Saturday, May 19, 2007

Visiting Patients

Margaret asks below: How do you decide which patient to visit? What do you talk about with a patient? Doing those visits is very wise I think.

At any given moment, we might have 600 patients in the hospital, ranging from very small babies to very old folks. So, of course, I can't visit everyone.

For a while I tried to visit people in a random way, just dropping in to rooms on different floors to check in. It turns out that this was not a good idea. It was just too jarring for most people to have a stranger walk in, even the president of the hospital, with no context for the visit.

So the simple answer to your question is that I visit people who are personal friends or colleagues; who are friends of friends or colleagues; who are on our boards of directors, trustees, and overseers -- or related to a board member. There are people in some of these categories who want privacy, though, and whom I do not visit. Sometimes, too, the nurses, doctors, or social workers tell me about someone who might appreciate a visit.

What do we talk about? Everything you can imagine. I often ask about and get reports on the quality of the experience -- doctors, nurses, transporters, housekeepers, food, cleanliness, clunky television controls. Sometimes we discuss the patient's personal medical progress and expectations. Sometimes it is about the business status of the hospital. Often, this being Boston, the main topic is the Red Sox, Dice-K, Mike Lowell, Manny, Papi, or their last win or loss.

If I am really close to the person and we both know the disease is terminal, we might talk about how it feels to be near the end of life. To be clear, this is a very rare occurrence and can only happen when we are very good friends. I sometimes have similar conversations with his or her spouse or partner. I never thought I would have the emotional wherewithal to do this, but it turns out that it is a marvelous gift to the patient or spouse (and to me, too) to have this discussion.

Topics that are absolutely off-limits with all patients: Conversations about donations to the hospital. Status reports on other patients.

The other people I visit are the babies in the neo-natal intensive care unit (NICU), when the parents are not there. The nurses have gotten used to this. I find it inspiring to watch a 1.5 pound baby breathe, sleep, and otherwise get used to life "on the outside". With these patients, there is not much talking, at least from their end, but these are some of the best conversations I have.