Another NEJM Gem: The Doctor’s Dilemma

I always rather enjoy the narrative perspectives that the NEJM publishes every week, and some of those hit very close to my heart. The Doctor’s New Dilemma talks of how Modern Medicine today is facing away from the patient and into the computer screen. The author, Dr. Suzanne Koven, MD (you can follow her on twitter here), delves into how, in the hustle and bustle of modern medicine, doctors and patients today are failing to make the connection that was once the soul of medicine.

Dr. Koven recounts a tale, that simultaneously appeals to the medicine lover and the fountain pen lover in me (not a combination that usually gets appealed to!):

Once, when I was covering for a colleague, I saw an older woman I’d never met before. I pride myself on being able to put patients at ease, being able to establish rapport with almost anyone, but this woman would have none of it. She expressed skepticism about everything I said. Finally, she pulled a pen out of her purse to write down my diagnosis, clearly intending to look it up later and marvel at my foolishness in proposing it.

“What a beautiful pen!” I blurted out. And it was: a lovely tortoiseshell implement with a shiny gold nib. The woman’s hostility melted. She told me that fountain pens were a great passion of hers. She collected and traded them. She’d been to pen shows and pen shops all over the world. I told her that I liked fountain pens too, that in fact my husband had just bought me one for my birthday, at a shop in Dublin. Of course she knew the shop. “What make of pen?” she inquired. I confessed I didn’t remember, so she asked me to describe it. Thick . . . natural wood shaft, chrome cap . . . “A Faber-Castell!” she pronounced, beaming. “That’s it!” I shouted, my grin matching hers. She put her pen away without recording my diagnosis. She believed in me.

Medicine today is cutting out the stories, the bond, the connection that was once one of the best parts of the job.

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