NO ORDINARY PATCH
More than just making people smile and laugh, Dr. Adams raises serious issues that he believes physicians should face
By Lucio Victor Jr.
"IF YOU HAPPEN TO WRITE A SHORT ARTICLE ABOUT ME, I AM ALL ABOUT PEACE, JUSTICE, AND CARE…I LOVE HUMANITY AND I LOVE EVERYTHING ABOUT LIFE."
-Dr. Hunter "Patch" Adams
The physician has come a long way.
Dr. Eugene Ramos, vice president and general manager of Biomedis Inc., notes that doctors nowadays not only possess better skills, but have at their command technology that can save patients from illnesses deemed incurable or difficult to manage decades ago. But he also observes that while doctors may have "gained much, they may have also started to lose that which is basic, simple, and warm." He points to the diminution in the quality of doctor-patient relationship.
"The distance between the doctor and the patient has grown wide," said the practicing internist-cardiologist to preface Biomedis's advocacy movement called the "Joy of Caring," which recently brought to the Philippines as part of its initial salvo the noted Dr. Patch Adams.
It is this gap, which Ramos sees as the result of "doctors getting more busy and patients getting more demanding," that "Joy of Caring" aims to address-by helping health-care practitioners maintain a good doctor-patient relationship on professional and personal levels. This advocacy "seeks to restore the old and beautiful balance that saw the doctor apply his scientific skills and maintain the required level of professional detachment, but at the same time win the patient's trust and respect-with warmth, sincerity, and ability to connect on a personal basis," said Ramos.
And who else could best provide inspiration to bridge the divide than Adams whose movie won the hearts of many Filipinos, doctors among them?
For two days last February, Adams, a staunch activist who for more than three decades, has been waging an all-out campaign for peace, justice, and the "humanization" of the medical community, was in Manila for a series of inspirational talks and a visit to a local hospital.
Adams visited patients at the Jose Reyes Memorial Medical Center and spoke before more than 8,000 medical students and physicians in Manila and Cebu City to whom he imparted a few words of counsel.
Underscoring the importance of building good relationship between physicians and their patients, he said: "I don't know how a physician can call themselves a physician unless they are working to eliminate the gap between them [and their patients]. A doctor could have a relationship with a patient in which the thought of the doctor would [be enough to] lower the patient's blood pressure. I know that [when patients are] in the deathbed or [when patients feel] intractable pain, and I cannot solve their [medical] problems, [it is] our relationship that would be of greatest value."
He urged medical students to develop early in their careers habits and attitudes that would make patients feel more comfortable and at ease with them, particularly during history taking. He noted that lack of trust and a feeling intrusion to their privacy can cause patients to omit important details of their medical history. But he said that could be overcome by spending time in taking the patient's medical history, which is what he does. "I try to make my patients fall in love with me and me with them," he said.
To his fellow physicians, he acknowledged that tension and burnout often get in the way of establishing a good patient-doctor relationship. "It is a humiliation to life that people lose energy," he said as he urged physicians to maintain an element of fun and enjoyment in their practice. "A doctor's life is a life in service to all people, compassion, and generosity. [It should be] a delightful service, not a long, hard, difficult, and strenuous task. You sure could put fun in there, somewhere-the fun of joyful service and love and compassion for all people," he said.
Activist Doc
Between speaking engagements, Adams found time to talk about his life and share his thoughts with members of the Philippine media. On this occasion, he discussed a wide range of issues from his favorite poet (Walt Whitman) to his view of President George Bush (he considers him "stupid, a dangerous president, and a threat to humanity").
A voracious reader, Adams has a collection of 12,000 books-his most-cherished works, he said-among them by his favorite writers Fyodor Dostoevsky, William Shakespeare, Virginia Woolf, and William Faulkner.
He even has books of Jose Rizal and F. Sionil Jose, whose works he said he read because "I try to read at least five authors of a country before I go and visit that country."
Apart from his literary collection, he also has, of course, books on medicine and the sciences, including 70 on insects and 60 on birds. He subscribes to 120 monthly magazines and 500 newsletters. He regularly corresponds to 1,600 people, writing to them in longhand at least every month. He travels extensively, averaging three to four thousand miles a year to give talks and spread his unorthodox but caring techniques. Undaunted by security or peace and order problems, Adams last year spent two weeks in a Pakistani refugee camp and four weeks in Afghanistan.
In his talks, Adams advocates a shift from "an elitist, profit-oriented, and power-centered health care system to one with a value system based on compassion and generosity." He stresses that physicians must strive to promote a health care system for all regardless of race, creed, stature, and educational attainment. It must be, he says, one that "doesn't cost money, is free, and is open to all techniques. [A system] that will eliminate behavior that will cause burnout, will ensure peace and justice, and end the discrepancy between rich and poor."
He calls on the medical community to make it part of their responsibility to work for peace and justice. Specifically, he urges doctors to get involved in activities that seek protection of the environment and the abolition of nuclear weapons. He says he'd love to see doctors march to the White House and desist from their practice "until all nuclear arsenals are dismantled."
