Washington, DC — You’ve probably sat in meetings like I have where people, with the best of intentions, reduce a customer down to a failure, a stereotype of their limitations. The comments start with realistically, they’d never try that … or The best we could hope for them to do would be …
That moment is a building block of healthcare experience. It’s the moment when we shift from creating hope to making do. It’s the difference between fighting to help someone succeed and accepting that they cannot.
It’s a moment Dr. Peter Attia knows all too well.
His TEDMED talk has been the one most shared across our North American offices this year. It’s an incredible first-hand account about how the negative things we believe about our customers can change the experiences we create for them.
In the spring of 2006, Attia was a surgical resident at Johns Hopkins hospital taking emergency calls. One night, we was paged at 2AM to see a woman with a diabetic ulcer on her foot. He said he can still remember the smell of rotting flesh as he pulled back the curtain to see her. His decision to make was whether or not she needed an amputation (she did). His regret is that he didn’t treat her with the same empathy and compassion he’d shown, say, the 27-year-old newly wed who’d come to his ER a few days earlier with lower back pain that turned out to be advanced stage pancreatic cancer. In the latter case, he was committed to doing anything possible to help her stay comfortable, down to getting coffee for her and her parents, even though there was nothing he could do to truly save her. In his words, he passed no judgment on her because she’d done nothing to bring this on herself.
Back to the woman in the same ER with the horrifying rotting flesh asking for help at 2AM.
“Why did I hold her in such contempt?”, he asked. “This woman had Type 2 diabetes. She was fat” (his emphasis). “And we all know that’s from eating too much and not exercising enough, right?” He believed that if she’d just try – even a little bit – she wouldn’t be in this situation. He felt justified in judging her because he thought he had her all figured out. She ate too much; she got unlucky; she got diabetes.
Attia is a researcher. In his lab, he knows to question everything, to challenge all assumptions. But, the assumptions about diabetes didn’t seem like they needed questions – they seemed like truth, like settled science.
Three years later, Attia was the patient. Despite working out up to three or four hours every day and carefully regulating his diet, he gained a lot of weight and was diagnosed with metabolic syndrome; he was insulin resistant. Once you’re insulin resistant, he explained, you’re on your way to getting diabetes. He was on the same road as the woman in the ER – facing a potential cascade of pathologic events that could lead to heart disease, Alzheimer’s, cancer, or amputations.
He radically changed his diet and lost his weight. But the conventional wisdom about nutrition failed him – like it may be failing others. It made him question everything he thought he knew about the causes of both diabetes and obesity.
He asked: What if diabetes and obesity are the symptoms of a much deeper problem? What if obesity is the effect, not the cause of insulin resistance?Listen to his entire TEDMED talk to hear his theory about how obesity is a coping mechanism for cellular change.
At the end of the talk, he tearfully asked that woman in the ER for forgiveness. Although he hadn’t sacrificed her clinical care, he’d treated her differently, held back from getting involved or even simply caring. “As a doctor, I delivered the best clinical care I could,” Attia said, “but as a human being I let you down. You didn’t need my judgment and my contempt, you needed my empathy and compassion.”
In healthcare, our job is fostering hope. The kind of hope that helps people fight, that makes them believe they can try again. What would change if we questioned everything we think we know about people living with (enter the therapuetic category you work in) and the healthcare professionals treating them? What could it change about us and the experiences we create?
Posted by: Leigh Householder
