Sunday, January 14, 2007

The Complexity of Humanity

Here are few anecdotes of surgeons startled by patients…

Surgeons usually try to comfort the patient in spite of knowing that there is a modest hope. They are inclined to feel that they have figured out everything about the patients and so they can fairly understand their pain. But, human nature is not a fixed graspable essence. It cuts through all predictions and is a dynamic pattern that can never be completely known. The more you try to clasp it, the more it will evade; I’ve learnt to try to grapple with it in its taints and tinges.

Here’s a psychological quirk from a preeminent psychologist who unsurprisingly won the Nobel prize in economics, Daniel Kahneman (b. 1934). Had it not been for this unusual event, perhaps he may have been less tempted to take up psychology and etch some stimulating theories that would redefine human reason:

It must have been late 1941 or early 1942. Jews were required to wear the Star of David and to obey a 6 p.m. curfew. I had gone to play with a Christian friend and had stayed too late. I turned my brown sweater inside out to walk the few blocks home. As I was walking down an empty street, I saw a German soldier approaching. He was wearing the black uniform that I had been told to fear more than others - the one worn by specially recruited SS soldiers. As I came closer to him, trying to walk fast, I noticed that he was looking at me intently. Then he beckoned me over, picked me up, and hugged me. I was terrified that he would notice the star inside my sweater. He was speaking to me with great emotion, in German. When he put me down, he opened his wallet, showed me a picture of a boy, and gave me some money. I went home more certain than ever that my mother was right: people were endlessly complicated and interesting.

That’s about the complicated species we are and how we unfurl this complexity through our life.


A patient has been diagnosed with inoperable cancer. The surgeon consults her family and calls for a discussion. The patient, her family and the team of surgeons table the case. The patient is apparently disgusted at her becoming a public spectacle even though in a closed room with few people.

One of the surgeons asks the patient: “I know this must be a difficult time for you.”

To which the patient fumes: “You have no idea what this time is for me. Have you ever been in a similar situation?”

The surgeon was shocked because assuming that by diagnosing her cancerous cells, he had also delved deep into her feelings and emotions that follow.

The surgeon slumps: “You are right. I said it to comfort you.”

The patient pats him: “Honey, I know you are trying to make me feel better, but don’t ever assume you know how I feel. Ask me. Don’t tell me.”

Assumptions can often become Concoctions. At any point of time, we have few facts, fewer details and maybe, a fair understanding of anything.


If patient just needed painlessness, a doctor could be duped for a robot. Patients need someone who would patiently listen to their condition or rather to their story. I think this perspective must be part of the primary care. Nowadays, a doctor’s standing is scaled by the patients waiting to visit him or for how many more days can’t a patient get the doctor’s appointment. Before beginning to know the patient’s plight, the doctor is already drooling for the next patient. Time seems to be oned for the doctor.

A middle-aged man enters the outpatient clinic with severe stabs in his leg. He was groaning and grubbing for some relief. The doctor who was a new intern was from a distance already thinking out how to sew up the wounds. As he grew nearer to the patient, the doctor was already armed with suture to rejoin the separated joints. The patient supposed that he was the strong one in his family and so he was experiencing a compound pain: a mix of physical pain and psychological anguish as the pain was demolishing his strength to endure it.

The patient began to tell his story of what happened and why he was here. The doc tilted his attention between sewing the wounds and the amazing narration of the patient. As time passed by, the patient was happy that he had discovered an avid listener and this warmed up his wounds. The patient left thanking the doc for listening to him – not for sewing up his leg. That’s the power of conversation and docs have to conserve it – lest it becomes a luxury.

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