The Golden Rule

I rarely have a “normal” visit to the doctor. A regular visit introduces phrases such as “huh, well, perhaps you should try wearing a heart monitor for a few weeks” or “I have never seen these frostbite-like symptoms before.” With one exception, my doctors have provided me with medicine to treat my symptoms without getting to the heart of the situation. That word—treat— boasts multiple meanings: it refers to methods of curing illnesses, to how one handles various matters, and/or to how one behaves towards other people. [1] Instead of making superficial assessments, we need to learn how to treat people by compassionately and genuinely taking interest in who they are.

Oliver Sacks with one of his patients from "Awakenings"
Oliver Sacks with one of his patients from “Awakenings”

In An Anthropologist on Mars, Oliver Sacks relates the struggles of seven creative people with neurological disorders in a humane and personable way. For Sacks, these people are individuals—not science experiences, not “oh, we will just give him drug X and see if he feels better.” Sacks writes of Father Brown, a mentor in the field, who, when asked his secret, said: “I don’t try to get outside the man. I try to get inside him.” [2] Using this approach, Sacks forms relationships with his patients in their own context; at their homes, at their jobs, etc. By speaking with these individuals on their own terms, Sacks gains a more complete understanding both of the person and of the disorder.

While Sacks endeavors to demonstrate highly empathic treatment for his patients, he is perhaps an anomaly. In the case of “The Last Hippie,” Greg F. (a pseudonym)ends up in Williamsbridge Hospital after a midline tumor causes him to go blind to be severely disabled neurologically and mentally. Sacks describes a schedule of programs for Greg: “physiotherapy, occupational therapy, music groups, drama.” [3] Although Sacks writes of activities for patients and opportunities for them to socialize, he admits that the back wards of these types of hospitals stifle individual expression. He explains: “There is a simple round that has not changes in twenty, or fifty, years. One is wakened, fed, taken to the toilet, and left to sit in the hallway; one has lunch, one is taken to bingo, one has dinner and goes to bed.” [4] The personnel may “treat” the patients in the medical sense of the word, however, the patients fail to receive personal, compassionate treatment.

This system, including a cow chute and conveyor, is an empathetic design by Dr. Temple Grandin
This system, including a cow chute and conveyor, is an empathetic design by Dr. Temple Grandin

Sacks is not alone in his observations. Dr. Temple Grandin also notes: “I find a very high correlations between the ways animals are treated and the handicapped.” [5] Instead of pitying and mistreating those with various conditions, Grandin challenges us to see the value within the disorder. In a 1990 article she writes:

Aware adults with autism…may ask why nature or God created such horrible conditions as autism, manic depression, and schizophrenia. However, if the genes that caused these conditions were eliminated there might be a terrible price to pay. It is possible that persons with   bits of these traits are more creative, or possibly even geniuses…If science eliminated these genes, maybe the whole world would be taken over by accountants. [6]

Grandin asserts that wonderful things can result even in the most difficult situations. However, unless we treat all people with the compassion and allow all people to let their unique personalities shine, we will fail to grow as an inclusive society.

Contrastingly, Sacks observes Dr. Carl Bennett (a pseudonym) with his surgical-outpatients and is impressed by Bennett’s care and concern. Bennett’s coworkers characterize him as an incredibly compassionate surgeon who makes his patients feel valued. [7] Bennett and Father Brown are each worthy of emulation: Both exhibit an interest in the person, not simply the medical situation. They earn trust and respect by looking beyond what is “wrong” with the person to see the whole person.

When I first started thinking about this blog post I reflected on our class’s eugenics discussion, immigration debate, personal space and transgender concerns, among other interesting conversations and I found that all of these topics boil down to one thing: how we treat people as categories and not as individuals. My own treatment at the doctor’s office is a testament to that. As a society we like to place people into boxes to determine proper treatment. In the museum profession we organize special tours for people with autism or who are blind to demonstrate inclusivity. Universal design goes beyond and seeks to make all aspects

Universal design graphic from Imagineer Remodeling
Universal design graphic from Imagineer Remodeling

of museums accessible to all people. We do not treat people very well, and so we need to revamp the system. We need to try to get inside and get to know people for who they are, and not what they are (or are not) capable of, and in doing so we will all gain a much richer world.

[1] “Treat,” Dictionary.com, 2015, http://dictionary.reference.com/browse/treat?s=t.

[2] Oliver Sacks, An Anthropologist on Mars (New York: Vintage Books, 1995), xix.

[3] Sacks, An Anthropologist, 51.

[4] Sacks, An Anthropologist, 69.

[5] Sacks, An Anthropologist, 280.

[6] Sacks, An Anthropologist, 292.

[7] Sacks, An Anthropologist, 91-93.

12 thoughts on “The Golden Rule

  1. I love your narrative, Christine! I think going to the hospital/doctor can be very intimidating for many of us. As I read these stories I kept thinking about patients with amnesia or Alzheimer’s. Many of these people cannot remember what they did yesterday or even what they had for breakfast. In these cases it begs the question as to consent. Most of these people have legal guardians who make decisions for them, but it made me think about if I was being studied and I didn’t know it. I do think we need to study these diseases so we can look for ways to cure them, it just got me thinking about how these studies should be conducted and where the line is when they can’t necessarily speak for themselves.

