As I pointed out in my own experience in the chapter about the fly fisherman, Donald, no one has the right to destroy another’s hope. Hope belongs to each person’s heart alone. I cannot count the times I personally witnessed or heard later from patients or their family how another fellow physician carelessly trampled and dashed their hopes. Why? I absolutely can’t see any justification for such a cruel act. It is wanton, emotional murder. I’ve been guilty of it, but not since I learned better. Hope is a delicate, fragile thing.
Emily Dickinson wrote:
“Hope is the thing with feathers
That perches in the soul.”
There is a fascinating phenomenon I have observed consistently with terminally ill patients. No physician need ever worry that a patient will not eventually comprehend that the end of life approaches. When the time is right, they always know and they’ll always tell you, their doctor. I am not advocating that any doctor lie to his patient at such a moment. However, patients will give you subtle cues as to how much they want to hear from you.
Some will ask you to escort them right to the edge, and hold them, so they can stare steadfastly into the abyss. They’re demanding to see squarely what lies ahead. Others will only ask you to take them a couple more steps. It is a most delicate balance. Again, a doctor needs to hear how much the patient is really asking to know. That’s why listening actively, passionately, is so important. If you’re in doubt about how much to tell a patient, then it is better to err on the side of leaving too much hope rather than cutting it down too hastily. There will always be time enough for hope to die. Lastly, there is so such thing as false hope; there’s only hope, plain and simple.
of course, that's a very important thing to give to a patient before the operation..
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