Is There Anything Else You Would Like to
Tell Me?
Of course, direct contact is hardly of minimal
consequence in the doctor-patient relationship. We
go to great lengths to help medical students
understand the topology of this landscape, and not
run away from it in terror because it involves their
own feelings as individuals and the need to really
listen emphatically, treating patients as people rather
than solely as disease puzzles and opportunities to
exercise judgment and control So many things can
get in the way of direct contact. Many doctors lack
formal training in this dimension of medicine. They
remain unaware of the crucial importance of effective
communication and caring in what we call health care
but which too often is just disease care; and even
good disease care can be sorely lacking if the subject
is excluded from the equation.
My mother, exasperated at her inability to find a
doctor willing to treat her concerns seriously,
described how, at a follow-up visit initiated by her
because she was still not walking well and was in a
lot of pain, the orthopedic surgeon, who had replaced
her hip with an artificial one, studied the X-ray,
commenting how good it looked ("superb" was the