"I think we are living in a very dangerous time in human history where we have to decide if we have room to live as a species or die in our own filth and slime for the love of money," he laments.
Born May 28, 1945, Adams spent his childhood in many places. His father was in the US Army and took his family with him on every assignment. He lived in countries with diverse cultural backgrounds, and moved from state to state within the US.
But this did not in any way cause adjustment problems for Patch and his older brother Robert. In fact, it brought them closer. It was also through his exposure to various cultures that he learned to appreciate the diversity of people. Going around also gave him the ability to make friends quickly and find it easy to assimilate with the environment he is in. Also, with his father constantly away on duty, he developed closer relationship with his schoolteacher mother and older brother. It was his mother who helped him build self-esteem and inspired him to be what he has become.
As a youngster, Adams excelled in school particularly in science and math. "I grew up a science nerd," he said of his childhood. "I was very brilliant in science and I always wanted to be doctor. I don't know if there ever was a time I didn't want to become a doctor."
While their family was living in Germany, Adams received a microscope for Christmas, and with it discovered the world of cellular structures. He also developed a fondness for chemistry and did experiments with glassware and chemicals. He participated in the All-Europe Science Fair, winning in the biological sciences category more than once.
Revolution of Love
It was also in Germany that he became a war orphan, which triggered in him an aversion to violence and injustice and anything that destroyed life and glorified anarchy. As a soldier's son he saw war destroy the human spirit. These things he said, inspired in great measure the activism in him. Said he: "Having a mother full of love, and a personal experience with injustice and violence, made me want to work for peace and justice for the rest of my life. And where better to start this revolution of love than in the profession that is supposed to be the heart and core of human compassion and generosity-medicine?"
After his father died, the family moved to Virginia where they initially lived with his aunt and uncle, an independent-minded lawyer with whom Adams developed an affinity for as a "surrogate father."
In high school Adams had to live with segregation and prejudice, but he developed a reputation as a "nigger lover." He went to civil rights sit-ins and marches and wrote articles against segregation, religious hypocrisy, and war. In his freshman year in college, Adams's uncle committed suicide. It had a great impact in his life. Later, he and his girlfriend of many years grew apart. He plunged into depression and even entertained suicidal thoughts. Then shortly before Halloween of 1964 Adams talked to his mother and committed himself into a mental hospital, a turning point in his life that was the initial scene in the movie Patch Adams.
It was during his stay in the hospital that he saw patients drowned in a maelstrom of medical, emotional, and psychological problems. He saw first hand how a health-care practitioner who swore to take care of the sick could be cold and distant instead of available and caring. After he left the hospital he worked shortly as a file clerk with a college chum, went back to school, and finished an undergraduate degree from George Washington University in 1967. He then proceeded to the Medical College of Virginia and graduated in 1971.
His superiors in medical school found him excessively funny and "unprofessional." And while in medical school, he was appalled at the indifference and insensitivity that many patients had to go through. He was disappointed by the condescending way some physicians treated other health-care professionals, paramedical and hospital staff, and medical students. Despite these barriers, Adams connected with his patients and befriended them, and knew them beyond what their charts and clinical abstracts told.
Though frowned upon for establishing excellent rapport with his patients, and despite the dissenting opinions of some of the school's officials, Adams got his degree in 1971. He took up a one-year pediatric residency training at Georgetown University. Not too soon after, he established the Gesundheit Institute. Gesundheit means "good health." Here, Adams and his team treat their patients as friends and infuse medical treatment with fun. They do not charge for services; neither do they accept third party reimbursement. Gesundheit, however, accepts donations and uses the income generated from Adam's Wellness Show to keep its services running. The institute has no malpractice insurance and values the health of the staff and their patients equally.
Gesundheit was established in 1980 on 310 acres of land in Pocahontas County, West Virginia. The institute promotes proper exercise, good nutrition, and personalized care. In 1983, Adams decided to be open to media publicity and shortly after, many visited Gesundheit seeking to experience its unorthodox concept of health care. The hospital is also open to the use of various forms of complementary medicine. "Even though it was against the law, our practice has fully integrated acupuncture, homeopathy, naturopathy, chiropractic, ayurvedic, and herbal medicine, and faith healing," said Adams.
Since opening Gesundheit out of his own home, Adams has provided free health care to an estimated 15,000 people. This realization is, according to Adams, "why we work from eight to twelve at night and why it is thrilling to work for love. Our home is the hospital and we have an astounding relationship with our patients. They come and stay with us, we know their families, they know ours."
Adams has also written two books. Gesundheit: Good Health is a Laughing Matter, published in 1985, tries to seek an answer to the eternal question of what is an ideal health-care system. In Housecalls, published in 1993, Adams discusses his experiences as a doctor and explores the intricate doctor-patient relationship and how it can be nurtured and cultivated.
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