by Turya Nair
I recently completed three years of residency training at Loma Linda University Family Medicine program, which is in southern California in the U.S. It is a unique Seventh Day Adventist institution that embodies the loving values of this Christian sect and applies them to medical care. I was initially drawn to the training program because of its strong emphasis on the inclusion of spirituality and love into the care of all patients, which I have always thought is very important. This philosophy was a continuous thread running through my training, especially through a special practice called Love Rounds done in the Loma Linda hospital once a week. This unique idea was started by Dr. Wil Alexander, PhD, who is currently 94 years old and still teaching and lecturing within the family medicine department. He is not a physician – he is a minister and professor of religion at Loma Linda University, and brings an important non-medical perspective to the way we learned to look at patients, which I value to this day.
Love rounds involves the following process: the medical team chooses a patient who they are caring for in the hospital—usually a particularly sick or sad patient, or one who has been in the hospital for a long time—and ask the patient’s permission to bring the team with Dr. Alexander to the bedside and learn more about the patient as a person. When the team comes to the bedside with Dr. Alexander, we watch him pull up a chair in front of the patient’s bed, greet all the patient’s family members, make a few jokes, and then begin asking the patient questions that perhaps no one else has been asking during the rest of the hospital stay. These include questions such as, “How do you feel about being in the hospital?”, “Tell me the story of your sickness”, “Tell me about the last time you really felt well”, “What are you famous for? What do your friends and family love about you?”, “Do you blame God for your sickness?” or “Do you think God is punishing you for something?”
These questions have the magical ability of restoring the patient from simply a list of lab numbers, xrays, and a sick body in a bed, to a human being—not only in the eyes of the medical team, but oftentimes more importantly in the eyes of the patient themselves. And we are all reminded that the relationship we enter between doctor and patient is a sacred one that involves the patient’s spiritual beliefs about their health and sickness as well.
I remember on one such Love Rounds, we chose a patient who was in his 60s and who had been in the hospital for almost two weeks. Let us call him Mr. M. Two weeks is quite a while for a hospital stay, and the medical team wanted to send him home as soon as we could. However, his case was complicated – he had leukemia for which he was in treatment, but recently developed a fever due to a fungal infection, which can be very dangerous for a leukemia patient. Despite our treatment with anti-fungal medications, his fever was still coming and going. In fact, we had attempted to discharge him home when he had been fever-free for a full 48 hours. However, due to a pharmacy error, he did not receive the anti-fungal medications to continue at home. Without these pills, Mr. M’s fever returned again and he had to be admitted to the hospital again within 24 hours of going home the first time! Both he and our medical team were frustrated with the lack of progress. Because he also had diabetes, he was kept on a strict hospital-based diet with no sugar to ensure his diabetes was controlled, per hospital protocol.
As Dr. Alexander and the team spoke with him on Love Rounds, we learned that Mr. M was very active in the local government and politics, and had a wife and two daughters. One of his daughters was graduating shortly from college, and he desperately wanted to be safely discharged from hospital in time for her graduation ceremony. Despite his frustrations with the pharmacy and his ongoing fever, he was charismatic and had a great sense of dark humor. For our team, love rounds transformed this “diabetic leukemia patient with fever” into a vibrant active citizen, a proud parent, and an intelligent and funny gentleman.
We asked him if there was anything we could do to help him feel a bit better while he had to be in the hospital. In exasperation, he said, “I know that I’m a diabetic...but...this hospital food is terrible. All I really want is to have some ice cream!”
After love rounds, we discussed with Dr. Alexander how the hospital protocols did not allow us to override his “diabetic diet” order. But we came up with a plan together: we, his doctors, went to the hospital cafeteria and bought a serving of ice cream. We snuck back into his room with the ice cream and gave him this little gift, in an effort to bring a little sweetness back into this frustrating and uncomfortable episode of his life. He accepted it with laughter and gratitude, and in that moment he knew that we had a greater goal than treating his illness – we wanted to know and care for him, just as he was, as a whole person.
As I reflected on this experience, and continue to ruminate on it even today, I am so grateful for experiences like this that infused my three years of training and kept me focused on the true goal of my profession on medicine, which is to heal and serve not just bodies, but hearts and whole people. This particular Love Rounds experience also taught me an important lesson about seva, or service. Oftentimes, as we contemplate performing a service or a kind act, we worry about all the things that could go wrong, or over-complicate what we plan to do. Sometimes we give up on a project or a kind act even before attempting it because of these doubts, and because we want it to be “perfect”.
We could have given up on this small act of getting Mr. M the ice cream he longed for, because that would not have been “perfect” care of his diabetes. But instead, we did an act of loving service for him, which is something we can always find a way to do. Service does not have to be “perfect”, but it must always be in the spirit of love – and then it will be perfect anyway. And sometimes, the perfect thing to do is just give someone a bit of ice cream.