Such a courageous story is in stark contrast to how the government and TEPCO responded to the nuclear crisis in Fukushima. Their combined lack of leadership and inadequate disclosure of information on the risk of radiation contamination deprived them of trust from both the Japanese public and the global community, creating chaos and confusion.
Again, I was reminded of my clinic patient. After she had suffered the stroke, I was fearful that it could disrupt our therapeutic relationship. I thought I might have lost her trust. I expected her to stop listening to my recommendations. I even thought she would fire me.
To my surprise, however, she not only kept me as her physician, but also recruited her husband to become my patient. She continued to take her medications and follow a diet that I recommended. She said she liked how I continued to visit her in the hospital during her worst times. I was sincerely relieved to hear that, because it took a great deal of nerves to see her in the hospital after what had happened. Fortunately, her weakness improved significantly as she went through rehabilitation and, eventually, she recovered to the point where I could no longer tell if she had ever suffered a stroke. I believe that the trust she had in our healthcare system saved her.
In both cases, trust played an essential role. Trust can make people resilient at critical junctures because it gives them hope. The question for hospitalists then becomes how to build trust. More simply said than done, I believe that some form of personal sacrifice is necessary. This might mean that we may need to spend more time at our patients’ bedside, but it might mean that we have to make ourselves emotionally available to patients’ needs and remain compassionate.
A few years ago, I worked with an intern who spent a couple of hours with his patient during his call on a Saturday night. He was talking to an anxious patient who had just been diagnosed with advanced cancer and wanted to give up. After that night, the patient decided to stay and undergo treatment. The intern provided the patient with hope, and the patient trusted the intern. The patient is doing well today and, whenever I run into him in the hospital, he always asks about the intern.
Another intern I worked with exhibited outstanding bedside manners. She always sat down and held her patients’ hands as she explained her plans. She was kind and caring. One of her patients appreciated her and trusted her so much that he insisted on finding her a husband. We all laughed, mirthfully. Even though we could not do anything about the terminal cancer he was diagnosed with, he still left the hospital smiling.
In hospitals, we witness disasters and devastations daily. They might not be as visible as the images of earthquakes or tsunamis, but we know the impact of disease or injury is challenging. As responders to personal catastrophes, hospitalists must strive to allow our patients to trust us, trust our healthcare, and, above all, trust themselves. We have to constantly remind ourselves that the very existence of hospitalists came out of the necessity to have a readily available presence of physicians in the hospitals. We can help our patients by rededicating ourselves to the values at the heart of our profession.