The following is an essay written in response to my nomination to the Gold Humanism Honor Society. In it, I share some impactful moments for me as a practitioner of medicine and elucidate some origins of my insights into whole person care and humanistic medicine. I was asked to respond to specific prompts, which are bolded.
What is Your Definition of Whole Person Care?
Classically, the definition of whole person care varies but frequently involves integrating another more humanistic dimension to the typical biological and psychological domains of medicine. Not merely approached as an adjunct or a means to some statistically significant improved outcome, but a way to honor the lived experience of another; to acknowledge the interconnectedness of the biological and psychological along with the emotional, social, and spiritual. Reflecting on this definition, whole person care can be helping realign a father’s broken self-concept in the wake of a new diagnosis; it can be recentering an ageing grandmother’s position in her family and community; or it can be reconnecting a neighbor’s sense of spirituality when encountering events outside of human control. The power in these examples elevates a clinician’s impact beyond what is found on the facesheet.
It is easy for us as physicians to hide behind the screen of our EMR, not simply directing our gaze away from the patient, but our heart as well. However, to me, the idea of whole person care involves pursuing this state of difficult vulnerability, whenever possible. It lies in the difference between seeing room 6834 and seeing “Angela”. A memory I often anchor to my concept of whole person care occurred during my third-year of medical school. I was serving one week on addiction medicine, and came across a 60-something-year-old woman whom I will call “Angela”. She was admitted status post liver transplant 18 months ago for new-onset alcoholic liver failure: a harrowing presentation. I entered the room, introduced myself, and pulled a chair up to Angela’s bedside. It was just her and me. We talked about her journey to this point, and I felt the regret in her voice. She told me that she knew God had given her a second chance following her transplant a year and a half ago. And she told me she did not deserve another. I immediately sank under the weight of this statement, this burden she carried. It broke my heart. I not only sympathized but empathized with her. How often, despite my own best attempts, had I been left feeling undeserving of God’s grace? We continued to talk, and as she finished her story, I asked if it would be helpful to her for me to pray with her, and she eagerly agreed. Through that prayer, I reminded her of God’s inexplicable mercy, His superhuman compassion, and His supreme foreknowledge of the events preceding and following her transplant. I recentered her identity as His daughter, and was reminded of my own too. Opening my eyes at the end of that prayer, she had tears in hers. She thanked me, we shared a hug, and I then left the room to see the next patient… At that moment, I knew I was created for that purpose. That is what whole person care is to me.
What Does This Nomination Mean to You?
Outside of practicing whole person care with patients, I have also sought to be a community leader to my peers. I believe that if I want to make a difference, it should start with serving those nearest me every day. I ran for student class president in my second year of medical school under this pretense. I sought to advocate for the interests of the entire student body and to realign who we were as individuals outside of medicine by encouraging community engagement. I enjoy meeting new people, from the hard-to-miss extrovert to the quieter student who sits in the back. I made it a priority during my tenure to get to know every person I could, and have made some truly great friends I otherwise would not have known. I wanted to know their story, to understand what they wanted out of their medical school, and what my role could be in accomplishing that. I did all this not for personal gain, but because I too used to be the quiet one sitting in the back, feeling as if my voice was not heard.
Writing this essay, I am beyond grateful for this nomination to the Gold Humanism Honor Society. To me, it means that my effort in making an impact has mattered. I am honored that my peers have recognized my desire to compassionately serve and that they believe I am among those who represent humanistic medicine. It is entirely humbling to me, and I am both overjoyed and reignited in my purpose and pursuit.
Reflecting from before starting first year, to now, a few weeks from starting my last, I feel I have grown immensely. I have always had a heart to serve, but I did not fully realize the breadth of diversity of the people I would meet, or how I would come to appreciate the plethora of determinants that can affect their health. A Hispanic mother struggling to raise a severely autistic son, a Haitian immigrant sick and surrounded by people of a language that she does not speak, a widower without family struggling with thoughts of suicide: all these are life paths that I can not begin to fully comprehend, yet I was at their bedside. Not just learning about the social determinants of health but truly experiencing how these can take effect has recontextualized my place in serving my community. When my patients confide in me, they are effectively believing that I will respect them, maintain their interests, and protect them. I believe that these ideals and this awareness have come to permeate my actions and are visible with my patients and with my peers. I am more compassionate. I am less assumptive. And I have come to truly honor the trust that is held within the patient-physician relationship.
How Can You Encourage Whole Person Care?
When I think about my most cherished memories of whole person care, it is not the lectures on social determinants of health or the speeches from those who have practiced before me, albeit helpful, but it is remembering Angela and people like her. It is hard to know exactly what “whole person care” is without experiencing it, which therein lies the challenge when thinking of how to promote it. How do you create a vulnerable encounter? I don’t believe this can be forced, but I do believe a student meeting their own “Angela” can give them an anchor for their idea of humanistic medicine.
A project which I wish existed when I was on campus was a homeless outreach, soup kitchen, or food bank for the needy. An event, perhaps bimonthly, where needy individuals from the community are met. Pre-clinical students may not yet be able to provide medical care, but can have a critical role in interviewing those who show up, learning about their needs, their family size, and their background. They could listen to their struggles and have a part in meeting their needs: distributing food, connecting them with local shelters, non-profit clinics, and health education materials. Beyond the school, into the hospital and with clinicians, one of the most accessible ways to encourage whole person care is through culture-forming. By sharing stories and intentionally humanizing the patients you see, the benefits of practicing whole person care can be appreciated by, and used to inspire, your peers.
Again, I am very grateful for this nomination and will continue seeking to represent the ideals of humanistic medicine and whole person care throughout my career to both my peers and my patients. Thank you.