asked how he feels. He replies, just before he is shot and killed, 'You know, nobody's asked me that in a long time. I feel great.'

Sometimes just asking how someone feels is a gateway to serving their greater needs. And not asking pro forma. Really putting down your clip board and asking.

Ted  

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