HOW DOES THE DOCTOR- PATIENT RELATIONSHIP EVOLVE?
Hospitals are installing national computer systems to avoid human error in transcriptions, but they won’t be used unless doctors are taught one-by-one how to use them. Similarly, mindfulness will be a waste of human resources unless doctors are taught to recognize their own humanity one-by-one, through experience and narrative, not by didactic lectures. An 80-year-old woman in my practice suffered enormous pain when a transcription error denied her pain medication for the day. When she asked the nurse for relief, she was chastised and told that the orders had to be followed. The family, recognizing her distress, climbed the chain of command to get assistance, but to no avail. She suffered needlessly. At Johns Hopkins a rapid response team has been set up solely for the purpose of listening to family members, those who are often the first to recognize trouble. In a poem by Rumi, God’s joy moves from unmarked box to unmarked box as diagnosis moves from cell to cell, as rain water tickles
