Unlearning “Bobble Head Medicine”

bobble head doctor

By Morgan Wills

The case revolved around an experience I had caring for a patient late one night in the emergency room at the VA hospital several years ago. A young man with a history of a brain tumor (a “frequent flyer,” according to the nursing staff) had come in yet again complaining of vague symptoms and demanding an MRI to rule out a recurrence of his tumor. There was no clinical evidence from the workup to do so, and I was tempted to just send him on his way. But a gnawing sense of conviction led me to stay up late and pursue the patient on a personal level in a way which transformed the experience for both of us—and helped the VA team care for him better (and more cost-effectively) in the future.his past Monday I had the chance to share at the first of a series of lunchtime presentations at Vanderbilt Medical School about the joys and challenges of Whole-Person health care (WPHC) Although we write and speak about this concept a lot at Siloam, it was good to have the opportunity to articulate some of this approach in the academic setting as well.

Below are a couple of highlighted principles from what we covered.

1. Most clinicians (including myself) are trained in a way that prioritizes cognitive knowledge and technical competence over human interpersonal skills. This results in doctors who are a lot like “bobble-heads.” You know: the little dashboard toys that bobble from side to side with the movement of your car because of the weight of their disproportionately huge heads? Too often, that’s us! So, like our patients working through the 12 steps, the first step in WPHC is to admit we have a problem!

2. A second, and related, point is that WPHC begins with tending to our own personhood. Mindfulness, or the practice of fostering deliberate awareness of what’s happening inside ourselves, is a key first step. For good and ill, we bring desires, moods, and agendas (some might say, baggage!) to the clinical encounter that inevitably frames what we will find there. There is no such thing as a completely neutral clinical encounter—just more or less transparently personal ones.

In the next installment, we will consider some more principles from this case. In the meantime, I want to leave you with a link that dramatically highlights how our brains filter and/or frame reality. It’s a review of a fascinating story of a non-religious neurosurgeon reflecting on how his near-death encounter helped him to see how our brains can “screen out” spiritual realities that are right in front of us…

2 thoughts on “Unlearning “Bobble Head Medicine”

  1. Morgan, your holistic approach is inspiring. We all need reminders to see past the objective evidence on the surface and dig a little deeper into the issues concerning the whole person. I especially love the idea of examining our own “baggage” that we bring into the exam room. It certainly colors my perpective on clinical encounters more than I’d like to admit!

  2. I apologize for not following up this post sooner. Other posts (such as the CHI news and the “Escape Fire” documentary announcement) have intervened. But we’ll revisit these themes before long…

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