Understanding the Heart and Soul of Medicine

The story goes something like this. When I was a child, I felt called to medicine. I loved the sounds, sights and smells of the hospital and the doctor’s office. I loved the equipment, especially the stethoscope. It taught me there was a connection to the heart of the patient.

In medical school we learned the cardiac cycle, this is the technical physiological term of the heartbeat. First the top part of the heart beats, (atria) then the electrical impulse passes down to the spot between the atria and the lower part (ventricles) then down around the ventricles as the current goes, the specialized cardiac muscle is infused with the electrical impulse and inherent knowledge to contract, which causes the heart walls to constrict and blood is forced up and out of the heart, whoosh, into the aorta and then around through the body. With each beat there are many intricacies the body maneuvers, both in the normal an diseased state; tight blood vessels, not enough blood volume, too much blood volume, heart valves that work correctly, or not. This goes on and on as does the days and lives of each of us. In every step of the cardiac cycle there are layers of physiology that determines and responds in a beautifully intricate manner.

We also learned in medical school that the heartbeat meant how we connected with the patient in the Doctor/Patient relationship. What are the emotions, the experiences, and the various perceptions that the patient and the physician both bring to the encounter? Some may call this the “softer side of medical science”, the fluff and not hardcore anatomy and physiology. I think both aspects of the cardiac cycle are equally important and intricately related.

I call this the heart and soul of medicine, in medical school and still to this day some 24 years later, I remain intrigued by both the heart (physiology) and doctor/patient relationship (soul) of medicine.

Working with patients as their physician, I am privileged to sit in their inner circle, hear their stories and understand their perspectives. Knowing about the anatomy and physiology, using a holistic approach to their care by honoring the body’s self healing capacity and knowing structure and function work together and understanding that our experiences, yes, even our diagnosis can teach us many things about our selves and others and this is a high honor.

Wouldn’t it be nice to have a doctor you can communicate with? One who has time to listen, and asks good questions? One who considers many facets of both a disease and health system and yet has the optimism that “everything is going to be OK” no matter what?

That sounds amazing doesn’t it? OK, then try and find that…good luck. How is that working for you? Those are today’s responses when this specific question is asked.

Here are some tips to find a good Doctor/Patient Relationship.

  1. Is there good communication? Does the doctor listen to me and hear what I am asking? Do they let me explain my viewpoint and ask questions? Are there a number of both open-ended questions and direct questions to lead us in our discussion?
  2. What is the diagnosis and treatment plan? Is there a clear way through something even if it feels we don’t have all the answers yet? Even if there are other physicians involved such as specialists and other testing, do I understand what we are doing?
  3. Is there a Pill for every Ill or a test for every complaint or a specialist for anything beyond a sniffle? If so, run the other direction with both vim and vigor.
  4. Am I willing as a patient to put time into this relationship? The results of a good relationship are from the engagement (showing up), the transparency and the willingness to communicate in a given situation.
  5. Am I treated and do I treat the physician with respect, dignity and concern. A lot is said about the stress on or medical system. This includes the broken system, frustrated physician and the stressed patient. It is fair to say both the doctor and patient usually come into a situation feeling the effects of it all and they often feel discouraged or defeated.

The importance in medicine is how we as a doctor and patient work together putting both the structure and function of the relationship in place.

The structure of the appointment, method of communication, labs, imagine etc. The function is to share concerns, perceptions, and feelings and together arrive at a diagnosis and treatment plan. When each part is working and with patient and physician, there can be a robust and heartfelt approach to your medical care. That my dear patient describes the “heart and soul of medicine.” That is how long ago, I determined to practice with patients and that is my goal with each of our patients who join me at the Colorado Integrative Medical Center.

Thank you to those patients who have already joined in at our office and here is to working with each of you in this meaningful way.

Be Well ~

Dr. Louder