Metric loss

A new type of metric in medicine

Today I propose a new type of metric in medicine.

I say. I say. (I hear the uncomfortable clearing of your throats.)

From one side of the room: Of course we’re human, aren’t we?

On the other: Here we go again, Doctor Touchy-Feely. Let’s go. I have work to do.

But if …

We rewarded a “main complaint,” written as a patient concern or family observation, fleshed out features, revealed context, in their own words. I/We are concerned about the loss of…

And if…

A complete “systems review” began with the interiors, the salient flashes of sadness, the constrictions of fear, the beauty of a granddaughter’s smile.

Or, what if…

In our “physical exam”, we gave points for the description of eyes that were tired, shiny, or watery with pain? Or a quivering mouth, a forehead lined with worry? A jaw clenched in anger?

Or, what if…

Instead of an “evaluation”, we rejoiced in a moving testimony of the whole landscape of the human before us. And we expected an in-depth account of the hills and valleys of life that led up to that moment hunched over in a leather exam room chair.

What if …

We removed our fingers from the keyboard and took his trembling hand, watching the sea with his eyes, the children dancing on his heart, the determination in his breath.

And if…

The best “plan” was not a list of problems and solutions but a vibrant map of desires with us, the co-captains, cruising the waterways in sturdy boats made of desires.

Today I propose that we examine our impact on the human soul.

Eve Makoff is an internal physician.

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