Whole Person Care on a Busy Medical Ward

Abstract

This chapter discusses whole person health care in medical education and includes a fictional case vignette that demonstrates the need to include the patient in decision making as an individual and unique person. The transition from layman to physician is a maturing process as participation in reality becomes more intense. The movement from the classroom to the bedside provides experiences that are outside of the stated educational objectives of the formal medical curriculum. This role change is accompanied by real threats to the idealism that prompted many to seek a future in medicine. These other things include the focused emphasis on the doctor-patient relationship, the genuine interest in the psychosocial aspects of medical practice, the personalization of clinical experience, and the sharing of life stories. The conscious role model is forever vigilant for the teachable moment when a human story can lead to a generalizable lesson. By the time medical students and young physicians in training arrive on the medical wards to care for real people, they have a very good understanding of pathology and physiology. They know how biochemical processes can be altered by genes, by microbes, and by the environment to cause and to perpetuate disease. They can list the causes of symptoms such as weakness, dizziness, chest pain, and headache. They know which laboratory tests to order and how to interpret them. They use the imaging techniques that have the best chance of providing the answers to the diagnostic puzzles that confront them. Once the patient has been deconstructed into problems such as anaemia, weight loss, abnormal liver function tests, or a calcified lung mass on a chest X-ray, the treating team calls into action an array of steps and strategies to deal with each and to reach eventually the correct diagnosis and to formulate an effective treatment plan. The treatment is aimed at eliminating the abnormality either by attacking the cause or by helping the patient accommodate the abnormality to reach a new state of balance. The challenge on the wards of a busy teaching hospital is to assist and to guide these young people to transition from the care of problems that happen to reside in patients to the care of patients who happen to have problems. This task requires a shift of attention to the container rather than to the contents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)