Thursday, September 13, 2012

Struck by Dignity

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Another opportunity to think on my feet: I was told to see a returning patient who was following up on pain problem.

The patient told me about her pain and that she figured out what started it all: holding the phone with her head for hours while working around the house. At that time, a new relationship was beginning for her, and she would spend a lot of time on the phone. After a few more minutes of history, I asked her conversationally about that relationship.

She told me it was great! They were finding so much in common and it was a great source of enrichment and joy for her. I could see that it lit up her face. Then, between sentences about how the relationship was flourishing she said, "now, I won't lie to you, it's not a man--it's another woman, and..."

I stopped hearing her for a few words, feeling as though I had been struck. Everything was so normal until that sentence. Now what do I do? Instantly I began to determine how I should receive this news: it is clear that this relationship is more than friendship and I know that homosexual acts are naturally disordered and spiritually harmful. But I am not this woman's doctor and am, in fact, a stranger and a medical student visiting the office for education. But will I give scandal if I calmly smile and nod? I am wearing a crucifix and am therefore a representative of Christ for this woman, who is surely observant enough to notice my necklace.

The patient was concluding, saying that she felt valued in her relationship. I decide to say true things but withhold the truth that is inappropriate to provide. "I am so glad that someone can make you feel the dignity you have as a person, can appreciate your worth," I said.

Her response was almost as shocking to me as the original admission. She was delighted! She said, "that's exactly it," and that I completely understood. She went on about her partner while I went off into thought. Untangling my thoughts later, I wondered:
  1. This woman only found appreciation of her transcendental value in this relationship. This is terribly sad: everyone can appreciate everyone's human dignity...we don't need intimate relationships for this (although I'm sure this love is crowned with greater intimacy).
  2. Is hunger for this appreciation fueling homosexual intimate relationships and the gay marriage drive? 
  3. If there someone else made this woman appreciate her human dignity, her , would she ever want a homosexual relationship?
  4. This woman is missing out on a unique element of marriage: self gift as a woman, to a man. There is so much more to marriage than simple (though profound) appreciation of human dignity.
The patient later told my preceptor that I was "an excellent human being" (I guess, the highest praise of the secular world?). I think I was at least excellent in one thing: I saw what she loved about being loved.

Tuesday, September 11, 2012

The Preceptorship Diaries

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During second year, medical students at my school are placed one afternoon each week in a physician's office to learn to take histories, perform physical exams, create assessments and plans, and document their work at a tempo that resembles real life. (This replaces the lovely take-your-time atmosphere of the simulation center.) I became really excited: finally, a chance to play doctor at a real pace!

I knew that my preceptor, Dr. F, was an internal medicine physician. Further, I'd heard that she gave an informal talk on superfoods and was going to come talk to the Holistic Medical Society (which is actually a cool group, when it avoids the hippie commune end of the spectrum and adheres to good practice using all available wholesome methods). Her name was Indian.

Her office was adjacent to an acupuncturist's (later she told me that she was also certified in acupuncture). I entered and was asked to wait in the waiting room while she got off the phone. This was unusual for a medical student (usually, I'm told to come right back), but I sat among the patients and quietly waited the short time until I was called back. I noticed that this office, like Dr. D's, attracted people like the doctor: Dr. F's staff and clientele were more brown than, say, Dr. C's or Dr. A's.

When I was called back, Dr. F greeted me warmly and sat me down in her little office. She asked me what my goals were for this preceptorship, for which I was grateful. Next, she discovered that I studied philosophy and theology, and asked me for a favorite scripture. I mentioned the Song of Songs, and recited the verse that appears when my alarm goes off in the morning ("Arise, my beloved, my beautiful one, and come!"). She was charmed, and hinted that she might look up the book on Google.

While I was describing TAC, she learned that I was Catholic. She asked me, "what do you think of diversity?"

I answered honestly, if in an abbreviated fashion. "It's beautiful," I said. "I haven't always spent time in the most diverse environments" (TAC had one black student?) "but I realize that people's different experiences and cultures are enriching." This was true, and largely the product of my summer with Dr. D. I left other thoughts about diversity unstated: its ascent to a replacement for true exchange of ideas in this culture is strange at best, and relativist at worst.

Dr. F smiled slightly, but then looked at me squarely. "I meant difference in religion," she said.

For an instant, I was at a loss. I gathered that Dr. F was something of a pancretist: she had a large carving of a Native American medicine man on driftwood in her office, she wore a tiny rhinestone angel pin, she had a calendar displaying a Hindu god, she promised to look up the Song of Songs, and she was asking me this question.

I could not lie. "While I believe that my faith is the truth, I cannot and will not treat others without the dignity they have as human persons."

Boy, that was hard to say! A little wall went up in her eyes after the first clause, and her next sentence started in a tone most professors reserve for the correction of a wrong thought. ("Well, hypertension is associated with atherosclerosis, but this question is actually asking something else....") I'm not sure whether this preceptorship will go as swimmingly as I'd hoped. Time will tell.