Family, Medicine and the Power of Touch

Since graduating from the Oregon College of Oriental Medicine, I have been taking some time to reconnect. I have been connecting dots between many parts of my life, and this process has been great fun. Recently I have thought frequently about my late Granddad, Dr. Griffing. He was quite a character, and I feel like I connect with him in some way when I practice medicine.

During a couple recent weeks of post-graduation family visits, my Aunt told me a little more information about her father, my grandfather, who worked for years as an anesthesiologist in Kansas and Montana. We both grew up with his funny stories about his clinical experiences, but I only visited him in the summertime and therefore benefited from the choicest selection. He would shock me and my brothers with stories about grisly farmyard amputations as well as more humorous tales of the wide variety of objects that “inexplicably” became lodged in rectums. I began to understand the gallows humor of the physician at a young age, but it was always couched in an understanding context. As grandkids we learned that the human experience is often tragi-comical, and that life is meant to be enjoyed and shared without judgement.

My admiration for his worldly knowledge only increased when I learned that he started learning medicine as a soldier in WWII, stationed in Oregon and treating injured veterans. His education began as a type of apprenticeship;  they needed everyone with any type of medical knowledge in the service, and he had some veterinary skills from his days growing up on a farm in Kansas. He went on to attend medical school after he returned to Kansas, which he achieved by train-hopping and hitch-hiking his way through California and across the Southwest, back to his home. His attitude of affirmation of life and kindness (not to mention humor revolving around jokes of the blue variety) carried through those rough times.

Granddad looked for the humor in every situation and strongly expressed his love of friends and family, which included terrorizing me and my brothers with lung-crushing bear hugs every time we visited. I was the happy recipient of many of his letters throughout my childhood and college years. They were always type-written letters imprinted on the backs of chinese restaurant paper place-mats, backs of coffee can labels, and any other interesting material that could fit into a type-writer. I have to giggle when I think of his pioneering re-usage of kitschy material for letters before the ‘zine movement made that popular among teens. Granddad would tell me stories about his life, about local and national politics (he was horrified by HMOs), about my father’s family, and he always expressed support and admiration for my own journey.

He didn’t get to see me graduate from the Oregon College of Oriental Medicine, but I have thought about him frequently for the past four years of schooling. It seemed appropriate, then, that my Aunt told me that Granddad had looked into acupuncture as an anesthesia technique in the 1970s, when this information first began filtering into the American public sphere. He really liked the idea, but being somewhat isolated in Montana, could not pursue that line of inquiry. He also helped pioneer the protective hypothermic anesthesia techniques that are practiced today. However, he did practice medicine in a way that is only rarely practiced today.

For the majority of the time that Granddad was practicing anesthesiology, they had not yet codified dosages in the amount of detail that we have today. Even now, anesthesiology requires a special touch. Anesthetization brings patients to the edge of death, a place from which they must recover on their own. Grandad addressed his medicine from a direct scientific standpoint, but he also used his own sense of intuition based on experience to create the most accurate dosage for each patient.

The evening before he was scheduled to anesthetize a patient, Granddad would “do his rounds,” visiting the patient in their own home and spending time getting to know the patient and their family. He would take this time to not only help reassure the patient and their loved ones, instilling a positive attitude about the following day’s procedure, but he would also find answers to many qualitative factors that influence his medical practice. Is the patient happy? Are they in a supportive home environment? What do they eat? Do they get enough sleep? What are their personal habits? Do they live alone? Have a pet? These kinds of questions can be answered much more thoroughly in a person’s home environment, where observation and casual, friendly personal interaction can take the clinical edge off of these questions. Granddad wanted to get the exact right dosage for the patient, and he had a deep respect for the process of purposefully bringing the person out of the realm of consciousness. I think his “rounds” helped to settle his own nerves to some extent, and to assure himself that he was doing everything he could to take care of the patient. It became a ritual that benefited the patient and the doctor, connecting them with each other as well as the patient’s community.

Perhaps the most important detail of his practice was his habit of holding the patient’s hand throughout the process of being anesthetized and during their recovery from anesthesia. He told my Aunt that patients recovered more quickly and easily when he maintained a connection with their hands. I was not surprised when I heard this, since I could easily see him sitting next to the patient’s bedside, holding their hand with the calm persistence he exhibited when I knew him. He routinely completed several crossword puzzles per day and played marathon 3-hour card games with his grandkids. When I think of Granddad as a medical practitioner, he inspires me to mirror those attributes of thoroughness, calm awareness, and supportive availability.

Recently, a patient sent me the link to the video below, a TED Talk by Abraham Verghese titled “A Doctor’s Touch.” Besides the engaging and clear quality of the speaker’s narrative, I greatly enjoyed seeing the articulation of a concept that informs the basis of my practice. I am hopeful that the attitude and principles exhibited by Dr. Verghese will become more common practice now, as they were years ago, in my Granddad’s time.

http://video.ted.com/assets/player/swf/EmbedPlayer.swf

Dr. Abraham Verghese: A Doctor’s Touch

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