Tuesday, June 2, 2009

Unnatural medicine

A lot of people don't like hospitals. They are sterile, unbeautiful, they are a place where you might die. Most of all they are radically abstracted from the natural world in which the individual has agency. They are a kind of bureaucratic sleep-away camp, where the needs of the organization trump the desires of the individual. Health care visionary Dr. Don Berwick, had a nice article about this in which he makes the case that patients should be in charge. He gives agruments for the ways he thinks it will improve medicine, but in the end he confesses that his extreme views stem from his fear of being a patient:

Last month, a close friend called a clinic for her mammogram report and was told, “You have to come here; we don’t give that information out on the telephone.”
She said, “It’s OK, you can tell me.”
They said, “No, we can’t do that.”Of course, they “can” do that. They choose not to, and their choice trumps hers: period.
That’s what scares me: to be made helpless before my time, to be made ignorant when I want to know, to be made to sit when I wish to stand, to be alone when I need to hold my wife’s hand, to eat what I do not wish to eat, to be named what I do not wish to be named to be told when I wish to be asked to be awoken when I wish to sleep.

Got to love a guy who is able to put dialogue into a scientific journal.

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