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ER Goddess

ER Goddess

The Best Medicine is Love

Simons, Sandra Scott MD

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doi: 10.1097/01.EEM.0000532179.99443.10
    TLC
    TLC:
    TLC
    Figure
    Figure

    I walked straight from the finish line to the hotel lobby, and parked myself triumphantly at the bar in my sweat-soaked marathon clothes, medal around my neck. But the debilitating nausea hit me before the waitress could return with my celebratory mojito. I fled to my room, and used the plastic hotel laundry bag as an emesis bag, then collapsing on the bed. I wondered what my lactate and creatinine were after 26.2 miles in the oppressive Miami humidity. “Don't throw up, don't throw up, don't throw up,” pleaded my inner voice.

    Nausea plagues many endurance runners, and after 18 marathons in 11 states I am used to riding out the waves of queasiness alone. I never had anyone with me through the pathetic, wilted aftermath of my lactic acidosis. I never had anyone see me gag on Gatorade as I struggled to rehydrate myself. Without having anyone around when I felt too lousy to interact with the world, I had never understood how a little love makes a big difference.

    Enter Matt. He crept tentatively into our room. An EP himself, he thought Miami in January would be a nice respite from sick people. Little did he know that supporting me meant waking up at 4:45 a.m. on marathon day, running miles in the humidity to buoy a whiny girlfriend, and now, finding himself in a doctor's role on his day off. It would have been easy for him to give me some Zofran and IV fluids back at work, but he didn't have those in our Miami hotel. “I told the bartender you were sick. She poured you this ginger ale over ice with a splash of grenadine and some bitters, and said it would help you.” All he had was this concoction and TLC.

    He vigilantly stationed himself on the bed next to me, genuine concern in his eyes. “Should I hold your hair if you throw up?” he asked. I felt relieved to have him there. We've all discharged patients who are scared to leave, worried about not getting help if their symptoms worsen while home alone. The fear of suffering unaided makes illness more ominous, so simply being in the ED is reassuring. I understood why that day. If I got worse and couldn't make it out of the room or if I spent the night vomiting, Matt would be there, and that soothed my nervous stomach. I actually kept down a little of the ginger ale concoction.

    He rubbed my head and back. The energy in his hands was relaxing and encouraging. Touch is powerful. Studies show how touch deprivation stops babies from growing and developing properly. Touch has been shown to relieve pain, improve circulation, loosen tight joints, decrease levels of stress hormones, boost endogenous levels of serotonin, enhance sleep, and increase relaxation and well-being.

    The Best Medicine

    I told Matt that I was turning my post-marathon misery into an article that would feature some of the complementary therapies he used that day and what I had read about healing and therapeutic touch. Instead of balking as I expected, he told me, “Yes, I actually incorporate that into my practice. I shake hands, and I touch patients' wrists to feel their pulse. I put a gentle hand on their shoulder. I think the doctor's hand on them puts them at ease when they are scared.” He's right. With his hand on me that day as I laid listlessly in the hotel bed with my marathon medal still around my neck, my muscles loosened, my stomach unknotted, and I felt like I could breathe more easily.

    I still craved the conveniences of modern medicine, and I whined for Zofran. Wishful thinking because there was no antiemetic in our hotel room. Next thing I knew, Matt was googling pressure points for nausea. He grabbed my hand and started acupressure on my inner arm near my wrist. “Pressure points?” I thought to myself. “Seriously?” But his fingers felt good, so I kept my skepticism to myself and let him keep rubbing.

    It was not the critical care that he is highly trained to do—no IV fluid boluses, just ginger ale; no measuring lactate, just touching my skin. It wasn't the critical care but the caring that was critical.

    As I reflect on that day, I wonder how it would have been different without Matt's critical caring. What if I had remembered to pack Zofran but had been alone in my hotel room? What if I had stopped by the medical tent and someone had given me a Zofran? Would I have felt as comforted? Absolutely not.

    The first rule of taking care of patients, it's been said, is caring about the patient. Good doctoring requires love—love for your fellow human. When CMS mandates have us rushing in and out of patient rooms and insurance policies have us sending little old ladies who live alone right back out the door, we need to remember that real healing is not about CMS mandates, insurance policies, or electronic medical records. Real healing is about compassion.

    On that muggy Miami day, I was reminded of what really matters. Matt treated me with nothing but TLC, and it was enough. We don't always need the latest technology; we just need to show that we care. It's the simplest gesture that often has the greatest effect. The best medicine is not found in the pharmacy but in our hearts.

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