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Good Medicine Is What Does Work, Not What We Think Should Work


I treated my young patient with asthma "by the book" and alienated his mother as I did so. I didn’t have the time to really listen to what she really needed from me.

Medicine is what helps or heals our patients, even if we, as a treating physician, do not believe in it or think it should have worked.

To say I have not been an early adopter in the areas of complementary and alternative medicine would be an understatement. My medical education did not cover any of these areas and in a busy practice and administrative life, I struggle to keep up with what I considered legitimate treatments, therapies, and diagnostic testing.

I was much more likely to discourage patients and parents wanting to explore areas like this-mostly because I did not think I had the time to make sure the treatments the parents were wanting to “experiment” with would not actually harm their child.

So when the mother of a young asthmatic 5th grader in for a school physical and checkup asked about Buteyko Breathing techniques at the very end of the visit when I was already behind, you might envision my response. Her child did not have the worst asthma I had ever seen, but he was receiving more medicine than his family wanted and asthma was not letting him do everything he wanted.

I focused on appropriate inhaler techniques, avoiding allergens, and an appropriate asthma action plan-all of the things the asthma guidelines tell me to do medically. What I failed to do was identify, at that moment in time, what Dave’s mother really wanted. While I do not remember my exact response, I am sure I was less than supportive of the complementary treatment. I do not think I was rude, ugly, or disparaging, but I am sure that my response failed to make Dave’s mother feel that I had really “heard” her.

Dave never came back to my clinic.

Fast forward 2 years. I am at a little league game and see Dave’s mother. I stop and say hello and ask how Dave is doing. After going through all the niceties of 5th grade math, science, and adjusting to middle school, she very poignantly told me his asthma was doing great.

She said that they had begun breathing training and significantly reduced his asthma medications. While she was very nice about it, she was also very clear that she believes that the breathing training, and not all the “medical things” I did were why her son’s asthma was so much better.

While I did not realize it at the time, my failure to identify this mother’s concern and appropriately display empathy let my patient and his mother leave the office with the impression I was at the least uninterested in complementary and alternative medicine or, at worst, that I was uncaring related to this mother’s needs.

Likely if I had been a better listener and acknowledged her desire for a complementary and alternative treatment, Dave and his mother would still be in my practice.

Asking questions such as “What do you know about Buteyko Breathing?” “What would you like to do next?” or “Why do you think Dave would benefit from that treatment?” would have displayed empathetic communication behaviors that would have made them feel like I was at least addressing their concerns. Likely if I had done this first, my opinions at the time about complementary and alternative medicine would have been better received.

Thanks to Dave and his mother, I made an effort to learn a lot more about complementary and alternative medicine and try to be empathetic no matter how busy or far behind I am.

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