…for the secret of the care of the patient is in caring for the patient.”
-Francis W. Peabody, M.D.
It was in 1926 that this statement was made at the conclusion of a student lecture by Dr. Peabody at the Harvard Medical School. It has been passed down through several generations of Neurosurgeons finally arriving at my ears at the beginning of my training.
This simple and elegant statement is certainly worth contemplating. What does it mean to care for the patient? Is it simply about prescribing the right medicine or recommending the right surgery? Or is it much more complex? We care for our own families, but we would not say that our caring is simply a matter of providing good advice every once-in-a-while; that is just the beginning.
My interpretation is that caring for the patient is exactly the same as caring for your own family. It means putting yourself in the shoes of the person for whom you are caring. This requires the doctor to take a step back and consider the entire picture. Is there a family history of this disease? How is their job contributing to the condition? Are they nearing retirement, or are they young and perhaps a career change should be considered? Clearly you can see that the conversation has to extend beyond ‘here is your problem and this is the surgery you need.’
As surgeons we are often faced with treating a particular problem once it has reached a point of no return. However, we must consider the factors that have contributed to the condition so that we can make lifestyle recommendations that will help prevent recurrence. To prevent recurrence, one has to understand how the condition came about in the first place. We must understand the patients’ life and lifestyle.
For these reasons, I insist that I meet with every one of my patients on every visit. This means that you and I will speak on every visit before surgery and every visit after surgery. During surgery, I am with you throughout the entire operation. There is never an exception to this. There are no assistants in my office or in the OR that will attempt to take my place. I do this because your story is worth listening to and I don’t want to miss even the smallest detail that might assist me in helping you.
Ultimately the advice that I will give you is exactly the same advice I would give my mother or father, sister or brother. There can be no greater clarity of thought then to recommend for your patient exactly what you would recommend for your own family.