Icarus by Henri Matisse

MedConference: A Reason to Learn to Fish

The three-day annual conference highlighted the central role of the person in medical care, focusing on the complex needs of the patient. Among many speakers, the testimonies of seven young caregivers gave hope for the future of medicine.
Webster Bull

Icarus hovered over Jersey City. Not the prideful young Icarus of myth, a technician who builds wings and flies too close to the sun. Not the Icarus of Marc Chagall, either, who plummets wounded to earth. The symbol of this year’s Med Conference was the Icarus of Henri Matisse, a fully human being with his heart visibly in place, reaching, if awkwardly, for the stars. While the medical conference held in New Jersey July 16th–18th–“Medical Care and the Person: The Heart of the Matter”–featured many experienced caregivers, beginning with keynote speaker Alberto Reggiori, M.D., the heart of the weekend was a panel of seven medical students and residents with less technique but just as much passion, more caritas than craft. In a profession distracted by technology and technique, and reduced by financial pressures, legal restrictions, and so-called reform, four women and three men gave witness to the beauty and simplicity of forging ahead, without calculation, in their desire to put their passion for the human being at the center of their medical careers. The Saturday afternoon panel discussion led by Federica M. Fromm, M.D., was the result of hard questions posed by some of the same young doctors-in-training at last year’s Med Conference. Fromm, Mandy Reimer, and others had testified that they often found their humanity reduced by rote cramming in medical school and the rigors of lockstep training.
“I am disturbed that there are so few poets in the medical profession,” Reimer had said last year. “Medical education demands a certain way of being that does not cater to the fullness of being a person. In the past two years, I have felt myself–at certain times more poignantly than others–becoming less and less human and more and more machinelike. It’s actually quite easy to do. I can willingly neglect those things that allow me to be moved by the world.”
Fromm summarized the challenge: “For the rest of my life, I want to be able to always recognize the truth and value of a patient. How can we never forget that? I do not want to become desensitized. I want to learn to love my patients more and to truly treat them as human beings–that is, persons with a value and a destiny.”

As eye-witnesses. Conference organizer Elvira Parravicini, M.D., heard these questions in 2009 and proposed to the young men and women that they return to this year’s conference as witnesses. David Isaacs, a medical student at the University of Indiana, led off by describing his experience caring for single mothers delivering children in a county hospital. One was a prisoner handcuffed to her bed, and once her child was delivered she was given little time to be with her newborn before being locked up again. He visited her in the middle of the night, just after she had given birth, and he was struck by the tenderness with which she looked at her child. David said: “That’s the same way I want to be looked at.”
Other accounts were offered by Dulce Cruz, who learned to “follow the patient” while caring for an elderly woman who refused medications, and Landon Roussel, who treated an HIV-positive man, then encountered the same man on the #7 train. This reminded Roussel about the need to “look at people in the entirety of their lives.”
Maximillian Zucchi, a physiotherapy student at McGill University in Montreal, was moved by watching another physio work with a woman with multiple sclerosis. “How can this patient find a reason to live?” Max asked himself. But then the patient said, about the physiotherapist, “It’s only thanks to people like her that I can find life worth living.” Laurence Normand-Rivest, also from Quebec, took part in a letter-writing campaign when the minister of health in her province supported euthanasia. The third-year medical student urged “going deep into the question,” beyond political preconceptions, to understand that euthanasia is “a matter of the person, not a matter of society.” Quebec has a very high suicide rate. “I was frightened,” she said. “I did not want this for my people.”

Steadfast compassion. Mandy Reimer, a medical student at the University of Alabama, had less than an hour to go before vacation when her beeper went off. A woman had opened fire on the Huntsville campus; three victims of the shooting were being brought to her ER, and Reimer was called to duty. But what could she do? Without accreditation, she felt “useless,” waiting in one of the emergency bays, while experienced doctors and nurses circled. When a man finally was brought in, she saw that he had been shot in the head and was unconscious. What could she do while trained technicians intubated him, wired him up, treated his wounds? Reimer moved to the head of the bed and cleaned blood off the man’s face. A woman and teenage boy were brought into the bay. Asked to identify the victim as her husband, the woman said, no, that was not him. Her son said, “Mom, you need to look again. That’s Dad.”
Reimer found herself deeply moved by the experience. “I am just a medical student,” she found herself thinking. “But I can suffer with the family.” She prayed for a way to be with the patient, who survived, and with his loved ones. In the days and weeks ahead, now “off the rotation” which covered the victim, she broke medical school rules by returning to his room and playing music for him. Eventually, the victim went home and began relearning to walk and talk with the aid of therapists. A blog tracked his remarkable progress (www.josephleahy.
On her first day as an intern at a New York hospital–her first day as a doctor, not merely a student–Fedi Fromm was given a daunting assignment. The Orthodox Jewish wife of the chief of cardiology at a major hospital was being brought in, and Fromm was asked to care for the woman until death. Fromm’s chief made it clear that the woman’s cancer was very advanced and that the patient was not likely to leave the hospital alive.
“I learned so much from this woman,” Fromm said, especially after she had let go of her first impulse, to prove to her chiefs that she was a great intern. Her mission was complicated by her own pregnancy, and nausea. She had a memorable early encounter with the patient’s husband, who admitted, “Here I am, a chief of cardiology with so many degrees, and here’s my wife dying, and there’s nothing I can do.” A remarkable friendship arose between the older Jewish woman and the young Catholic doctor. At one point, a minor procedure had to be performed on the patient, and the patient asked Fromm to do it. “I don’t know how to do it,” she admitted. “I have never done that before.” The woman looked at her and said, “I don’t care. I want you to do it because I know you care about me.” When the woman died, her husband came to see Fromm. He said that his late wife had given him six letters, one for each of her five children, and one for Fromm. The letter, signed by the distinguished cardiologist, recommended her for any medical position Fromm might seek anytime in the future, because of the humanity she as a doctor had demonstrated in her encounters with this dying patient.

Love and reason. In his opening remarks, Alberto Reggiori spoke of finding himself suddenly on the other side of the relationship of caregiver and patient when his own 18-year-old son suffered severe head trauma in a car accident. One of the conclusions he drew from his experience is that we can only cure those we love. Getting to the bottom of what moves him as a doctor, Reggiori offered a variation on an old chestnut. It is often said that it is more valuable to teach someone to fish than to merely give them a fish. The saying goes that a fish will feed a person for a day, while learning to fish can feed them forever.
The saying is incomplete, Reggiori said. Something else must be given to the fisherman: a reason to learn fishing. Christ gave His Apostles such a reason–one that seven young people are discovering as they practice medicine while working to keep their reason and affection fully mobilized.

(For more information on this year’s meeting, see http://medicalconference.us/.)