  2. We want to treat or cure a disease as soon as possible so the likelihood of recovery is greater; this means actively looking for symptoms. I understand why this is necessary but then I think you lose the forest in the trees. Dr. Sacks approach of treating the person, not the symptoms is so eye-opening. I don’t think enough doctors are doing it. When engaging with individuals we need to see the whole person, not just the bits and pieces.

  3. Great post! Like you this week’s readings made me think about topics that we’ve discussed previously in class but I think you sum it up very eloquently with: “how [in society] we treat people as categories and not as individuals.” This seems to be the case for a lot of doctors, because I presume it is easier to treat a patient based on known information about their disease/issue and it takes a lot more time and effort to get to know the individual. I’m interested to hear what the Bassett students have to say tomorrow!

  4. Christine, I had the same difficulty in making too many connections to readings from earlier in the semester and finding something cohesive to say out of all of it. You are right on, though, society puts way to much effort into fitting people into categories. The beauty of Oliver Sacks is that his approach is to treat a whole person rather than focusing only on their symptoms. I know that my dad tries to do the same in his practice, but most medical doctors aren’t really trained to think that way it seems.

    1. Great post Christine! I agree Noah that too many doctors focus only on treating the symptom instead of the whole person. I love Oliver Sacks approach and believe that all doctors should take on this same approach.

  5. I really enjoyed Oliver Sack’s approach to narrative in these case studies. As some of you have said, relating to the person and their overall life, not just focusing on their disease and its symptoms, is what sets him apart. I agree with Carly – I’m interested to talk to the Bassett students tomorrow.

  6. I completely agree with the concept of treating people instead of the disability. It can be seen in concept of hearing aides. The programming need to be focused on how the person perceives sound and their lifestyle. Using me as an example, my implant has the option of reduced sounds for concerts, microzoom and several other options. These are personal treatments. My only qualm is that I wonder if these pre-set options to program is still treating the person, not the disability.

    (I had issues typing up this comment. I mentally flip floped between all potential treatment being personal or impersonal. I have chosen personal)

  7. Reading this post reminded me of an experience I had in college. I was having severe headaches, so I went to see a nurse practitioner. She could have just handed me some painkillers and walked away, but instead she sat and talked to me about possible causes for my headaches. We discussed stress, sleep habits, diet, vision issues, dental problems, etc. Instead of just treating the problem, she took the time to discuss all the possibilities and find out what was really behind the headaches. She wasn’t opposed to prescribing medicine, but she also wanted to look at other options. (It turned out to be a combination of needing new glasses and a tooth infection, and the headaches eventually went away.) I was really impressed by this holistic approach, and I think we should all seek to do the same. We need to not just look at what appears to me the problem, but look at the entire person and treat them as an individual.

    1. Emily reading about your experience made me remember almost an exact opposite experience I had not too long ago. I went in to see the doctor for a sprained ankle and came out with a bunch of random prescriptions for migraine medicine….
      Unfortunately I had to see a different doctor than one I’m used to seeing, and when asked about my medical history and hearing about my chronic migraines decided to completely forget the fact that I came in to see if my ankle was okay, and decide to push strange medications on me even after explaining I had a neurologist who took care of all that for me. I had never experienced someone who so clearly did not see me as a real person but as a disease. I couldn’t imagine having to deal with that with literally every person I talk to.

  8. I had a similar experience to Emily. In college I had chronic stomach pain, and multiple doctors could not figure out what was wrong. They gave me many tests and tried different medications, with no result. Sometimes I was in such constant pain that my identity felt subsumed by the illness. Eventually the pain began to go away on its own for no apparent reason, but it was not until I went to a doctor years later who looked at my entire lifestyle rather than just my symptoms that I began to understand where it might have come from. Having a doctor treat me as an individual rather than a disease has made a huge impact on my health.

  9. I had two immediate thoughts when doing the readings and then reading this post. The first is that it seems that doctors have a truly significant challenge in treating patients, especially ones with diseases and disorders which they will most likely have for the rest of their lives. I like the idea of doctors really getting to know their patients and treating the whole person, however there is also a danger in doctors becoming too personally attached to the person and not making the best medical decisions as a result. I will say that my sister, who is a doctor, has commented on this very idea. She worked a rotation in a terminal wing of the hospital, and it was a daily occurrence for doctors to have to tell patients that they will be put on a ventilator for the rest of their lives or that they have a terminal disorder. My sister noted that the doctors were very cold about it, because it would be too difficult to feel that kind of intense emotion every day. My sister, on the other hand, would hold patients’ hands through the whole discussion to let them know that someone was there for them. However, she also said that she could not imagine doing that job for her entire career, because it was simply too sad. I can’t imagine how difficult it would be to do that day after day, and can begin to see why doctors have to begin to harden themselves in order to make through the day.

    The other thought was about how it seemed to be considered horrible news to find out that someone in your family had dementia or Alzheimer’s. While I wouldn’t wish these debilitating disorders on anyone, I think that it is important to see that these people are still living and can have meaningful and valid life experiences despite their struggles. They should still be treated with respect and given opportunities to express themselves and find joy in their lives.

  10. Thank you for a great post and sharing your personal narrative. Your last thoughts about how museums and other institutions use universal designs really struck me. It’s such a hard balance both trying to see everyone as individuals but also accommodate for as many groups as possible. This is particularly hard when museums are trying to address issues of diversity. How can you know if your institution is truly diverse without putting people in qualifying boxes? Which sounds terrible but is a reality. Treating everyone individual would be a fantastic goal for an institution, but what does that realistically look like?

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