Tuesday, June 28, 2011

The Golden Rule

Treat others as you would like others to treat you.
That is a very simple rule. I know I remember learning it from my grandmother. I couldn’t have been very old, probably preschool age. And it was probably in response to fighting with my brother. I’m sure most have you have learned this early in your life too.
I was reminded of the Golden Rule recently when I was talking to my son about how he should be treating his friends at school. As I was giving him examples of how the Golden Rule plays out in everyday life, I was surprised at the number of examples I could give. Unknowingly, I realized that I commonly do things in my daily life based on it.
I hold the door for people. I try to stop for pedestrians trying to cross the street outside the crosswalk. I say hello with a smile to people I see in the hallway. The list could go on. But, I generally try to do these things because I know I would like it if someone did them for me.
The next example I gave my son, was that I treat patients like I would want to be treated. This one, I am conscious about. I will commonly try to put myself in a patient’s position before I go into the room. Doing this helps me to relate better to their particular issue. After interviewing a patient, I may also learn new things that completely change my understanding of their problem. I will then alter a bit the way that I interact based on how I would want my doctor to respond.
For instance*, I was once sent a patient for evaluation of gallbladder disease. The emergency physician had noted a rise in liver enzymes, and a gallbladder that had thickened bile, or sludge as it is called. The patient also had frequent bouts of vomiting. The scenario seemed to make sense on the paperwork that I was sent. So, I went into the room expecting to book the patient for surgery. But the tip off to me was that the patient smelled of alcohol. So, I researched old labs and found that his liver enzymes have been elevated for years. A little more research showed another recent ultrasound that was perfectly normal. So, I began to delve into the alcohol questions.
As it turns out, he only has episodes of vomiting after binge drinking. And he never really has pain in his abdomen, except after vomiting a lot. It was clear now that this wasn’t gallbladder disease.
But, probably more important than the medical facts of this patient are the social ones. He was actually glad that I asked him about his drinking, and what he was doing about it. He was happy for me to encourage calling his sponsor and getting back to an AA meeting. He really knew all along that it wasn’t his gallbladder. He told me that by the end of the conversation. He just wanted me to listen and support him.
That’s how I would want to be treated.
Leave it to George Bernard Shaw to have a problem with the Golden Rule. He famously contorted his own version of the Golden Rule, which honestly, I don’t understand. Suffice it to say that his argument was that not everyone wants to be treated the way that you would want to be treated. I can accept that. Sometimes, the way I would want to be treated isn’t exactly what my patient wants. And in that way, it is good to realize that Shaw wasn’t all wrong in pointing out that subtlety. 
I think the real key is to understand this and try your best to meet the patient’s needs. After all, we all want our needs met. 
Whether we are in the school yard or the doctor’s office, treating others as we would want to be treated really is a Golden Rule.

*As always, the details are changed so as not to indicate a specific patient.


Jamie Smith RN said...

I couldn't agree more! Everyday I apply this rule to my own nursing practice and I am always surprised when someone thanks me for being kind. Isn't that our responsibility as caregivers?? I often wonder how other medical professionals lose sight of this simple idea of treating others with respect and kindness. I understand that we are ofter overworked, understaffed, and are faced with very difficult situations but it is during those times that being nice to one another helps get everyone through the situation. Thanks for the reminder to treat people well!!

Mark Roseberry said...

Well said, and well thought out, my brother. Would that all doctors took this approach.

Elise S. said...

I am just now reading the book “How Doctors Think” by Jerome Groopman and what you write about in your Blog compliments many points he makes. He too highlights the importance of knowing your patient’s perspective, their history, and carefully considering that all of the clues of the case add up with no alternative diagnoses before jumping into action. There is a whole chapter on surgeons, and the unique challenges they face as doctors in finding something different than expected AFTER they have opened up a person (that section you might particularly appreciate). Have you read this book?

Your comments reflect the attitude of a seasoned doctor, and it is interesting to have a window into a doctor’s perspective to help get the best medical care. Thank-you for taking such good care of me regarding my own medical issue. Hopefully now I will live a long, full life, well into my 90th decade!

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