Maintain an Open Mind When Providing Care - Patient Care - @

Maintain an Open Mind When Providing Care

Assuming you know the situation can lead to inaccurate diagnosis and a lack of empathy



Thom Dick | From the November 2012 Issue | Friday, November 9, 2012

I had a friend once who said you should probably expect to have about as many friends in life as the fingers on your left hand, and as many enemies as the fingers on your right. The rest of the people you meet, he said, may act like your friends. But they would never be more than acquaintances.

One of my true friends was Bill Joynt. At 5'6", Bill was a tough little retired Navy chief who had fought World War II in the Pacific theater. He bore all the mental, physical and spiritual scars of a warrior. He also smoked, drank and cussed like one; and his politics were just as tightly wrapped as his view of people. I met Bill at Phil Middleton’s Shell station, where we both worked nights and weekends. Phil’s station was a stone’s throw from San Diego State, where I was studying journalism.

My dad was no college man, and he didn’t see any of his 13 kids being more educated than he was. So I paid rent to live at home, I paid my own way through school, and I fought him over that degree. Bill offered me a free place to live, so I took his spare room. Then I got into EMS and moved into an ambulance station. I married my best friend. And here I am, 42 years later, writing to you like I know something.

I’ll always owe Bill the debt of my life for his kindness, Life-Saver. But thanks to the wisdom of another friend named Mike Taigman, I’ve learned to see people much differently than Bill did. Than I did, actually.

I think it’s okay to be wrong about stuff, but it’s not okay to get fooled. When what you do with your life is interpose yourself in the affairs of people you don’t know, you learn to keep your eyes wide open. You learn not only to see, but also to hear, smell, feel and generally sense what is. If you limit your perception to what you expect, you will miss realities that will short-circuit your diagnostics—and more importantly, jeopardize your safety. As you know, critical thinking and safety are both essential to the life and function of any medic.

I remember being horrified the first time I encountered a child who had been coined. Coining (also called cao gio or gua sha) is a practice among Asian healers. It involves applying some kind of medicinal oil to the skin, usually of the chest or back, and then rubbing or scraping the skin with a smooth-edged object like a coin or a spoon until you see subcutaneous bruising. The bruising can look pretty dramatic, but it heals in a couple of days. The technique is used to relieve everything from nausea, vomiting and coughing to chills, fever, headache, backache and muscle pain.

Like so many Asian medical practices, coining is probably much more ancient than the Western medicine with which we’re much more familiar. I was sure our little kid had been physically abused, and I made a fuss about it. I was wrong, and I’m sure I was disrespectful to its parents. (That was wrong, too.)

I’ve noticed there’s a huge difference between Western medicine and Eastern medicine. Western medicine seems to be grounded in the premise that sick people are impotent and their physicians (reinforced by a powerful pharmaceutical industry) are omnipotent. Eastern medicine presumes every sick person has the capacity to heal themselves, and a few special, gifted people called healers have the capacity to facilitate that healing process.

Think back to your first class on human physiology. Is the body designed to heal itself—whether from hangovers, infections or broken bones? It certainly seems to be. Otherwise, none of us would have survived long past our births, and our mothers would probably have died during that process.

Nor are we unfamiliar with healers. The best internist I’ve ever had was Gary Johnson, a DO, a veterinarian, a licensed acupuncturist and a chiropractor. I referred my medic partner, Les, to him. When Gary died, his successor inherited a long waiting list of people who wanted him to be their doctor.

Maybe you’ve known medics who could diagnose a drunk at 100 yards without so much as an exchange of greetings, much less an exam. People deserve better than that from a professional. Even drunks are just people. Open your mind (and your heart.) Use their names, and treat ’em like friends. You’ll be surprised at how reasonable and how sensible your career can feel.

To them, and to you. 

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Related Topics: Patient Care, Tricks of the Trade, Thom Dick, Jems Tricks of the Trade

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Thom Dick

has been involved in EMS for 43 years, 23 of them as a full-time EMT and paramedic in San Diego County. He's currently the quality care coordinator for Platte Valley Ambulance, a hospital-based 9-1-1 system in Brighton, Colo. Contact him at


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