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The Power to Sustain Hope or Destroy Hope

Program nurtures humanity and compassion, along with science, in students and health care workers

 

The first words one physician said to a new patient – a woman he had never seen before – were: “Hmm…I see you are post menopausal but not on hormone replacement therapy. That’s not good.”

The first words from another physician to a new patient were: “Tell me, what’s your life been like since you last saw a doctor.”

The first patient felt defined by her hormone deficiency; the second felt connected with a doctor who saw a person.

“Our work is based on the premise that the good physician not only masters the biomedicine but also connects with the person in the patient,” said Rabbi Samuel E. Karff, D.H.L., at the Feb. 15 University of Texas Health Science Center at Houston President’s Executive Luncheon.

During the luncheon at the River Oaks Country Club, Karff and Thomas R. Cole, Ph.D., discussed the work of the John P. McGovern, M.D. Center for Health, Humanities and the Human Spirit at the UT Medical School at Houston.

The work of the center reflects the tradition of Sir William Osler, who exemplified the highest ideals of humanism in medicine, when he saw 100 years ago that “the more medical education became scientific, the more physicians were at risk for losing their own humanity,” said Cole, who is the Beth and Toby Grossman Professor and director of the McGovern center.

Bringing ethical, humanistic and professional content to medical students is important, Cole said. “But we’re not just interested in bringing humanistic content to students. We’re interested in evoking and nurturing the humanity of students by preserving and developing and growing it alongside the medical education. We’re interested in integrating it into the scientific work that they do.

“What we’re really about,” he said, “is recovering compassion as the driving force of caring and infusing all the scientific and technical work with compassion.

“We’re interested in not only preparing students to become physicians and caregivers for the whole person, but we’re also interested in addressing the needs of the students as whole people,” Cole said.

One of the ways the center accomplishes that is to create space and time in the curriculum for reflection. In one class students are asked to write stories based on their experience in the clinic or the hospital, first from their own perspective and then from the perspective of the patient.

“Empathy is fostered by imagining what happens in the world of the other person,” said Karff, who is associate director of the McGovern center and visiting professor in the Department of Family Medicine.

“Our role is to train physicians who are both great clinicians and healers,” he said. “A healer tries to appreciate how the condition is being experienced by the other, what impact it has on that person’s life and experience. A healer knows the power of a physician’s words to sustain hope or destroy hope.”

In another, third-year class, “students practice how to relay bad news without prematurely snuffing out hope. We invite a professional actor to play the part of the patient. We critique how well the students are doing, and they make suggestions to each other,” Karff said.

“So part of our mission is to help train physicians who appreciate the healing power embedded in the doctor/patient relationship,” he said.

Another part of the mission is to help health care workers see their work not just as a job, but as a calling. A program called Sacred Vocation is conducted in partnership with Episcopal Health Charities. This intervention targets health care workers in hospitals, clinics or nursing homes. The McGovern center currently is engaged in a year-long intervention with 400 techs at Baylor Hospital in Dallas.

“Techs interact with patients more than anyone else,” Karff said. “They bathe patients, they change the bed, they walk patients down the hall, they bring food trays, they take patients to the bathroom if necessary, and some of them take vital signs. The premise of our program is if you want the techs to nurture the patients, you have to nurture the techs.”

Through a series of exercises, techs discover the value of their work in validating their lives. They discover that they are a part of the healing team, and they devise strategies to cope with difficult situations. At the end of this phase of the program, the techs formulate an oath, which they take during a public graduation ceremony.

In the second phase of the program, led by Benjamin Amick, Ph.D., associate professor of behavioral sciences and epidemiology at the UT School of Public Health, small groups meet to ask: “What if you had the ear of the CEO of this hospital, what changes would you like to see that would make you feel better about working here and make you better able to serve the patients?”

Karff said, “Our experience has been that management accepts many of their suggestions. And you can only imagine how empowered that makes them feel.”

So, what do the programs in the hospital and in the medical school have in common? “They’re both designed,” Karff said, “to help those engaged in healing, in health care, realize that if they do their work as a sacred vocation, their work can be part of what gives meaning to their lives.”

By Ina Fried, Public Affairs