Bedside Manners : One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and He aler
In beautifully crafted vignettes, physician and NPR commentator David Watts explores the world of modern-day medicine and reveals the emotional truths and practical realities at the heart of the doctor-patient relationship. Bedside Manners is an engaging, often surprising investigation into what happens when we sit down and talk openly about vital issues of health and mortality.
Combining the grace and precision of a poet with the down-to-earth, compassionate manner of a doctor who deals with the problems of real people every day, Watts describes situations both odd and touching: the patient who stays awake during an endoscopy to ward off demons; the woman who recites poetry to get through a frightening treatment; the man who arrives at Watts's office bearing Internet research on syndromes that have little to do with his own condition; and the seventy-four-year-old architect who faces a tough cancer diagnosis with dignity and courage.
Readers will come away from these tales of difficult diagnoses, irreverent colleagues, brave survivors, and examining-room poseurs sharing Watts's own sense of humbled astonishment. As he tells each story, Watts closes for the reader the protective distance many doctors employ, and touches all of us who have felt vulnerable in the position of patient. Refreshing, wry, and reassuring, Bedside Manners holds important lessons for both healers and those who seek their help.
"Sickness brings out the worst in people.... Many of my patients exhibit neurotic behavior.... But generally, their basic attitude is that of prayer-an almost desperate pleading for mercy at the hands of illness." These words by Watts, a poet and commentator on NPR as well as a practicing physician, exemplify his nuanced and thoughtful attitude toward his patients. Both empathetic and practical, Watts relates encounters that have informed his ability to understand, diagnose and treat sickness. In "The Morbius Monster," a youngish man suffering from severe indigestion asks to be heavily sedated during an endoscopy, but even while unconscious resists the procedure. Through intuition and sensitive questioning, Watts elicits an account of early child abuse, and with the patient's cooperation, talks him through a second test with local anesthetic. In another case, Watts describes the day when, beset by the demands of his schedule, he reluctantly went to a convalescent home to visit Codger, an elderly Jewish man who was a garrulous curmudgeon. After listening to Codger's tale of how he came upon the death camps as an American soldier in WWII, Watts concludes that by making the time to see and listen to this patient, he made a human connection. All of the incidents related here, whether sad, frustrating or inconclusive, are unfailingly compelling. Agent, Michelle Tessler. (On sale Feb. 8) Copyright 2004 Reed Business Information. -- PUBLISHERS WEEKLY.
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February 27, 2006
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Excerpt from Bedside Manners by David Watts
Frank is in my waiting room, which means I'm going to be spending a lot of time chasing rabbits--little questions he brings on small crumples of paper that skitter around on my desk, issues he's researched on the Internet and gotten emotional about that usually don't have anything to do with his own circumstance. What's worse, he's about to have an operation, which means he's really going to be worked up.
I'm remembering that he's the guy with too many colonoscopies. "Well, something might have gone wrong since the last one," he'll say. True, but mostly not true. Still, you can resist that argument only so long and then you find yourself torquing another scope through the colon.
And it's not a trivial deal. He goes vagal in the mid-transverse colon, drops his blood pressure, looks like the life force is beating it out of town on the lam. We haven't killed him yet, but we may have come pretty close. And it probably doesn't do a lot of good for his oxygen-starved brain cells that his blood turns to molasses like that. Besides, watching him go shocky sends my coronaries into spasm.
I made him sign a release before the last one. That was after the cardiologist told him no more colonoscopies until he got his carotid arteries fixed. Even the S word, stroke, couldn't deter Frank.
I'm not going to have a stroke, he said.
It struck me that he has one set of evaluators for a real disease that could do real harm and another set for the harmless imaginary one.
He wrote a long letter releasing everyone this side of Kansas from any kind of liability connected with colonoscopy. This is a man who knows what he wants even if it doesn't make sense. We did it, but not before I secretly cleared it with the cardiologist. And we survived. All three of us. But I told him no more nonsense until he got a little more blood flow to his critical body parts.
Now the time has come. 'Bout time, I say. The vascular surgeons are ready to ream out his carotids, but he wants to ask me a few questions first. I knew that. And I know what's coming--so here we go.
I understand you can get a stroke from this operation.
How common is it?
I don't know. Not very common. It's a question you should ask the vascular surgeons.
They don't hold still as long as you do.
Tie them down and ask them. Meanwhile, they don't do the surgery unless the risk of waiting outweighs the risk of the surgery itself. It's a complicated formula and I'm sure it's only partly accurate, but that's the intent. It has to do with the extent of stenosis.
How narrow is mine?
Ninety percent, both sides.
Is it safe to say it's small?
The risk of stroke.
It's small. Smaller than if you didn't have surgery.
How long will I be in the hospital?
Don't know. These days, probably not long.
I read that they will put me on something to thin my platelets.
What'll that be?
It's up to the cardiologist and the vascular surgeon.
What are the side effects?
And I'm thinking to myself, This is an example of how questions get asked for the sake of asking. Fueled by their own passion, they spring from a point beyond the platform of knowledge. How would I know the side effects if I don't know the drug?
I can't answer that.
A long silence.
The rabbits were moving from one pile to another.
Well, I have some questions about these bor . . . I can never say it.
Sounds in my abdomen.
Yeah, that. I keep getting these loud noises.
You always have that.
Yeah, but I don't believe it's normal.
I know you don't believe it's normal, but you've always been normal. Every colonoscopy has been normal. We've studied you from teeth to toenails and there's nothing in there. Nothing.
What do you listen for if you think you've got cancer?