Doctors, Your Patients Are Human Beings

http://silenciorn.deviantart.com/art/Stethoscope-279190421I’ve seen a lot of doctors in the past three years – too many to count on my own two hands.  The number of doctors by whom I felt heard and truly cared for, though, is less than a handful.

Maybe my expectations are too high, but after running the gamut of doctors, I’ve come to believe that a doctor’s responsibility runs much deeper than simply diagnosing a physical complaint and running a treatment protocol. That’s because when we go to a doctor, we go not just as a bundle of body parts and malfunctioning cells sitting in an isolated exam room. We go as living human beings connected to families, communities, religious traditions, and a reality beyond the material.

All too often, doctors seem to miss this reality. Admittedly, we aren’t going to them to get our souls treated; doctors are tasked with treating our bodies. But then again, bodies are much more than anatomical parts and processes. Furthermore, western medicine is not the end-all-be-all authority on diagnosing what’s going on in our bodies. Reading physical symptoms, taking medical images, and running tests only reveal a partial truth. The truth of what the patient is experiencing, in my opinion, is just as weighty.

Melanie Thernstrom, in her book The Pain Chronicles, describes that in recent centuries, the question that doctors ask their patients has shifted from “What happened?” to “Where does it hurt?” It’s a subtle shift, but one that reveals a dramatic reorientation of perspective. No longer is the doctor asking the patient to tell their story about how they’ve ended up in the exam room, with all its starts, stops, hesitations, and implied meanings. Doctors now completely bypass patient understandings and instead hone in on the physical problem, minus patient narrative.

My own countless doctors’ visits attest to this fact. I would go into the exam room prepared to explain to the doctor when my ankle pain started, how I think it started, what I’ve tried to do for self-care, and my questions. Oftentimes, before I got a chance to get out more than a few sentences, the doctor would jump in. “Okay, take off your shoes and socks. Does this hurt? Can you rotate your ankle this way? Resist when I try to push your foot this way. Okay, now get up and try to stand on your toes. Hm…okay, take two ibuprofen three times a day for two weeks and it should be fine.” Before I could re-gather myself to ask questions, the doctor would be gone.

This description is only a slight exaggeration of my experiences. In short, the treatment of many doctors has left me feeling voiceless, like an inanimate object squeezed into a too-short time slot, cursorily poked at, and then ejected from the exam room right in time for the next inanimate object to arrive, and not a minute over.

My friend in her second year of medical school pointed out to me that a lot of the problem is the whole health care system in the United States. Unless they run their own practice, doctors don’t have a lot of say over how much time they are allotted to spend with each patient, and they are required to see a certain amount of patients a day in order to satisfy the group or hospital requirements. The system of which doctors are a part, willingly or not, simply doesn’t give them much wiggle room to take a more personal approach. I agree. I think the system needs to change.

Beyond the logistics of the system, however, lies a deeper issue of epistemology – that is, how knowledge is arrived at. Western medicine has evolved such that knowledge is believed to lie in concrete physical facts which can be measured, compared, quantified. Pain is rated on a scale of 1-10. (I’ve always disliked having to reduce my experience of pain to a number.) To be sure, numbers are helpful, and without such cut and dried measurements and processes, we might still be getting bled and leeched every time we saw the doctor.

The problem with numbers and cold measurements, though, is that human experience often gets cast to the wayside. How has the stroke affected Mrs. Farhad’s life? Does she see it as an act of God, something that she should resign herself to, or as a result of diet and lifestyle, something that she can gradually improve upon?

What patients themselves make of their ailments matters, not just for treatment, but also because how they interpret their experience through the matrix of their own cultural and metaphysical understandings of the world is a kind of truth. It is the truth of their everyday existence, of how they live their lives. Even if it is not the lens a medical professional uses to diagnose and treat maladies, this does not mean that it is irrelevant.

What am I asking for, then? I am asking that doctors listen to their patients. Not just listen to the number at which they rate their pain, but listen for what their pain means to them, how it has changed their lives, what it does to their sense of self. I am asking that doctors step down from their pedestals of lofty, scientific training and approach their patients in a collaborative eye-to-eye relationship. I am also asking them to take into account different kinds of knowledge – personal experiential knowledge and not just abstract textbook knowledge. Bottom line, I am asking that doctors treat their patients as human beings whose voices matter.

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Lopsided People: Somatizing and Spiritualizing

On the website of “Can,” a documentary about a Vietnamese war refugee who struggled with bipolar disorder, I came across an intriguing statement, “Asian Americans frequently somatize their problems,preferring to go to their primary care physician rather than seek help from a mental health clinician.”[1]  This statement rings true for my own family experience.

Growing up, I was never encouraged to give voice to my emotions. My parents and I kept our inner lives to ourselves and I learned to keep any internal distress under wraps, so much so that my friends always joke about my “poker face” and that I am “hard to read.” I never before linked my family’s emotion-suppressing patterns to other things, but as I read about mental health issues among Asian Americans and the tendency to “somatize” mental and emotional problems, other family patterns began to make sense.

My family, like a lot of Chinese families, is hyper-sensitive about our bodily health. My mom always likes to tell me, “Your health is the most important thing you possess. Without it, you cannot do anything else in life.” This is true to some extent, but sometimes this mantra can be carried to the extreme. If we think physical health is our most important possession, we can put so much energy into cultivating this one aspect of our being that we neglect other crucial parts of ourselves – like our emotions and our spirits.

Eventually, like the sadly true statement I read on the website, we can forget that other non-physical parts of our being even exist. We begin to think that only the material exists, thus going to a physician for an issue that also requires the care of a psychologist or pastor.

