A new kind of metric in medicine

Today, I propose a new kind of metric in medicine.

I know. I know. (I hear the uncomfortable clearing of your throats.)

On one side of the room: Of course we are human, are we not?

On the other: Here we go again, Doctor Touchy-Feely. Let’s get on with it. I’ve got work to do.

But what if …

We rewarded a “chief complaint,” written as a patient concern or a family observation, features fleshed out, context revealed, in their own words. I am/We are worried about the loss of …

And what if …

A complete “review of systems” started with the interior ones, the salient flashes of sadness, the strangleholds of fear, the beauty of a granddaughter’s smile.

Or, what if …

In our “physical exam,” we gave points for the description of tired eyes, bright ones, or those foggy with pain? Or a quivering mouth, a forehead lined by worry? A jaw clenched in anger?

Or, what if …

Instead of an “assessment,” we rejoiced over a soulful witnessing of the whole landscape of the human in front of us. And we expected a deep accounting of the hills and valleys of life that led to this moment hunched in a pleather exam room chair.

What if …

We removed our fingers from the keyboard and took her shaking hand, observing the seas of her eyes, the children dancing across her heart, the determination in her breath.

And what if …

The best “plan” was not a list of problems and solutions but a vibrant map of desires with us, the co-captains, navigating waterways in solid boats made of wishes.

Today, I propose we consider our impact on the human soul.

Eve Makoff is an internal medicine physician.

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