Are Patients People?

Medical journals are generally full of straight, double or tall talk from and about doctors. For a change, some back talk from a patient has appeared in the British journal Lancet. This particular patient was so fed up that she went on for five columns. The burden of her complaint: hospital patients are not treated like grownup human beings.

Medicine & Manners. Medical care in a hospital is fine, the anonymous patient wrote, but medical manners are terrible. First of all, she was kept waiting around in the clinic, "on the principle that a minute of the doctor's time was more valuable than an hour of the patient's." Later she entered a ward where doctors and nurses kept asking her questions without even explaining who they were. They did not expect the patient to ask them any questions.

Worse still was the feeling of being used as a cringing guinea pig* for the instruction of students. "When the doctors and students gathered around, I was politely asked how I was and where the pain was. Then I was disregarded. For ten minutes or more they talked about me . . . as if I were not there. At the end of their incomprehensible conversation, when all my fears and suspicions had been aroused, they left me suddenly, without an explanation or so much as a nod of their heads."

Worst of all was being told nothing, left in ignorance of what was wrong, what treatment was being followed, and why. "Why should an adult cease to be regarded as a normal and reasonable human being merely because he is in a hospital? I am not talking about patients who are desperately ill or in great pain, but people in full command of their senses . . . They were all treated more or less like children . . . ordered about, humored, talked down to, but never taken seriously."

Drafts & Fears. In a two-column editorial, the Lancet sympathetically agreed that such medical manners might well be mended. "The embarrassment some patients feel at exposure of their abdomens to a class of students is nothing compared with the anxiety that can be created by an exchange of obscure and alarming terms over their heads. While some teachers never lose sight of their patient's feelings, others . . . forget about the patient entirely, exposing him physically to drafts and mentally to fears while they compare his condition with other grave disorders, and make technical jokes when a student blunders."

*In Britain, any ward patient may be used for instruction in teaching hospitals unless he objects; private patients are so used only if they have a rare ailment and consent. In the U.S., ward patients and some private patients are used for instruction;never--in theory--without their consent. When the need is explained, and doctors are tactful, patients in both countries often enjoy being used as specimens.

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