Blog 30: Kindness and the “Rabbit Effect” in Health Care

Recent blogs have emphasized the importance of the “personalist” approach to life that is open and respectful of others and that takes the time to listen to them.  In my most recent blog, we saw that such an attitude benefits ourselves as well.  On September 8, 2019 Colman McCarthy published an article in The Washington Post that added another dimension – a medical dimension – to our understanding of the positive effects of kindness.

I am pleased to call Colman a friend and have had happy encounters with him that go back to post Peace Corps days.  He is a former Washington Post editorial writer and columnist who directs the Center for Teaching Peace, a Washington-based non-profit group. Recently he received a letter from a former student, Kelli Harding, that brought him great joy. He describes what he learned:

Her year-long service included comforting HIV/AIDs patients at a free health clinic and following up with the solace of delivering meals to the homebound. It was a world apart from her undergraduate days at the University of California at Berkeley and majoring in political science. The Washington experience, which Kelli would later call “transformative,” was the fuel that carried her into medicine to earn a master’s degree in public health from Columbia University and a medical degree from the University of Rochester, and almost two decades of practice as an emergency room psychiatrist at NewYork-Presbyterian Hospital and a clinical professor of psychiatry at Columbia University Irving Medical Center.

….

Enter the rabbits — not those bunnies scampering in our woodlands but ones serving in two month-long medical experiments to test the effects of eating a high-fat diet and the connections between cholesterol and heart disease. With similar diets, the expectations were that all the rabbits would have similar cloggings of their arteries. Yet one group had 60 percent fewer of them.

The reason? Instead of receiving the standard care given to lab animals, the 60 percent group was watched over by a newcomer to the lab who, Kelli writes, “handled the animals differently. When she fed her rabbits she talked to them, cuddled and petted them. She didn’t just pass out kibble, she gave them love. . . . The studies indicate something is missing in the traditional biomedical model. It wasn’t diet or genetics that made a difference in which rabbits got sick and which stayed healthy. It was kindness.”

 “The rabbit effect,” she explains, means that “when it comes to our health, we’ve been missing some crucial pieces: hidden factors behind what really makes us healthy. Factors like love, friendship, and dignity. The designs of our neighborhoods, schools, and workplaces. There’s a social dimension to health that we’ve completely overlooked in our scramble to find the best and most cutting-edge medical care. . . . Ultimately, what affects our health in the most meaningful ways has as much to do with how we treat one another, how we live, and how we think about what it means to be human than with anything that happens in the doctor’s office.”

….

 “Clinically,” she writes, “it’s common to see two patients with the same condition, such as recovering from a heart attack, have two very different courses based on seemingly irrelevant factors, such as their family relationships or their educational level. In my practice, the sickest people I see often share similar backgrounds: loneliness, abuse, poverty, or discrimination. For them, the medical model isn’t enough. It’s like fixing up an airplane engine and ignoring that the pilot is on his third drink at the bar and a massive storm is overhead. . . . To properly care for patients, we also need to care about the lives of the people getting the care.”

Kelli wastes no time taking cheap shots or potshots at the medical establishment and its body-centered biomedicine methods.

Instead, she remains positive, holding up for praise one of her medical school professors, George Engel, an internist “who always noticed not just a patient’s physical findings but little details about her life, such as if she had family pictures up in her hospital room or flowers delivered. He was the kind of trusted doctor you’d feel relieved to see and welcome into the room with a sick family member. He’d sit down to talk with the person not just about medical problems, but about her life and priorities. He built a large consultation service to address the holistic needs of hospitalized patients, including psychological and social factors.”

It’s a guess how many George Engels in their white jackets and stethoscopes are at work these days and another speculation on the number of Kelli Hardings the nation is blessed with. Please, dear God, may the totals be large and getting larger.

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