A cardiologist focuses on the human side of medicine

October 05, 2010

Physicians are scientists. Theirs is a life long study of biology, anatomy and chemistry, so they can diagnose, treat and cure disease.

They are problem solvers. They take a complex set of circumstances and symptoms, consider a variety of options, and choose the best course for each patient.

Cardiologists study the science of the heart, and solve problems of life and death each day. But cardiologists don’t just study the heart. They have hearts.

Take a glimpse into one cardiologist’s heart.

When did you first find out?
A little ache one day
And then the next a real pain?

Or did the food you’d always had two helpings of
No longer tempt?
I know you know (or do you know?)
How bad’s this crab that’s bit and won’t let go.

The right side of your heart has gotten big
I’d guess from pumping into
Pipes plugged up
With clots of blood.

I suck in air through open lips,
Then stop,
And blow it out.

Tonight I’ll taste each bite,
Put down my fork before the next
And tell my wife how good she looks.

Those are words written by Joseph Gascho, professor of medicine in the division of cardiology at the Penn State Milton S. Hershey Medical Center and member of the Doctors Kienle Center for Humanistic Medicine, a unit of the Department of Humanities. Gascho, whose poem was published in the “Journal of Medical Humanities,” has merged his interests in medicine and the arts to create a series of compelling projects -- some on permanent exhibit -- that serve as a reminder that patients are human beings with full lives outside their medical conditions.

It started in 2004 not with poetry, but with photography. Gascho began to visit his patients in their homes and communities, spending time discovering them as people, then capturing them with his lens.

“Patients are generally very happy to participate,” said Gascho.

Gascho captioned his photography with the abbreviations, acronyms and language of medicine. For example, a photo of a man at home with his wood carvings is captioned “81M; S/P 5V CABG; HTN; hyperlipidemia.”

The message: It’s easy for a physician to see only symptoms and a diagnosis, a scientific problem to solve. But that’s a narrow view. As Gascho explained, “These images help me see my patients as persons. When that happens, I become a better doctor. I can more accurately interpret symptoms, more clearly explain medical issues and better tailor treatment.”

Fred Richter agrees. Richter of Annville has been a heart patient of Gascho’s for 10 years and was photographed with his bicycle. “I’m not just a number, I’m a person. He knows what I like, where I live. It creates a healthier environment.”

Gascho’s photograph of Richter and others are on display at Penn State Hershey Medical Center, where it clearly has an impact.

“It is one of the most creative humanitarian projects I have ever seen,” said Kimberly Myers, associate professor in the Department of Humanities at the Penn State College of Medicine. “His work combines his professional medical training and his expertise as photographer and poet to edify individuals, our medical center, and the communities beyond—where his patients live.”

Gascho brings his philosophy to his position as director of the medical center’s Cardiology Fellowship Training Program. The three-year program trains the next generation of cardiologists, taking doctors fresh from their medical residency and into a busy schedule of seeing patients, reading tests, doing procedures and conducting research. Penn State’s program is highly competitive with more than 500 applying each year for five spots.

Gascho has directed this program for 23 years and worries about young doctors, afraid they will neglect the human side of medicine. “I see them coming in from their medicine residency spending so much time trying to grasp the science,” he said. “It’s easy for them to forget these are people with heart attacks not just heart attacks. My hope is that people in training can reflect a bit on treating more than just the disease and not forget that these are people.”

Gascho makes humanistic medicine an informal part of the curriculum, incorporating it into some lectures, explaining he aims for a “role model kind of teaching.”

In another project, Gascho combines the echocardiographic images of patients’ hearts with poetry he writes about a person whose test results he is interpreting but has not met, as in the above quoted poem.

His latest project is a work in progress, taking photos of his patients and often their spouses in his clinic. He superimposes on the photograph their thoughts that day, as well as his own. One subject in this project is Jim Thomas of Hershey, Gascho’s patient for three years. Thomas calls Gascho “gifted” and explained, “A good doctor is attuned to the personal aspect. I’m a big admirer of him as an artist and as a physician.”

Added Myers, “The impact of a specialist interacting with patients in such carefully considered ways is significant for the patient; it transforms the doctor-patient relationship altogether.”

This story is from the fall issue of Penn State Outreach magazine.

  • Click on the image above to view the fall issue of Penn State Outreach magazine.

    IMAGE: Penn State

(Media Contacts)

Last Updated November 18, 2010