Seeing your patients – use both eyes and your heart
By Ruth SoRelle, M.P.H.
Just when you think you've got it figured out, someone like Alan Blum, M.D., comes along.
You remember Blum, don't you? He's the anti-smoking advocate who picketed a Bill of Rights exhibit sponsored by Phillip Morris and protested a Virginia Slims tennis tournament in Houston. He was on the faculty at Baylor College of Medicine for many years. He's gone from Houston now and directs the Center for the Study of Tobacco & Society in the College of Community Health Sciences at the University of Alabama at Tuscaloosa. He remains a foe of big tobacco. And even more, he's an advocate for his patients.
See your patients
In an era of high technology, Blum pushes students to really "see" their patients. That he does it with creativity and humor is just another facet of a fascinating physician who has devoted his career to advocating good health.
Early in his career, he began sketching his patients – little doodles on notepads and lined paper that he used to take notes while he talked with them. The squiggles on paper that encapsulate the outward persona of those people prompt an inner voice that echoes in Blum's mind their stories.
"These sketches bring back the essence of the encounter," he said. The sketches remind him that the patient is more than a collection of symptoms. He or she is a person who lives in a community, exists within a family and is replete with the scars of what has gone before in his or her life.
"I think medical students and doctors should be rewarded for understanding patients," he told medical students and doctors during his presentation at one of the Compassion and the Art of Medicine lectures that enliven the end of summer and the beginning of fall at Baylor College of Medicine.
Understanding who they are
"Often, we doctors visit people in the hospital at our convenience," he said. "I hope you find a moment to go in and see the patient." Sit down and talk with them, he said.
Understanding how patients feel about their illnesses and treatment is a critical part of the puzzle of medicine. "Remember," he said, "there's a patient in all of us, waiting to get out."
Blum learned the importance of listening to patients at his father's knee. His father was also a doctor. His medical office was in their family home, and Blum recalls that his father was popular with patients because he was down-to-earth. "He never lost sight of the patient's world."
Where and how do patients live
Early in Blum's career, he made a house call to a patient whose blood pressure he could never control. "I asked to be excused, and went to the bathroom. I went to the medicine cabinet." Lined up in chronological order were all the pill bottles he had prescribed for his patient. None had been opened. High blood pressure mystery solved.
Blum's sketches flashed on the screen as he described the patients. He remember their ages, their children, their joys and, most important perhaps, their sorrows. In those doodles, you could see that he liked them – the mild, the boisterous, the cantankerous. Each had a story, and Blum had taken the time to solicit that tale.
It enriched their lives. It enriched his. And if his message got across to the students in the office, perhaps it could enrich the lives of many more as the art of personal medicine gets spread around.
