Caring for a patient with humanity
Geriatric Unit, Erasmus Hospital
Brussels, Belgium – Gaël Turine
It was not immediately apparent to me what I would photograph for this hospital project. The ever-present face masks imposed by Covid-19 measures prevented me, as well as the patients, from being in close contact with the caregivers, and allowing me to make them as visible as I would have liked. Photography is, in essence, silent, and deprived me of the sound that could have compensated for the concealment of faces. I feared that I would not be able to transcribe the quality of the exchanges between caregivers and patients, the intonations of voices, the reassuring smiles.
But something else appeared, something absolutely fundamental in what is called by many in primary care, presence. It is a way of being, caring for a patient with humanity. Whether it takes place before, during, or after the science of medical care is administered, this vital part of caring for someone is communicated with looks, words and gestures.
These actions, which have been seen thousands of times, are natural and reassuring.
“It’s normal for me, I don’t really realize it anymore,” one nurse said to me when I mentioned to her that her way of being with an elderly lady was so touching. These gestures, which are sometimes found in the smallest details and which I noticed for the first time in the ward, are profound and beautiful.
Hands placed with tenderness, or assurance, or sometimes with firmness, or even a subtle blend of all three are like physical extensions of the generosity that animates each person who works every day to take care of others.
If the masked faces of the caregivers in these photographs are nearly absent, it is their hands in contact with the patients’ bodies that speak to us for them. If this form of touch, far from a medical practice, is reserved for one’s intimate moments; then I would say, after having spent a few days in the company of nurses and their patients in the geriatric unit, that it is this intimacy that sustains the care of others.
In the midst of the scientific discourse that fosters our daily medical practice, I would like to talk about another facet of our work and relationship with patients.
This dimension of medicine is akin to an art of living, of listening, of hearing; it is the art of care, which I believe has a fundamental place at the heart of our practice.
The anguished patient is like a lost child. All his hope, his wish for survival, is directed to the caregiver. In the patient’s psyche, whatever we deliver can lead to even more anguish. Everything we say to him can also lead him to more peace and serenity. A simple word, a simple gesture, are enough to convey what is essential.
The way in which we enter a room speaks to the one we care for, impacting their body and their being. In our relationship with the patient, we can be in a love-joy relationship, defined by Aristotle who invites us to love without necessarily being loved.
In this definition of love, there are notions of fidelity, of respect, of sharing. This love is inseparable from the value we place on the person in front of us. Give what you have, selflessly, with the aim of bringing comfort, help, support.
Depending on our convictions, we can call this gift, compassion, charity or altruism. The expression of care goes far beyond the simple technical gesture; we can enhance the body of the patient, not only by words, but also through touch, through our way of being.
Whether it’s a nurse entering a room with a syringe in hand, whether it’s a doctor with a stethoscope around their neck, whether it’s a catering service worker delivering a lunch tray, or a cleaner with their broom; the way we enter the room, the availability that we have or not, the relationship that we can offer or not to the patient, these are the tangible proofs of the way we look at the patient that we treat, their body, their whole being.
Everything is important for the patient and is a testimony to the attention we give to him. The way we arrange a cushion, a pillow, the delicate or crude way that a bed is made, the attention we pay to mouth care, the act of making sure he has what is needed close at hand, the personal respect for a patient’s privacy and intimacy when they need the toilet or a massage. All these gestures, all these attentions, testify to the desire to help and care for others.
The patient we approach is in a state of dependency; he is in an exceptional situation, lonely, and anxious about what is happening to him. He expects much more from us than we imagine.