What a M*A*S*H episode can teach us about patient-centered care

[Originally published by Hospital Impact]

Being a “typical” (is there such a thing?) New Englander, when I first saw MeTV I, of course, assumed it meant MaineTV and thus I was both intrigued and eventually hooked on watching a number of television series from my youth–M*A*S*H being one of those series.

(NOTE: The Me in MeTV actually refers to “Memorable,” as in Memorable TV).

As I began to reconnect with my youth and enjoy the mix of great writing and acting and the comedic aspects and heart of M*A*S*H, I also found myself being inspired by many of the messages it shared. And today I would like to share with you one in particular that links very well to our desire to innovate healthcare by focusing on relationships and compassion in healing.

So for those old enough, take yourself back to Jan. 28, 1980, and join me in viewing from Season 8, Episode 19 of M*A*S*H … “Morale Victory.”

Much (as always) is going on in this episode, but I want to focus on Major Charles Emerson Winchester and his patient, wounded soldier David Sheridan.

Major Winchester performs brilliantly in surgery (as he will be happy to tell you) and saves David’s leg while also working on the soldier’s right hand and leaving only “negligible” side effects, i.e., less use of this hand. Charles is ecstatic and excited to share his brilliance with David post-surgery and to accept accolades from this patient.

Unfortunately for Charles, what he did not know about his patient was that David was a concert pianist before the war and the saving of his leg meant very little to him while at the same time the “negligible” side effect to his right hand meant the world.

Now as a surgeon in a M*A*S*H unit with wounded soldiers being brought in consistently, how could Charles possibly know his patient’s preferences … and yet … and yet once Charles realized (once he had the time to connect with his patient, to sit with him and listen and truly hear his patient’s preference) we see Charles’ humanity as his heart is touched and he strives to both learn how he can now help David and actually do so.

Yes, Charles struggles and relies on his own support system (Father Mulcahy in this case). He also taps into his own experiences and wisdom, and with his new understanding and this relationship with David he develops an approach that honors his patient’s preferences.

“Don’t you see? Your hand may be stilled, but your gift cannot be silenced if you refuse to let it be. … The gift does not lie in your hands. I have hands, David. Hands that can make a scalpel sing. More than anything in my life I wanted to play, but I do not have the gift. I can play the notes, but I cannot make the music. You have performed Liszt, Rachmaninoff, Chopin. Even if you never do so again, you’ve already known a joy that I will never know as long as I live. Because the true gift is in your head and in your heart and in your soul. Now you can shut it off forever, or you can find new ways to share your gift with the world–through the baton, the classroom or the pen. As to these works, they’re for you, because you and the piano will always be as one.”

As a healthcare leader, so many messages from this episode both resonate and reinforce the need for us to ensure we develop systems that:

  • Allow our patients to share their whole stories so that we have a better understanding of our patients, see them beyond a diagnosis and are clear as to their expectations
  • Allow for these stories to truly be heard, understood and honored
  • Allow for an authentic connection between clinician and patient to develop
  • Do not create barriers to this connection
  • Rely on the very best evidence-based care as the standard of care AND allow for individualized approaches aligned with the patient’s preferences and goals
  • Place an emphasis on relationship, trust and compassion for all stakeholders within the healthcare system–including patients, doctors, nurses, staff and families–and develop supports for each so that each of them (each of us) remain best positioned to heal and to care for and about one another

So yes, MaineTV … sorry … MeTV, brought back many memories while also reinforcing how much we must do if we are to truly innovate healthcare and create the healthCARING system we owe to our patients, families and our communities.

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