Sunday, May 2, 2010

Love is the Drug of Choice

"Healers in all major traditions recognize that the power of love is the most potent healing force available to all human beings."...Angeles Arrien in The Four-Fold Way.

People need people and people need love. In Family Medicine, we see people with a wide variety of problems and symptoms. These problems and symptoms are generally context sensitive. Often it seems that context is everything, especially to the extent that love exists for the patient. To the extent that love is missing in the patients life, the family physician may find signs and symptoms that try to fill the void. We may feel challenged to help the patient to find the human caring connection that prevents the loss of love or replaces the lost love. Some people may find a pet or even a plant that is a surrogate for human love. Love is the drug of choice!

Healers "recognize that the greatest remorse is love unexpressed." (Arrien) So, do family doctors have to become lovers to help our patients heal? Maybe. At least we can stay fresh in our love of humanity and the human condition. We can honor our patients as fellow citizens of the human condition, remembering to respect ourselves for the same reason. That shared humanity may allow the patient to feel the love, even if they smoke, eat too much, align with disappointing philosophies or political parties, or have an unusual aroma. Love is the drug of choice!

Toward the end of a patient care day in our offices, can we still feel love for us and them as we find ourselves hoping (and feeling guilty about it) that the lonely, talkative and WWII veteran senior citizen will finish the story about the awesome visit to the WWII Memorial in Washington, DC? Is it love or stress that has us humming the Jeopardy Theme Song faster than usual while watching the Rapid Strep Screen for the hyperactive six year old boy whose grandma is barking continuous commands to the lad? (Should we spin it clockwise or counterclockwise to make it register faster?) Have we already decided to treat the boy no matter what result the test yields?

In the same last four patients of the day sprint, do we breathe a sigh of relief as we break away from the chronic fentanyl patch, but worker's comp disabled fellow, who falls down all the time from his ineffective, system ignored unoperated spinal stenosis, who is actually there to follow-up from the ER visit associated with his vaccuum-like depressed mood, which we quickly dispatched with starter samples of vinlafaxine and a three week follow-up appointment? Does the sigh change into something else when he pronounces with a suddenly renewed energy, "They all have great respect for you in the ER. They said that you are the king. Thank you for being my doctor." As we say thanks, turn away and feel tears well up in our (needing to be dry for the remaining patient, a teen who missed a menstrual period) physician eyes we are honored and thankful that our patient remembered and reminded us that: Love is the drug of choice!


  1. It is so hard for students, residents (the micro perspective) and policy wonks and insurers (the macro perspective)to get it. Their is a complexity and chaos present in this view of Family Medicine. Far easier to count beans or focus on something concrete and "fixable".

    Keep up the good work.


  2. Sometimes, i feel a *HUG* works wonders with my patients, perhaps for this reason :) Great post, Dr. S!