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Tribune-Herald - June 07, 2011New Search
Waco Tribune-Herald (TX) - Tuesday, June 7, 2011
Author: MICHAEL ATTAS Guest columnist
He
had a fourth-grade education, and was, for all intents and purposes,
illiterate.
Yet he raised seven wonderful children and had adopted five others. All had
graduated from high school and several from college.
He had 24 grandchildren at the time he became my patient, and was raising one
of them.
He called his grandson, “my little buddy,” and his main concern was that he
lived to see the boy grow up.
So all of our conversations were filtered around these basic facts of his life
— what we could do to make sure that he lived to provide care for one of his
grandchildren.
He had a combination of a serious valve abnormality of his heart as well as
critical coronary artery disease.
He needed open-heart surgery that would consist of both valve replacement and
coronary bypass. The odds of him living one year without surgery was 50
percent; he had less than a 5 percent chance of living two years without
surgery.
That was five years ago, and he still is living a full life and raising his
grandson despite all medical odds.
He chose to have a stent inserted in his coronary arteries, and declined valve
surgery.
He knew the statistics, and made his decision and was willing to live or die by
that.
He always spoke of himself as a “dumb” county boy, yet he had a deep wisdom
about his body and science that was hard to describe.
It was “street life” smarts and not book smarts.
I respect that kind of integrity, and feel that he made a decision that in all
honesty was best for him even though it went against every grain of my judgment
as a clinician.
He seemed to have what I call a wisdom of the body — a deep understanding of
his life when placed in the context of his body and diseases that we all share.
Why some people have this innate body “wisdom” and others do not baffles me.
It is not a matter of education. It is not a matter of socioeconomic class,
wealth, status or religious beliefs.
It transcends race or ethnicity. Some people just seem to “get” their bodies
and how they will respond to various treatment options much better than we
health care professionals do.
As health care professionals, we come armed with science, statistics, even
years of accumulated experience.
And we make our suggestions for treatment options, and can even get entrenched
in patients doing what we want them to do.
Some physicians will even go so far as to terminate the physician patient
relationship when a patient makes his or her own call.
Yet when we are honest, we know that all science can do is approximate a
certain reality, a certain truth.
We often see through the glass darkly, and we are all reminded from time to
time how limited and fragile our knowledge can be.
There are times when patients make their own decision and it turns out poorly —
and all of us involved have a tendency to look at those cases with regret,
hindsight or even resentment.
But like my patient, the grandfather, there are also numerous times when the
patient “knows best” and the so-called collective wisdom of the experts are
left lacking.
Wise patients will often listen to their body and their life’s journey and make
sound decisions completely on their own.
And it is our job as healers to listen to those stories, respect their
authenticity, and maintain our jobs as best we can in the face of what seems to
be incredible odds.
Dr. Michael Attas is a local physician, a medical humanities professor and an
Episcopal priest. Email him at Michael_Attas@baylor.edu.
Section: accesswaco
Record Number: 15397326
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