Who’s a patient?
Saturday, May 9 2009
Patience: A minor form of despair, disguised as a virtue.~ Ambrose Bierce, The Devil’s Dictionary
I don’t like the word “patient” to describe sick people, but it’s seems to be all we’ve got. But let’s be clear: it only describes sick or injured people. If there’s nothing wrong with you, you’re not a patient.
We tend to equate patient to patience, as in “showing calm and self-control”. And ideally, this would describe most sick people, but often we’re not calm or self-controlled. An apparent paradox, yes – but in fact both words derive from the same root as “passion”, meaning “suffering”. As in “passion of the Christ”, in the Mel Gibson, blood-and-gore, crown-of-thorns, cat-o’-9-tails, nailed-to-the-cross sense.
“Patience” then, in the most literal sense, means the capacity to suffer. That’s why sick people are called “patients” – not because they’re calm and self-controlled, but because they’re suffering. You have to be sick or injured to be a patient. A person who has health insurance is not necessarily a patient. A person who worries about being sick some day is not a patient. A person who wants a nose job is not a patient. No sickness, no suffering, no patience, not a patient.
One of the most frustrating aspects of the health care reform debate is the fact that the word “patients” gets tossed around like it means pretty much everybody who’s not a doctor. Ezra Klein gets it wrong reading this survey of “randomly selected participants”; Kevin, MD parses the same survey as “Patients do not want their doctors paid a salary”. This isn’t a survey of patients. It doesn’t say anything about patients. It’s not about patients. You could just as well say this survey tells us what women want from health care. Or what Catholics want from health care. Or what dog owners want. Yes, the survey includes all those people – but it’s not at all reasonable to impute the results to their specific perspectives.
Patients suffer. Suffering is what makes us patients. Our suffering is why we have a health care system, and why that system needs reform. This debate is not about what “randomly selected participants” want. It’s about what suffering people need.
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