FROM THE EDITOR

High-Tech and High Touch

I believe in humanizing medicine because…

That was the prompt at a recent retreat, sponsored by the Center for Innovative Medicine (CIM), which drew dozens of Johns Hopkins clinicians from a wide variety of disciplines. Responses were revealing — and inspiring. A smattering:

“I truly believe that in order to heal someone, we have to know them.”

“I see how enthusiastic and bright medical students are when they enter medicine and I want to make sure that doesn’t burn out.”

“I believe it’s the foundation of solving health inequities. It’s the thing that can cut through all of the noise and remind us of who we are serving and who they are loved by.”

I think it’s important to shine a light on the early autumn gathering, aimed at galvanizing faculty involvement in CIM’s new Initiative for Humanizing Medicine, in tandem with our cover story that examines how artificial intelligence is transforming medicine.

The two efforts are not mutually exclusive. High-tech does not have to mean low-touch.

If implemented thoughtfully, as our experts discuss in “Future Shock,” advances offered by AI can free physicians to spend more time with patients; deliver personalized, more effective treatment; and improve screening to reach previously underserved communities — all tenets central to the mission of humanizing medicine.

I am heartened to see so many at Johns Hopkins actively engaged in keeping patients at the fore as they address today’s crucial issues in medicine. I hope you are, too.

Sue De Pasquale

LETTERS

A Patient Proxy Solution

I read, with interest, the article “Everyday Ethics” in Hopkins Medicine [Spring/Summer 2023]. It seems that getting consent for treatment for unrepresented patients is a big challenge at The Johns Hopkins Hospital.

Colorado has solved this problem with a law that allows the treating physician to choose another physician (who is not involved in the care of the unrepresented patient) to act as the patient proxy and make medical treatment decisions (including end-of-life choices).

A thorough search for relatives or friends, confirmation of the patient’s inability to make decisions for himself, and approval of the Ethics Committee are all required.

At our 170-bed hospital in the Denver suburbs, we use this option eight to 10 times a year. At larger, urban facilities, I imagine it is more frequent.

Arthur Strasburger ’65
Greenwood Village, CO

Avoiding the "C" Word

I read Hopkins Medicine from cover to cover. As always, the Spring/Summer 2023 issue was excellent. I especially appreciated the article by Wynne Parry that described the full range of teaching the essentials of clinical ethics to trainees at the Johns Hopkins University School of Medicine (“Everyday Ethics”).

But I was sorry to see the use, repeatedly, of what we called at Johns Hopkins Bayview the “C” word (case) when I was active on faculty there. The decision, adhered to pretty consistently at Johns Hopkins Bayview, to never refer to a patient as a “case” came about when a visiting professor gave a talk in which he repeatedly referred to a patient he was describing as a “case.” I was so stunned by this 40-minute objectifying of fellow human beings that I decided to communicate my concern to colleagues. Others shared my sentiment, and since then (about 10 years ago), there has been a genuine effort to not use the ”C” word when presenting or writing about a patient — one can always use the word “person” or “patient” instead.

As I write this note, I realize that my concern matches the concerns addressed by Mary Catherine Beach in her work finding and rooting out stigmatizing language in the medical record [“Words, Do No Harm,” Spring/Summer 2023]. 

Here’s hoping authors for Hopkins Medicine, going forward, will not use “case” to refer to patients.

Randy Barker ’66, Professor Emeritus 
Johns Hopkins University School of Medicine

Patient-Centered Issue

The Spring/Summer edition of Hopkins Medicine excelled, especially that it touted Sir William Osler’s dictum, “Treat the patient, not the disease.”

“Words, Do No Harm” advised that our perspective of our patients not have pejorative or discriminatory intimations. “Crohn’s and Substance Use Disorder” reminds me how addiction is always doing pushups in the basement waiting to strike again. “The Healing Power of the Arts” brought back my first lecture in medical school (before my internal medicine intern year and then residency at what is now Johns Hopkins Bayview Medical Center). An artist presented a slide presentation of famous artists to better learn how colors and shapes of the masters might allow impressionable medical students to utilize such an artistic perspective to better diagnose patient presentations and ultimately improve their treatment.

Inculcating responsibility for the future of patients we frequently saw only for fleeting moments was so remarkably described by the work of emergency medicine physician Dr. Nathan Irvin [“Journey to Recovery”].

Lastly, the Post-Op column by Interim Dean/CEO Theodore DeWeese [“Accelerating Aspirations”] reminded me of my own experiences recruiting inner-city Black high school students into a student-run clinic in Newark during the tumultuous early 1970s — an experience I brought with me to Johns Hopkins. So many decades later it is wonderful to see a renewed realization that “in communities with more Black physicians, Black patients live longer” and that planting a seed for a career in medicine, practice or research can make youthful dreams a reality. 

Peter J. Dorsen, M.D.
[email protected]