“Give me a moment,” said the doctor. “This condition is unusual, but I have seen it before.” He pushed the rolling stool on which he was perched back from the exam table, stood, and stepped to a four-drawer file cabinet across his office. “I think I have my notes right here.”
He pulled open a drawer. There followed indistinct muttering as his fingers flew from one buff-colored folder to another. An inexpensive, spiral-bound notebook emerged, extra pages jammed into it. He found a page, then tilted his head back to examine it through bifocals. From my vantage point, it looked like scrawled notes alongside a hand-drawn chart.
“Yes, here it is,” he announced, studying the page. “I constructed this chart years ago after studying two or three different cases showing the same symptoms.”
A few more muttered comments as he continued to scan, then looked up with satisfaction. “As I thought,” he said. “Your conditions are well within the expected range.” He smiled. “There is no cause for concern.”
It was a class act
I will not bore you with the irrelevant details of my case, my complaint, or my examination on that day long ago. You have already concluded it was long ago because of the references to a spiral notebook and a 4-drawer file cabinet. Who uses such things anymore?
I left the appointment that day not only relieved with the results, but with a great deal of respect for a man who knew his business.
Down one narrow rabbit trail of medical investigation, far off the beaten path of his specialty, he had once pursued a line of study that had intrigued him. He had observed symptoms, discussed conditions with patients, performed (no doubt) hard-copy textbook research, and developed a way to generalize conclusions.
The doctor then drew his own diagram in a cheap notebook with a ballpoint pen. He added his own hand-written explanatory notes before filing the project in a place where he could retrieve it, if he ever came across it again.
I was impressed. That was a class act. Doctor What’s-his-name was all-in.
What makes a good medico?
Through good fortune, or misfortune, I have had the opportunity to see medical professionals in action. (Some are more professional than others.) I have no complaints over my extended stay in a cancer ward two years ago, but there were some nurses and assistants and doctors who, in my memory, stand apart from the rest.
A CNA (Certified Nursing Assistant), on my first day hospitalized, came up with a box fan for my tiny, poorly ventilated room. I learned later these were scarce resources, but she found one to make my stay more comfortable.
A housekeeper, on seeing my losing fight with an undignified mouth sore, propped her mop against the wall and gave her full attention to offering a sincere (and somewhat raucous) prayer for me.
A young nurse on the night shift, completely taken by surprise by a sudden, precipitous drop in my blood pressure reading, did not hesitate to issue the emergency “rapid response” command on her cell phone. This sent a red alert to dozens of medicos, everyone of them older and more experienced than she. A false alarm would have been career affecting.
A doctor, a specialist in infectious diseases, took note of nearly invisible blemishes on an x-ray and initiated immediate antibiotic treatment. “You may die from the cancer,” she declared, “but you are not dying because of an infection I can treat. Not on my watch!”
That last one almost killed me anyway. Without the doctor’s immediate recognition of the potential hazard, and aggressive treatment, it would have succeeded.
Not exactly a time for patience
In each of those cases, it would have been quite acceptable for the actor to take a “wait and see” approach. None of them did. They each exhibited remarkable engagement with the case. Those of us on 7-North, the cancer unit, were fortunate indeed to have them.
I observed not only technical professionalism for doing the right thing, but also unapologetic passion for doing the thing right.
I am not sure how to train this elusive dedication into someone, or even if it can be trained. But I am pretty sure it can trained OUT of someone by an organizational culture more focused on quarterly performance than customer service.
At the hospital, I expect they call that “patient satisfaction.”
In my own case, my patient satisfaction was as high as the response scale would allow. The environment in that cancer unit was more like family than workplace. To an extent, this is due to good management, but good management only goes so far.
Good help is SO hard to find
I am no expert, but I observe there were really 3 different dimensions which combined to make such a positive experience while treating my cancer. First, that hospital had attracted a handful of staff (nurses and others) who showed intrinsic, personal motivation.
Second, there appeared to be a culture of putting the patient experience first. This was reflected in adequate staffing, job design, training opportunities (or requirements), and insistence on medically necessary protocols.
Last, and perhaps most important (even visible from my “lashed to the bed” perspective) I could discern that there were a few individual nurses who were key. They were older and more experienced, and showed the way for (and no doubt occasionally struck fear into) younger associates.
Personal motivation, organizational culture and quality mentoring. Indispensable keys to good health care.
And good anything else.
Is there an expert in the house?
I didn’t really mean for this blog to be a lecture on effective organizational behavior, but I’ll stay with the theme long enough to cite a resource.
ChatGPT tells me that Albert Bandura (Stanford University) published Social Learning Theory in 1977, “emphasizing the role of more experienced or influential individuals [in the work group] in shaping behaviors and attitudes…” These behaviors and attitudes, he asserted, directly impact employee engagement.
Bandura’s article is 41 pages long, plus 5 pages of bibliography. I’m glad he produced it, so I don’t have to. I haven’t read it; pretty deep stuff.
Today, we would say TL;DR. (Too long; didn’t read.)
But I have seen the effective work environment he describes in real life, in a real cancer ward. And I am pretty much glad it was there.
What does the Scripture say?
Seest thou a man diligent in his business? he shall stand before kings…
Proverbs 22:29
The doctor with the spiral notebook and scrawled handwriting who examined me so long ago was one of the first times I can remember seeing a fully engaged professional in action. “Impressive” is a term that does not do him justice.
We could do with more like him.
Your turn
We could also do with more copies of Alligator Wrestling in the Cancer Ward to be placed in the cancer ward. In the book, I wrote the following passage of the nurses, staff and assistants after my own 3-month ordeal with leukemia:
When I’m in trouble, I want this cadre on my side. An unruly lot, they are absolute troopers, and words cannot do justice to my appreciation for them. They are pleasant, upbeat, communicative, tender, business-like when required, and damn-the-torpedoes aggressive in an emergency. I owe them my life. Thank you, thank you, and thank you. They also like donuts.
You can make paperback copies of the book available to those currently suffering from cancer. Perhaps more importantly, you can offer it to their family caregivers. The journey is hardest on those who have to observe it daily.
Make your donation to Via Christi Foundation, and they will turn your gift into copies of the book for those fighting life’s battle. Your help is deeply appreciated. For some, the message of hope and determination and faith can be a lifetime turning point. Click the link below to contribute.
Thank you so much. Share the blog. And maybe, look for ways you can come alongside others and be a mentor. It is a fulfilling way to serve.
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