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2006; Lippincott Williams & Wilkins; Volume: 81; Issue: 12 Linguagem: Inglês
10.1097/01.acm.0000246679.00849.31
ISSN1938-808X
Autores ResumoDanielle was a ten-year-old leukemia patient undergoing her third, painful round of chemotherapy when I first met her. I was an anxious, apprehensive student, entering the isolation room of my very first patient. As I introduced myself to the frail child, she hardly removed her expressionless gaze from the sealed, dusty window overlooking hospital construction. She knew I would be just another hospital staff member to poke her, prod her, and relentlessly question her from where I hid behind my precautionary gown and mask. Even as I made small talk about the newest pop music star or offered her a coloring book to pass the time, her only response was to shrug her shoulders, and to turn up the volume of her television from the remote control on her bed. Danielle spent most of her inpatient stay alone in her hospital bed. Her parents could only visit after work, and only occasionally did a grandparent, an aunt, or a cousin stop by. They would enter her room enthusiastically with baskets full of board games, chocolate treats, and stuffed animals, only to emerge shortly thereafter, choking back tears. The child was too weary to play games, too nauseous to eat, too disheartened to befriend yet another teddy bear. I left the hospital that first day feeling like a failure, and for months I felt uneasy entering Danielle's room. Every day I would peek in to ask how she was feeling, but I was always met with the same blank stare, and often a look of disgust. “At least she makes eye contact with you,” one of the nurses joked. I realized I would virtually have to stand on my head to get through Danielle's wall of silence. And, as it turned out, I literally had to do just that. I knocked on her door one beautiful June day, when it seemed that the rest of the world was enjoying the summer sunshine while this gloomy child sat in her room with curtains drawn. I was disappointed in myself for allowing Danielle to be so miserable while the other pediatric patients were enjoying cheerful therapeutic activities that helped heal their tiny broken spirits. Her hardened stoicism went far beyond her years, and I was determined to find a way to bring back the radiant child I was sure she had once been. I walked in and found the stone-faced little girl sitting on her bed, and a man in a chair who introduced himself as “Dr. Scott.” He was in jeans, a T-shirt, and a baseball cap, with no stethoscope or reflex hammer in sight. “Danielle's been coming to see me at my pediatric practice since she was born,” Dr. Scott said. “Now that she's here in the hospital, when I get a day off, it's my turn to come see her.” Danielle appeared to blush in response to all of this attention. “I'm not like most doctors, so Danielle sometimes gets embarrassed when I come around. I've been known to start wheelchair races with the nurses, even to stand on my head!” Completely intrigued by this doctor, whose service to his patients apparently did not end on his day off, I replied, “Well, headstands are one of my specialties.” With that Dr. Scott jumped up, grabbed two pillows from a shelf, and threw one at me. “Well, then, I challenge you to a headstand contest!” When I saw just the hint of a curious smile on Danielle's weary face, I knew this was the chance we had all been waiting for. We placed our heads on the pillows and lifted our legs into the air, the lemon-yellow isolation gowns hiding our faces. What followed was the inspiration that, I believe, will stay with me throughout my career in medicine. Danielle began to giggle. She muffled her laugh with her hand, but for just a moment, she was a normal, healthy child, enjoying a moment of pure silliness. We had broken through Danielle's wall. When the contest was over (Danielle decided that Dr. Scott was the winner), four wide-eyed doctors in gleaming white coats stood peering over each other's shoulders through the glass door. They shook their heads, unable to comprehend this unique bedside manner. We just laughed, joining Danielle in a moment of triumph over the tragic part of her disease that had so mercilessly consumed her spirit. From then on Danielle began to talk, teaching me firsthand just what it was like to live with leukemia. To the delight of everyone who knew her and had watched her transformation, Danielle would go into a stable remission shortly thereafter and would never require admission to the hospital again. Humanism in medicine is defined by moments such as these, in which it becomes clear that treating a patient's spirit and dignity goes hand-in-hand with treating the illness. By fostering the development of Danielle's own sense of courage and inner strength, Dr. Scott was able to help the little girl prevail not only over her cancer, but also over her pervasive sadness and hopelessness. His service to the patients he cares for is unique in that it is performed not only in the role of a physician, but also in the role of a mentor and friend. In pursuit of a more humanistic service to the community, it often becomes necessary to step out of the white coat and into the patient's world, empathizing with their feelings of frustration and powerlessness. The impact that this type of selfless service has on medical care is as invaluable as extensive clinical knowledge and cutting-edge therapies. These altruistic, noble deeds exemplify the humanism that is at the core of every field of medicine. It is personified by the nurse whose gentle touch reassures a frightened patient, the medical student who takes the time to listen to a patient's fears and concerns, and the doctor who will literally stand on his head just to make a patient smile.Figure
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