'The scalpel can only go so deep': Why a neurosurgeon thinks genuinely caring for patients is so important
In The Tenth Nerve, UBC neurosurgery head Chris Honey says his patients have taught him to be a better doctor
A Vancouver neurosurgeon's recent book questions a common practice among medical professionals to emotionally detach themselves from patients.
Dr. Chris Honey has practised neurosurgery for 25 years and is the neurosurgery division head at the University of British Columbia. His book, The Tenth Nerve, published this February, features stories of seven patients who he says have taught him to be a better doctor.
Honey says in the 16th century, when medical technology wasn't well developed, a doctor's job was more about providing emotional support to patients rather than medical cure.
It's a big difference from how medical students are being trained today — they are told to limit emotional engagement with patients because, as Honey says, riding a roller coaster of compassion can pose a real personal risk to physicians' mental health.
But Honey argues that a real understanding of any illness requires listening to patients and having genuine care for them.
"The scalpel can only go so deep, and technical skill can only take one so far," he wrote in the book.
Honey spoke to host Gloria Macarenko on CBC's On The Coast about what he has learned from his patients, and why communication between doctors and patients is so important.
The following transcript has been edited for clarity and length.
"The scalpel can only go so deep, and technical skill can only take one so far." What were you getting at there?
When I began my surgical career, like many young surgeons, I thought I knew everything — I would just tell patients what they needed and I would go about operating on them.
But over the years, I realized that there were some patients who profoundly changed who I was, how I understood medicine, how I understood the human condition, and also how I understood myself.
What I have come to realize is that you can learn so much from patients by just talking to them and actually listening to their stories.
How has it changed your approach to surgery and your own view on life?
For example, several of those patients have conditions that have never been described before.
One of the standard practices in medicine is to listen to the patient's story and see if you recognize the pattern and then label them with a disease. But if you don't recognize the pattern, our knee-jerk reaction is to say, "You know what? It's all in your head — you're making this up."
I met a woman with a condition that people had just told her it was all in her head and it was psychogenic. But I believed her — she forced me to believe her.
Over the years we figured out what was wrong with her, and we ultimately discovered a new condition called hemi-laryngopharyngeal spasm, or the mercifully short acronym HELPS syndrome — when the vagus nerve, or the tenth nerve, is compressed, it can cause symptoms in your body.
We found a second condition that is going to be known in medicine as VANCOUVER syndrome.
VANCOUVER is the acronym for Vagus-associated neurogenic cough occurring due to unilateral vascular encroachment of its root. If you press the vagus nerve, it can cause signals that make you feel like an incredible tickle in your lungs. These people have coughing, but there's no lung cause for it.
Patients were told, "You just got a psychogenic cough, so learn to live with that." But we have fortunately found the cause and the cure, and so those patients taught me about medicine.
You were saying not only talking to patients, but listening to patients. Is there a message in there for other medical practitioners?
It's a message that B.C. has clearly learned with the stellar example being Dr. Bonnie Henry, who is really able to listen to patients and communicate back to them what they need to do in their best interests.
I think we've done very well in British Columbia in terms of our ability to communicate. But it is a recurrent theme in medicine — the doctor needs to listen to the patient to truly understand what's wrong with them, not just the disease, but how it affects the family in the patient's circle of caregivers.
LISTEN | Dr. Christopher Honey on his new book, The Tenth Nerve:
With files from On The Coast