Issue: BCMJ, vol. 51, No. 9, November 2009, Page 380 Editorials

(Man in loose pants, decorated in gold chains, cap on backwards, wife-beater T-shirt, baggy jeans with underwear sticking out enters stage left, extends arms with palms turned out and elbows bent, enters.)

“Woooord. What’s up?”

Actually, I don’t mean that kind of attitude, but it would be pretty funny if I were from the ’hood and a bunch of middle-class Canadian kids were trying to imitate me. 

The kind of attitude I am talking about is that of our health care providers, technicians, and support workers. I recently had a patient undergo major cancer surgery at a large tertiary care centre. The surgery was a collaborative effort between thoracic, vascular, and neurosurgery. 

As a result, my patient spent an entire day at the hospital for a pre-admission appointment, which consisted of pre-op blood work, an ECG, radiographs, and various assessments. My patient works in the health care field and he is a reasonable, noncomplaining kind of guy. His observations were very eye opening. 

Most people he came in contact with during his pre-admission appointment were hurried, uninterested, and dealt with him curtly. If this treatment had been a rare occurrence or involved only one or two individuals he probably wouldn’t have noticed. Here is a middle-aged man with a life-threatening diagnosis facing the ordeal of his life. He has probably never been so scared and vulnerable, and yet this is the treatment he receives just days before his major surgery.

Where does this attitude come from? Why doesn’t anyone appear to care? What would it have taken for someone to have paused and made a human connection? A gentle word or kind emotion could have made all the difference. I have no doubt that everyone was doing their job, but shouldn’t there be more? 

I realize that health care providers working in areas such as emergency often develop self-protective thick skin and a hard exterior, but this wasn’t the ER. This was the radiology department, pharmacy, laboratory, and admissions desk.

A general practice colleague once told me that he had adopted a Zen-like approach to dealing with patients. He treated each patient with respect and caring. He addressed their concerns, no matter how small, thereby reducing their fear and anxiety. He lived in the moment and didn’t focus on what had happened before or what he had to do next. He engaged his patients with kindness and left them with the feeling that they had been heard. He later admitted to me that the Zen thing was all BS and due to the antidepressant he was on at the time, but that’s not the point.

We can all learn from my colleague’s example. Make eye contact. Slow down a little. Smile. Be kind. Engage patients by asking a few questions about their life or how they are feeling about the situation. Take time to shake a hand or place a caring touch on a nervous shoulder. Sit down and talk. We don’t work at a factory or a store. 

Behind all of the diagnostic tests and procedures there is a fragile hu­man being. This isn’t a product we are dealing with; these are people—nervous, anxious, worried, and imperfect (just like us). Remember the lesson you learned in kindergarten—treat others as you would like to be treated.


David R. Richardson, MD. Attitude. BCMJ, Vol. 51, No. 9, November, 2009, Page(s) 380 - Editorials.

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