Monday, 18 April 2011

Manners and the healing profession

Malta has been renowned for its treatment of the sick right through history. It is interesting and poignant that tiny Malta, a simple dot in the Mediterranean, is still highly associated with the Knights of St John who were hospitallers before they became a warring Order. The Order of St John was renowned for its battles against maladies and suffering and the Sacra Infermeria in Valletta was internationally acclaimed. Today, the Knights have once more donned the mantle of hospitallers and are now a worldwide order, assisting and propagating medical and caring causes.
But is Malta also on the forefront of treating the ill with the care and humanity they deserve?
Of course, the most important thing in any medical person is his medical knowledge and no amount of good manners can substitute medical proficiency. Our medical system, with all its drawbacks, delays and deficiencies, is the envy of many, especially for a country our size and with no natural resources except our people. The medical people we have managed to produce are another enviable source of pride to all of us on this tiny rock. It is a pity that some bring it all to disrepute and some patients have to suffer the ignominy of being treated as mere numbers.
At some point or other in our life, most of us, including the best medics, become patients. It is with this acceptance of reality that we should look at patients’ rights. All humans are potential patients, so all humans should be treated with dignity and as humanely as possible.
The world will be celebrating Patients’ Rights Day today. But all rights are a collection of fancy words unless they are accompanied by a modicum of human care. In general, the medical profession in Malta deserves a shower of praise. Medics and those involved in the caring profession, are, in their vast majority, very attentive to detail and they sacrifice a lot for the sick and suffering. It is a sad fact, however, that they do not always remember or care to use etiquette while exercising their profession. When handling relatives of very ill patients or when imparting the news of their patients’ illness or situation, medical people sometimes lack manners and gentleness. It is true that, on the whole, we are used to putting up with a lack of manners in all spheres but when it comes to health and, especially, when someone’s life is in the balance, we expect more care than in other less traumatic instances.
To an extent, all medical people have to don a hard shell to protect them from empathising too much with their patients. A doctor or nurse has to be slightly aloof from the suffering and also from the emotional problems the sick and those close to the patient go through, otherwise they will find it impossible to carry out their work.
This aloofness, however, must not lead the doctor to forget that the afflicted are humans and, as such, deserving of proper and humane treatment. Sometimes, an illness seems minor but for the patient in his particular circumstances it may appear to be verging on the tragic. Imagine a minor ailment like a constant pain in the larynx, which could mean a curtailment of too much talking. Simple enough to anyone and petty-sounding to any doctor, I presume. Quite right, unless the sufferer is someone who depends almost entirely on his vocal chords, like a teacher or a radio talk show presenter. I know two people who have suffered from this seemingly silly ailment. One was treated with care and compassion, the other one was brusquely told to thank her lucky stars it wasn’t much worse and life-threatening.
All doctors and nurses and medical people and all personnel who come in constant contact with patients need to be well trained in people management.
Back in 2008, the New England Journal of Medicine published an article by Michael Kahn who said: “Patients ideally deserve to have a compassionate doctor but might they be satisfied with one who is simply well-behaved? When I hear patients complain about doctors, their criticism often has nothing to do with not feeling understood or empathised with. Instead, they object that ‘he just stared at his computer screen’, ’she never smiles’, or ’I had no idea who I was talking to’. During my own recent hospitalisation, I found the Old World manners of my European-born surgeon – and my reaction to them – revealing in this regard. Whatever he might actually have been feeling, his behaviour – dress, manners, body language, eye contact – was impeccable. I wasn’t left thinking: ‘What compassion.’ Instead, I found myself thinking: ‘What a professional’ and even (unexpectedly) ‘What a gentl­man’. The impression he made was remarkably calming and it helped to confirm my suspicion that patients may care less about whether their doctors are reflective and empathic than whether they are respectful and attentive.”
I think if we give this good doctor and all he points out a more important standing when teaching and training our doctors, professors and nurses we, as a nation, will feel more fulfilled and prouder of those who look after us so well in our hours of need or loss.
A forum about patients’ rights, organised by the Malta Health Network, will be held at the Conference Hall, St Vincent de Paul residence in Luqa today. For further details e-mail or phone 9949 3999.

This article first appeared in The Times April 18 2011

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