Big news: Kindness is healthy! Being kind releases oxytocin, which triggers the release of nitric oxide, which in turn shrinks inflammation, reduces blood pressure and minimizes heart disease. But do doctors need to be kind?
Like many television fans, I've watched House and enjoyed the sarcastic intelligence and conniving manipulations of Dr. House. The way he terrifies a new mom who won't vaccinate with his story about the business of tiny baby coffins, his constant breaking and entering to find the truth behind patient stories, and his overall annoyance with the tediousness of
My perspective changed, however, when I started medical school. Popular shows like House create a public perception of rudeness as justified if the physician is brilliant, but I believe rudeness is never justified. It happens, sometimes intentionally (the doctor with the superiority complex) and sometimes accidentally (the doctor under too much stress), but there is no merit to its practice.
The greatest example of rudeness in the show is the swooping refrain that a basic truth about the human condition is how everybody lies. Sure, I can believe that; however, why are we lying? I think when it comes to patients, if they are lying to their physician, there is a deeper reason likely grounded in fear and uncertainty. One that deserves consideration beyond judgment. When did we lose faith in humanity, to the point of always blaming others? As a mom, I'm forever teaching my daughters to take responsibility for their actions and try to model the same in return. If this game is "too boring," play another one. If this story is "stupid," write a better one. There is nothing productive in complaint and judgment. It's a question of perspective and we've opted to trust our patients and have faith in humanity because we know we aren't perfect and would expect nothing less in return.
Our training in medical school includes evaluation of our kindness in communication courses through role-playing, by our peers, and by our primary preceptors (physician teachers). Leslie Jamison, who wrote a book on being a patient-actress for medical trainees called The Empathy Exams notes that the most important category in doing an evaluation is "Voiced empathy for my situation/problem." So on the books, kindness and empathy matter. The issue with this approach is that students practice empathy to get the check mark in the box and not necessarily because they buy into its significance. Honestly, I remain unconvinced that empathy can be taught, except perhaps by life itself (becoming a patient, losing a parent, etc). Empathy does, however, matter and kindness should be foundational to any medical practice.
Indeed, a literature review conducted by the Center for Compassion and Altruism Research and Education (CCARE) [link: http://ccare.stanford.edu] at Stanford University outlines a growing body of scientific evidence that demonstrates the healing potential of kindness. Dr. James Doty notes in the Huffington Post [http://www.huffingtonpost.com/project-compassion-stanford/the-healing-power-of-kindness_b_6136272.html] that one study showed how kindness proved even more beneficial for health than the use of aspirin to reduce the risk of heart attack. With the rise in technology and scientific discoveries, we've started to underestimate the value of the mind on our overall wellbeing. It takes more energy to be rude than to be kind. Kindness is also infectious; a disease we can all afford to catch.
Now, kindness alone doesn't cut it; it needs to be combined with clinical skills and knowledge. But no patient should have to choose between a kind doctor and a skilled one. From my experience, skilled physicians abound. We could use a little more kindness – not just in medicine – but in