But this issue of emphasizing one part of our being to the neglect of others can also happen in another way, through spiritualizing physical issues. I experienced an instance of this last year when we visited a church and I went up to receive prayer after the service. I told the woman praying with me about the pain in my ankle and my desire for full healing. After a few minutes of prayer, she paused and asked me, “Do you have any unforgiveness in your life?”

I am totally in agreement with the idea that sin and spiritual clutter can result in physical symptoms. I am still in the process of letting God use my physical discomfort to alert me to larger issues in my life. However, the subtle message I received from this woman’s question, in the context of the rest of the church service, was that people who are spiritually pure should have victory over physical problems. If you have some ongoing ailment, most likely you just haven’t let God into your life enough, or you haven’t let go of something that you should.

This type of reasoning may be true in some cases. But I don’t believe we can say there is a direct proportional relationship between spiritual health and physical health. Carried to the extreme, this logic mutates into the “health and wealth” gospels that mislead so many.

Both somatizing and spiritualizing are pitfalls of over-emphasizing one aspect of our beings to the neglect of other aspects. Though God created us as whole beings, with integration of body, mind, and spirit, we often see ourselves as if through the lens of a carnival mirror, with one part way too large and other parts way too small.


Poor Bodies, Rich Bodies

When riding the green line train through Chicago to grad school last year, I would notice that as we left the downtown “Loop” business area and rattled deeper into the poverty-stricken South Side, people started looking different. Most obviously, the number of White people decreased and the number of Black people increased. By the time I reached my stop in the heart of the South Side, there were almost no non-Black people to be seen.  I also began to notice something less obvious, however, about people on the South Side – there were way more people on crutches, in wheelchairs, and missing limbs here than in the wealthier parts of the city.

This observation is, of course, only supported by my own “quick and dirty” street research.  Some other facts, however, contribute to its validity. The South Side is known for street violence. It makes sense that the bodies of the people living here would reflect this painful legacy. Also, poor people are not able to afford the same quality or amount of healthcare as wealthier people. Sadly, this lack of access to treatment results in debilitating conditions which could have been prevented. Furthermore, poor people often do not have the resources or education to make healthy eating choices. It is well known that there is more obesity among poor people, a condition which leads to a range of other health problems, such as diabetes and heart disease.

I found myself strangely drawn to these people on the South Side with their broken, beat-up bodies. One day, as the bus I was riding lowered to meet the curb and a wheelchair rolled on, I raised my eyes to meet the gaze of a very large boy in a wheelchair. He looked around 10 years old, but his weight was probably twice that of a grown man. Part of me wanted to look away in disgust, but the other part of me held his gaze, driven by a deeper impulse. The look on his face was heartbreaking. There was a hint of childish innocence and curiosity, but also a wistful listlessness and despondency.

The bodies of this boy and of others I encountered on the South Side profoundly unsettled me. But as I resisted the urge to turn away and ignore them, I was able to see in them something more than just the grimy and grotesque. These are the sick people for whom Jesus came to rescue! If Jesus were walking again on this earth, I am sure he would wind up in Chicago’s South Side at some point, putting his hand gently on the boy in the wheelchair’s drooping head, making up a dirt-spit plaster for the woman with the white burn scar streaking across her brown face.

Me? I recognize a bit of the Pharisee in me – the part that wants to escape to the shady streets of my quiet suburban neighborhood, where joggers with sleek, toned muscles and expensive running clothes breeze past, and where I don’t have to think about poverty and broken bodies. Yet, I am grateful for my exposure to the poor bodies on the South Side. In some ways, their scars, disfigurement, and pain seem more raw, more honest, and more ready for a Savior than the put-together, self-sufficient bodies of the wealthy. This doesn’t mean that we shouldn’t take care of our bodies and seek healthcare when we need it, or that we shouldn’t work with the poor to increase their access to healthcare and their chance to lead healthy lives.  I just wonder what we as the Church could gain from simply being with the poor and being in contact with their physical brokenness, and what we lose by ignoring them.

Invitation to Be

Welcome to Body & Being! I’m honored that you are visiting. How did I come to author a blog on embodiment and spirituality?

Many streams of life experience feed into this project: my mom sitting on my bed telling third-grade me that if I wanted to fall asleep, I should think about my belly button; receiving a What’s Happening to My Body? Book for Girls on my twelfth birthday from my dad, and feeling slightly mortified; dancing to Justin Timberlake and Sean Paul (I feel slightly mortified mentioning that now) on my high school drill team in small town Texas; leading young girls and college students at my church through workshops that explored worship and movement.

The most recent circumstances that have compelled this blog are some health issues that I’ve been struggling with for a couple years. You’ll hear more about that in later posts. Never before has the disconnect between having a body and being a body been so pronounced for me. If my body is part of who I am, does this mean that I am less whole than I was before my health issues started? I sure feel that way sometimes. But this cannot be – Christ tells us that we are a new creation in Him. How does the reality of this new gospel life touch the reality of our life in/as bodies that decay and die? Certainly it does not mean that we neglect our current bodies and live disembodied existences geared only toward our resurrected lives and bodies. Our bodies are important now. They have something to tell us about God, about life, about who we are as broken yet redeemed people. What that is – what our bodies tell us – is the question I want to explore. Read more on the heart of this blog here.

I can’t promise too many answers. What I do promise is an honest and thought-provoking excursion into the thicket of questions. I envision weaving personal stories, theological reflection, and cultural critique into these posts, covering topics like bodies in worship, praying with the body, Chinese and American attitudes toward the body, illness and healing, pregnant bodies, medical practice, etc.

I invite you to sit back, grab a cup of tea or a piece of chocolate (whatever gets you in the mood for good conversation) and join me in venturing deeper into the paradox of body & being. I also welcome your comments. Dialogue is always preferable to monologue.