Thursday, July 17, 2008

ethical dimensions of patient care #19

I have had the privilege of collaborating with a surgeon/anthropologist since 1995 when we were among the new faculty members recruited to the Louisiana State University Department of Obstetrics and Gynecology in New Orleans. Since 2002 he has been with the Department of Obstetrics and Gynecology at the Washington University School of Medicine in St. Louis. In addition to his training as a uro-gynecologic surgeon, my friend also received an Oxford D.Phil. in Anthropology. His Oxford thesis reflected the results of a yearlong field study focused on a rural African village. He remains deeply involved in efforts to improve women’s health in Africa (e.g., leading an initiative to make post-delivery fistula repairs available to women who otherwise live humiliated and shunned due to the offensive consequences of unattended uterine damage). He enjoys a secondary faculty appointment in Washington University’s Anthropology Department. He has made noteworthy contributions to the History of Medicine discipline.

My friend and I quickly became close friends in New Orleans, cherishing conversations uncommon in the hallways of academic medicine – i.e., conversations about experiences and subjects where values, ethics, history, anthropology, and spirituality intersect with medical education/practice. He was a regular participant in the ‘Who cares?’ gatherings I coordinated/facilitated with professionally fatigued faculty members. We continue to collaborate on publications for medical journals that draw attention to the ethical complexities faced in medical education and practice. Partnering with him is indeed a special privilege.

My friend’s father was a highly regarded physician during a forty-year career as an obstetrician-gynecologist. Soon after retirement in 1991, the University of Kansas School of Medicine established an annual lecture in his honor. I was invited to present the 1997 lecture, focusing on integrity between patients and physicians. I chose to weave a narrative of the lecture honoree’s professional experience into an analysis of the patient-physician relationship as obstetrics and gynecology evolved into/as a specialty. The core of the lecture follows.