Truth Telling In Medicine

Day 26
Originally uploaded by spoonleg.

Should doctors always tell the truth? Do they?

These were the questions posed to a group of doctors and other members of the caring profession who listened to a talk by esteemed pathologist and Deputy Director of the National Kidney and Transplant Institute, Dr. Aileen Riego Javier on "Truth Telling In Medicine". Dr. Javier currently heads the fact-finding team that is investigating the seven neo-natal deaths that took place at the Rizal Medical Center earlier this month. The results of that investigation are due by tomorrow, October 20. In her opening remarks, Dr. Javier said that the timing of the invitation to speak on the topic was definitely not a coincidence. Nothing ever is a coincidence in a Christian's life. Everything happens for a purpose.

Two things stood out for me during that forum. Yes, a doctor needs to always speak the truth but he/she needs to take three important things into consideration. First, is the patient ready to hear the news? Second, the manner by which the doctor breaks the news, and third, to share the news in the context of a Divine plan for each and every life.

Listening to the doctors who spoke that evening reminded me of my own experiences with doctors and truth-telling. The negative experiences stand out like they only happenned yesterday while the good ones serve as a balm to the heart no matter how long ago they have taken place. One of them remains particularly fresh no matter the years that have transpired...

Soon after I gave birth to Migi by Cesarian section on February 21, 1994, two days later, on a late afternoon, just as the sun was about to set, and I was all by myself (H had gone to the car to get something) in my hospital room, the pediatrician attending to Migi casually walked in. This man was one of the more senior pediatricians in the country, one of the best in fact. You would expect that he cushion whatever news he was about to break with some degree of softness. The very least, he could have done was engage me in small talk and wait until my husband returned. Instead, he opted to drop the "bomb" unceremoniously without any degree of sensitivity (he had not even bothered to ask how I was or if I was still in pain from my stitches) - very casually, he said that they had observed something unusual in my two-day old son. "He truns bluish when he cries and there is murmur in his heart so we need to do further tests on him." He said very rapidly. I could feel the tears welling up in my eyes and my heart began to sink at the same speed as the sun did outside. "You need to see doctor so and so when you check out of here so he can do a 2-d echo on your baby..." and his voice began to drift as my mind had only begun to comprehend what he had just told me. Before I could even ask any further questions, he was on his way out the door and I mumbled a weak thank you. A few minutes later, H returned and naturally he was very surprised to see my face awash in tears.

Clearly by God's divine hand, Dr. Insensitive's referral turned out to be, in my mind, one of the most wonderful doctors on the planet. Dr. Edgardo Ortiz, currently the chair of pediatrics at the Philippine General Hospital, is a wonderful and esteemed doctor who is one of the best pediatric cardiologists (if not the best) in the country. Through diagnosis and all throughout the four years that Migi was his patient, he held not only our hands, but our hearts as well.

When he broke the news that Migi had a congenital heart condition called Tetralogy of Fallot, he did so in a manner that gave us, his parents, so much hope. There was a postitive aura about him and we warmed up to him immediately. Surrounded by family, he took pains explaining what it was that Migi had and what we needed to do and what we could expect from a baby with his condition. Even Migi, not once, ever feared or dreaded the prospect of visiting his doctor. Each visit was filled with joy and hope, never with dread. And four years later, even as our son lay in a coma and it was clear that he would be going back to his real HOME, Dr. Ortiz replaced hope with compassion.

Talking about faith and spirituality is an important component when telling the truth about a patient's condition and even in this Dr. Ortiz was consistent. Somehow, one always feels better when you know that everything that happens to you is part of God's own personal blueprint for your life, diagnosis notwithstanding.

A doctor's life can be extremely stressful. Dealing with life and death situations each day of their lives tend to make some of the more "jaded" ones hardened. It is always such a blessing to find a doctor who, no matter the years, manages to remain gentle and reassuring, who always tries to place themselves in the patient's shoes. The doctor steeped in faith spends time with God, asks HIM to guide his/her words and work as he dispenses healing daily to broken bodies and spirits.
Truth-telling requires that one be in touch with one's heart and blessed is the patient who finds himself in the hands of a doctor knows who the true Healer is. Under the care of this kind of doctor, the patient can find confidence in knowing that whatever the prognosis maybe, he/she can find peace, and trust in believing that his/her illness is part of a sovereign God's plan who will steadily hold your hand and take you through whatever it is that HE takes you to.