Doctors often struggle to show compassion while dealing with patients

I was standing at my patient’s bedside. Mike Venata was having chills with a temperature of 103. Sweat covered his balding scalp like dew, then coalesced and rolled down past his staring eyes.

Just 20 minutes earlier, a specialist had informed him that he had metastatic pancreatic cancer and could expect to live less than six months. He was alone. I’d seen him once before; as an infectious-disease specialist, I’d been called in because his fever might be due to an underlying infection.

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I wondered: How do I show him compassion?

Many say our health-care system lacks compassion. I too at times feel that pills and surgeries, CT scans and radiation therapies, biopsies and blood tests have become a priority in medicine and that compassion — the “touchy-feely” part of medicine — has become an afterthought in patient care.

After a few days in the hospital, Mr. Venata’s fever subsided, and I asked if I could talk with him about his experience. He was a retired major who earned a Bronze Star in Vietnam, then became an executive for a multinational company, from which he had recently retired. He had never been married. I wanted to talk to him about how doctors should handle end-of-life situations.

I asked, “When you were told your diagnosis of the cancer, what went through your mind?” Sitting by his bedside, I expected to hear the usual description of shock or denial. But his case was different.

 “Well, the first thing I wanted to do was — I wish I was 10 years younger, I would have reached across and slapped the [expletive] out of the doctor.” Despite his words, he didn’t look angry, just deeply saddened.

 Startled, I asked why.

 He told me that the specialist had pulled out a piece of paper with his biopsy results and said, “ ‘Well, this isn’t very good. This is terminal.’ . . . He didn’t talk to me, he talked to a piece of paper. I got a guy sitting here reading the piece of paper telling me I am going to die [then] walking out the door.  That was not well executed.”

To him, the heartlessness of the doctor’s presentation was as painful as the news. 

Hearing this scathing critique, I broke out in a sweat. I could easily imagine myself on a busy day informing a patient that his or her blood test was positive for HIV, while at the same time my cellphone is ringing, the emergency room physician is waiting for a return call and I have to hurry to my clinic where two other patients are waiting in examination rooms. And to be honest, I make terrifying diagnoses every day. I fear that in such situations, I might not be as compassionate as my patients might like.

Compassion is one of what I call the four C’s; along with competency, communication and convenience, these are things patients should be able to expect from their doctors. Compassion and communication skills are part of a good bedside manner, something that medical schools strive to teach.

I am sensitive about the issue of compassion because even my own parents at times feel I am a bit abrupt with them regarding their health questions.