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January 27, 2015

Another entry in what is now a trilogy of posts about Dr. Michael Davidson.  Sorry, I’m not done.  This is important.

Speaking of important, did you see Tom Brady’s (the Patriot’s quarterback) video post on his Facebook page?!?  So cool!!!  Inspiring music swelling, heroic acts of football prowess in super slo-mo, sweat flying, muscles flexing.   Here’s the text (sexily spoken by Billy Bob Thornton):

“It’s real simple. To me, being perfect is not about that scoreboard out there. It’s not about winning. It’s about you and your relationship to yourself and your family and your friends. Being perfect is about being able to look your friends in the eye and know that you didn’t let them down because you told them the truth. And that truth is that you did everything that you could. There wasn’t one more thing that you could have done. Can you live in that moment? If you can do that, gentlemen, then you’re perfect.”

Hmmm. If the definition of perfection is truth-telling, the NFL is probably not the poster child.  However, the idea of truth as perfection is intriguing.  The problem is that truth is in the eye of the beholder, and therefore so is perfection.  Remember the beginning of the Patriot’s season, when they were down 2-2?  People said Brady was done, finished, over the hill.  The truth, to him, might well have been that he did everything he could.  Or maybe that was the truth he gave the media, or the truth he told himself in the middle of the night, or not the truth at all.  It doesn’t matter.  To the skeptical observer, Brady saying he’s done everything he can is defensive, off-putting, false.  Why?  Because something bad has happened, and someone must be responsible.  Brady is in charge.  The truth is it must be his fault.

Thankfully, an irate fan did not come to the Patriot’s quarterback’s place of business and put two bullets in his chest.  But someone could have.  Because the truth that the public has, or the patient has, or the patient’s family has, or second-hand observers have, is incomplete.  Unless you’re on the field, or in the operating room, the truth will always be incomplete.  Everyone can make their own judgement, and in extreme cases act on that judgement. In order for us to continue to live with each other we have to trust.  We have no choice.

I can guarantee you Dr. Michael Davidson, after Mrs. Pasceri died, looked Stephen Pasceri in the eye and told the truth: I did everything I could.  There isn’t one more thing I could have done.  Mr. Pasceri didn’t accept that truth.  His truth was different.  His mother was dead.  He didn’t trust.

The difficult thing about the doctor-patient relationship is that neither doctor nor patient have the whole story.  There is no way for the patient, unless he or she is a physician, to fully understand what is happening.  Just as there is no way for the viewing public to fully understand what is happening in the moment on the football field.  It is the job of the doctor to explain as best he or she can, and to understand as fully as possible the patient’s values and outlook.  There is no way that the doctor can fully experience what the patient or family is experiencing. Just as I have no idea what it is to have Vince Wilfork aiming for my ribcage.  It is the job of the patient to make the doctor see his or her own experience of the disease process.  This is why the doctor-patient relationship is so difficult and so important.  Everyone’s truth is slightly different.  Everyone’s lived moment is unique.  The closer doctor and patient get to a shared perspective, the greater the chance of an outcome that can be accepted by both.

We must trust each others’ imperfect selves.


From → Healthcare

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