A recent book by a Vancouver neurosurgeon questions the common practice among medical professionals to detach themselves emotionally from patients.
Dr. Chris Honey has been practicing neurosurgery for 25 years and is the head of neurosurgery at the University of British Columbia. His book, The Tenth Nerve, published this February, includes the stories of seven patients who he says taught him to be a better doctor.
Honey says that in the 16th century, when medical technology was not well developed, the doctor’s job was more about providing emotional support to patients than medical treatment.
That’s a big difference from the way medical students are trained today — they’re told to limit emotional engagement with patients because, Honey says, riding the compassion roller coaster can pose a real personal risk to doctors’ mental health .
But Honey argues that truly understanding any disease requires listening to patients and truly caring for them.
It depicts a doctor listening to a patient. Chris Honey says that truly understanding any disease requires listening to patients and truly caring for them. (kobps2/Shutterstock)
“The scalpel can go so deep, and technical skill can only take you so far,” he writes in the book.
Honey spoke with host Gloria Makarenko on CBC’s On The Coast about what he’s learned from his patients and why doctor-patient communication is so important.
The following transcript has been edited for clarity and length.
“A scalpel can go so deep and technical skill can only take you so far.” What are you getting at there?
When I started my surgical career, like many young surgeons, I thought I knew everything – I would just tell patients what they needed and operate on them.
But over the years, I realized that there were certain patients who profoundly changed who I was, how I understood medicine, how I understood the human condition, and also how I understood myself.
What I realized is that you can learn so much from patients just by talking to them and actually listening to their stories.
How has it changed your approach to surgery and your own outlook on life?
For example, several of these patients have conditions that have never been described before.
One of the standard practices in medicine is to listen to the patient’s story and see if you recognize a pattern and then label it with a disease. But if you don’t recognize the pattern, our knee-jerk reaction is to say, “You know what? It’s all in your head – you’re making this up.’
I met a woman with a condition that people just told her was all in her head and psychogenic. But I believed her – she forced me to believe her.
Over the years, we figured out what was wrong with her and eventually discovered a new condition called hemi-laryngopharyngeal spasm, or mercifully abbreviated HELP syndrome—when the vagus nerve, or tenth nerve, is compressed, it can cause symptoms in your body.
Chris Honey describes VANCOUVER syndrome as a syndrome in which a patient has a cough without a lung-related cause. (Shutterstock/mangostock)
We have discovered a second condition that will be known medically as VANCOUVER syndrome.
VANCOUVER is an acronym for vagal-related neurogenic cough arising from unilateral vascular involvement of its root. If you press on the vagus nerve, it can trigger signals that make you feel like an incredible tickle in your lungs. These people have a cough, but there is no pulmonary cause for it.
Patients were told, “You just got a psychogenic cough, so learn to live with it.” But fortunately we found the cause and the cure, and so these patients taught me medicine.
You said that you not only talk to patients, but also listen to patients. Is there a message out there for other practitioners?
This is a message that BC has clearly learned with the stellar example of Dr. Bonnie Henry, who is truly capable of listening to patients and communicating what they need to do in their best interest.
I think we did very well in BC in terms of our ability to communicate. But this is a recurring theme in medicine – the doctor must listen to the patient to really understand what is wrong with them, not just the disease, but how it affects the family in the patient’s circle of caregivers.
LISTEN | Dr. Christopher Honey on his new book The Tenth Nerve:
On the Shore7:23 The Tenth Nerve – Dr. Christopher Honey
“A scalpel can go so deep, and technical skill can only take one so far,” is a quote from a new book by Dr. Christopher Honey, a neurosurgeon at Vancouver General Hospital. He talks about finding the tenth nerve in the human brain and his new book.
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