Oct
22
Typically lost in the policy debate is the fact that health care, at its core, involves intimate, personal relationships between patients and their doctors. Those roles are usually narrowly defined, but sometimes it becomes necessary to cross traditional lines in order to forge a therapeutic, and ultimately compassionate, connection.
Anne Brewster, a Boston internist, has multiple sclerosis, an autoimmune disease of the central nervous system. One day, she decided to risk disclosing something about herself to a patient:
“I have the same disease,” I told my patient over the telephone. There was a pause, and then a sigh. “That makes me feel so much better,” she said.
I was speaking to Ms. R, a soft spoken 30-year-old female with gentle brown eyes whom I had seen the previous day in the urgent care clinic where I work. She had come in complaining of difficulty remembering things. “I am in the middle of speaking and I suddenly forget what I am talking about, or I can’t find the words to say what I want to say,” she had told me.
“My husband and my friends say that I am not acting like myself.” We spoke further. A few months back, she had noticed a feeling of unsteadiness when walking, “like the world was off kilter,” but this had since improved. And perhaps she had been more clumsy than usual lately, dropping things. “I know something is wrong and I am frightened,” she had said.
She had a left-sided Babinski sign on exam–her big toe flexed upwards toward the top of her foot when I stroked the bottom surface with my thumb, a normal reflex in infants but pathological in adults, and evidence of damage to the central nervous system. I ordered MRIs of her brain and spine. The studies were done the following day and showed numerous demyelinating plaques consistent with Multiple Sclerosis.
read the rest via Boundary Issues: A Doctor With MS Confides In Her Patient | CommonHealth.
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