Medicine is more than just a technical pursuit – it’s also about the metaphysics of the human predicament

I was fortunate to have the opportunity to live in a beautiful part of England, sunny Devon, with my wife and family from 1999-2006.  There was much health reform happening at that time under the then Prime Minister Tony Blair.  It was an exciting time for most.  My post, so to speak, was at the Royal Devon and Exeter Hospital Research Unit where I worked alongside Dr Kieran Sweeney (RIP) who became a super work colleague and friend, and just as important, someone to challenge me at golf!  Towards the end of our time together, Kieran become a Professor of General Practice for the University of Exeter.

We were both passionate about medical philosophy, particularly that which focused on the patient-doctor relationship. Together we explored measuring the interpersonal skills of health professionals in their interactions with patients, and how to improve these interactions based on what was measured. Initially there was resistance from certain sectors of the health profession about focusing on this ‘soft science’ instead of ‘getting people better’. Thank goodness there’s now lots of evidence about the relationship between health outcomes and good interpersonal skills.

Sadly, Kieran was diagnosed with mesothelioma (asbestos disease) and we are grateful for him telling his story about the quality of his care. You can see the shorter 6min version here or the longer 12.5min version here . I know we’re all busy, but if you want to listen to some extraordinary and moving insights into what really matters in care, then I would very much encourage you to watch the shorter or longer version.

Kieran talks about the danger of health professionals hiding behind the ‘science of medicine’ and avoid the ‘metaphysics of illness’. Last weekend my wife and I went to the Cat Stevens (now Yusef) concert in Brisbane and he asked the audience to make sure we look up the word ‘metaphysics’. This reminded me of Kieran – that care is in the context of people being vulnerable, and that just being in care (like a hospital) is ‘vibrantly different’ and unusual for people.  In such environments, we are often asked to ‘do this for me’…..such as ‘can you give your date of birth for me’; ‘can you pop up on the bed for me’. It may not sound much, but such language, as Kieran mentions, is more about locus of control. It is saying that the person/patient is ‘being care for’ (transactional) rather than ‘cared about’ (interactional). It really is worth watching the longer version of the video. You’ll also hear about how health professionals inadvertently ‘heap small humiliations on patients’. He gives the example of his care in radiology.

As a medical doctor, Kieran finishes with the wonderful statement that it is a privilege to ‘rediscover the humanity of patients’. He says it is infinitely rewarding and a win-win for the doctor and the patient.

So what does all this have to do with Patient Opinion?  Well everything really. Many of our stories posted on Patient Opinion deal with the ‘how’ of care (see here). Sure, there are stories about the ‘what of care’ but overwhelmingly stories focus on how they were dealt with by staff – in both positive and negative ways.

Health professionals need to hear these stories. They need to hear what it’s like for patients to be in their care. This is not only from the patient’s point of view so that the safety and quality of care can be continuously improved. But it’s also for the health professional’s benefit as they will grow too in their own professionalism as they ‘rediscover the humanity of patients’. After all, we’re all in this together.  Thank you and R.I.P. Kieran Sweeney.