Unlocking compassion: lessons from a prison clinic

The healing potential of human interaction should always be considered, particularly when practicing medicine. Early in my medical career, I worked in the electromyography laboratory at Charity Hospital, Louisiana State University. During my time there, I saw an astonishing variety of patients. Among other things, we were the hospital of choice for the nearby Louisiana State Penitentiary, Angola, or “The Alcatraz of the South.” This prison was infamous for housing violent offenders.

I was still a somewhat inexperienced doctor the day I watched correctional officers bring this imposing man into my clinic. He was robust, muscular, and shackled from his neck down to his ankles. I watched, astonished, as it took the officers minutes to fully unbind him. Then, adding to my growing unease, they left me alone with him. By law, the correctional officers had to wait outside the room while I examined the prisoner. Unfortunately, it was my job to stick him with needles and administer other intrusive diagnostics to evaluate him. I noticed I was sweating as I set up the medical instruments. My hands were also shaking. However, surprisingly, I also noticed his hands were sweaty as well. “Will this hurt, doc?” he asked in a profound yet fragile voice. “I do not like needles,” he added.

I looked up into his face with a jerk, unable to disguise my surprise. In my mind’s eye, I saw him looking back at me, growing angry and trying to make some desperate attempt to escape. Instead, I found him watching me with evident anxiety, the same as I might see in many other patients. His unease may have been augmented by very overt apprehension. But I found myself placing my trembling hand on his for comfort. “It will hurt,” I said, “but not much,” I reassured him.

The man took a deep breath, half a sigh of relief and half steeling himself. Unexpectedly, he shared, “I killed somebody,” and “That’s the reason I’m in Angola.” My mouth went dry. I did not know how to respond. What could you say to that? I focused on the tests I was administering. Regardless of the unusual circumstances, I was finding it impossible to see this man as anything other than another patient. He was a nervous human being waiting for the needle. I wondered what circumstances he must have been in so that committing murder seemed necessary. His willingness to expose his fears increased my empathy for his situation.

As I spent more time in the lab during that period, I found that my work resulted in more of these atypical interactions and related introspections. Perhaps there was something about the fact that the work required physical touch. Also, the fact that many of the patients were unexpectedly afraid and felt better by sharing their feelings. They took this opportunity with me, a stranger, to show vulnerability and share their most profound burdens, perhaps because they considered a doctor to be a non-judgmental player.

As a health care professional, I have listened to countless stories from my patients. However, I must admit that at times, their stories leave me in disbelief, at times, in awe. It’s incredible how much we can learn and appreciate about the people around us when they open up and share their experiences. Perspective is everything, and learning about someone’s struggles and history provides a fantastic focus on appreciation. I often wonder, as I pass people on the street, about their stories and what roads they have traveled to be at the places they are at the moment.

The doctor-patient relationship is a unique bond built on trust, confidentiality, respect, and empathy. Patients often feel comfortable sharing their deepest concerns and fears with their health care providers, which can foster an atmosphere of honesty and openness in the relationship. Several factors contribute to this dynamic, including doctors’ being trained to listen well and provide compassionate patient care. Additionally, patients may feel relieved knowing they can speak freely without fear of judgment or reprisal, perhaps for the first time in their lives.

This level of trust and vulnerability can be humbling and rewarding for health care providers, as they can provide support and guidance to those who need it most. Ultimately, the doctor-patient relationship is an essential aspect of health care, and it plays a crucial role in promoting healing and well-being for patients and their families.

In today’s world, technology is advancing rapidly, and medicine is no exception. While technology has undoubtedly brought many benefits and improvements to the medical field, one must ask whether we are losing the art of medicine through a significant increase in the pace of medical care. The “art of medicine” is solidly based on the human connection between the patient and the doctor, considering the patient’s unique circumstances and needs.

As technology and automated diagnostic capabilities become more prevalent in the medical field, it is essential to remember the importance of the human element in medicine. While technology can significantly impact diagnosis and treatment, the value of human interaction and empathy should be recognized. Doctors must remember that they treat a patient with a disease. By maintaining the art of medicine, we can ensure that patients receive the best care possible and that doctors can connect with their patients on a deeper level.

Francisco M. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine and can be reached at Florida Spine Institute and Wellness. 


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