C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

3 Lessons in Hospitality From my Patient

Takeaway

Hospitality is a human connection through the gift of attention and care. When hospitality becomes our modus operandi, care is transformed from transactional to sacred.

Earlier this year, my patient Mrs. Johnson gave me the gift of awareness about hospitality with grace.

 

It is a strong human drive to provide and receive hospitality, although the concept is now sometimes confined to restaurants and hotels. Seeing hospitality in healthcare usually catches everyone by surprise.

 

Mrs. Johnson was admitted to the hospital for cellulitis, an infection of the skin and underlying tissue. When I started taking care of her, she had already been in the hospital for three days. Her skin infection was getting worse with each passing day.

 

I walked into her room with what I felt was a terrible news – things were not improving, antibiotics were not working, the biopsy didn’t tell us much, the high dose steroids was not working. Despite all our efforts, her ulcers were getting bigger and more painful. Before entering the room, I prepared myself to deliver unpleasant news to this kind lady.

 

She was in excruciating pain. Moving her arm or leg brought tears to her eyes. The ulcers on her arms and legs were getting bigger. Every time we entered the room, she would greet us with a smile. There were times she sought our permission – yes that’s right, sought our permission –  to give her a second for her to cope with pain before she attended to us.

 

Many times, I wanted to leave the room, pained to see her struggling with her disease with such grace. I felt helpless and anxious, as she would refuse my offer of pain medications. I wish I had more to offer to help her with her pain. She was the one who was able to dispel my anxiety so tactfully by self-deprecating humor.

 

She treated us, her treating team, as guests entering her living space – always concerned about our comfort. “Have a seat, I have water bottles for you, candy is on the table by the window, please help yourself.” She was always caring for us.

 

Wasn’t that supposed to be my job? I was supposed to be the care provider, yet the role was so casually reversed. I was still her attending physician, but she was the one providing care for her medical team –  mental and spiritual care – by checking in and attending to what she perceived to be our needs.

 

On Valentine’s Day, every guest entering her room was greeted with a beautiful red rose carefully wrapped in cellophane with a red ribbon and placed in a yellow plastic hospital water pitcher.

 

During her hospitalization, she exemplified grace and poise in the face of pain and suffering. She transformed doctor-patient relationship to one of guest and host. She taught me what hospitality can mean in healthcare.

 

Despite changes in healthcare, principles of hospitality remain timeless.

 

1.) Hospitality is a central component of human connection through the giving of care and attention.

Mrs. Johnson connected with us through her daily offerings of water, cookies, and a red rose. Food is sometimes the way we express care and connection. Finding small human moments in my patient interaction to make them feel seen and heard is a daily discipline that I actively work on. I am reminded of Dr. Abraham Verghese’s quotation, “Disease is easier to recognize than the individual with the disease.”

 

2.) Hospitality is exceptional care thoughtfully given with consistency.

Providing excellent diagnostic and management skills as measured by our quality metrics, is service. Exceptional service is a prerequisite to be able to deliver on hospitality. Lacking excellent medical care wouldn’t make up for hospitality. Mrs. Johnson trusted and respected our expertise, and then she was able to teach us a lesson in hospitality.

 

3.) Hospitality is a team sport.

It requires everyone on the team to create a culture and environment of mutual respect. It starts with our interactions with people on our team before it is translated to patient care. I can only imagine Mrs. Johnson asking someone from her team of friends and families to get water bottles, cookies, and flowers as her preparation to greet us. Cultivating an environment of mutual respect in a complex system is paramount. When everyone on the team makes hospitality their modus operandi, care transforms from transactional to sacred.