Dr. Abraham Fuks completed his medical training at McGill, specializing in internal medicine and clinical immunology, as well as a postdoc training at Harvard in the fields of immunogenetics and histocompatibility antigens. Not only is he a McGill grad and professor, Dr. Fuks also served as Dean of the Faculty of Medicine at McGill from 1995 to 2006. Dr. Fuks has done research and teaches about the language of medicine and its metaphoric structure, notably the impact of language on the physician-patient relationship. He has recently been named to the Order of Canada for his many contributions to the advancement of Canadian medical research, education and scholarship.
Words are like drugs: they have benefits, they have toxic effects. And we as physicians need to learn how to use words, in the same way we learn to use Digoxin: what’s the right loading dose, how much do you give… The more potent the drug, the more potent the side-effect. Words are the same: words that have the real power to heal, may in other circumstances have the power to harm.
Dr. Abraham Fuks
We discuss:
- Dr. Fuks’ medical training, career, and how he came to be interested by the language in medicine (1:16)
- Insight during years as practicing physician and Dean of the Faculty of Medicine at McGill that led to working on the physician-patient relationship:
- Insight from students while being the Dean of the Faculty of Medicine at McGill (6:50)
- Notion of physicianship, the physicianship curriculum (8:40)
- Relationships in the hospital, in the clinic; the triangle physician-patient-student (9:57)
- Article by William Donnely (1986), about the language and discourse of the hospital and clinic (11:10)
- Dr. Fuks’ meaning for mindfulness, a polysemic word (12:25): Zen, a modality of wellness, of self-knowledge, mindfulness training for patients.
- The mind’s effect on blood sugar levels (15:00)
- Dr. Fuks’ interest in mindfulness: the awareness of a physician and patient in a relationship, the interactive mindfulness (17:44)
- Living inside language (18:55)
- Connection of mind and body (21:40)
- The placebo effect: a pharmacology of words (22:40)
- How does a physician learn to choose the right words with a patient? (24:45)
- The use of “something” versus “anything”, a clinical example (32:30)
- Can the practice of mindfulness help us become more aware of a patient’s reaction to our words? (34:40)
- The importance of practicing with the patient (35:30)
- The importance of feedback, and getting better at what we do (37:00)
- Psychiatrists using their own reactions to understand what’s going on with a patient: sensitivity to the other is an important index of clinical effectiveness (39:00)
- Patient-centered? Why not patient-physician relationship-centered? (40:00)
- Patient empowerment? What does that mean? (43:30)
- The collusion of anonymity (45:36)
- The idea of reflection, and reflective engagement (46:40)
- Being present, listening actively, showing that you care, and asking questions to get to know the patient (48:00)
- The physicist versus the physician (49:13)
- Taking the history (51:26)
- Short paragraph from Olive, Again, a novel by Elizabeth Strout (52:58)
- The magic bubble (60:40)
- Physician presence = Awareness + Focus + Attention, with the intent to understand and connect with the patient (62:29)
- Language and mindfulness (64:04)
- Clerkship: a study in language, awareness, and mindfulness (66:00)
- The value of humanities in medicine (70:40)
- Pearls for the medical learners (73:50)
- Enjoy what you do, enjoy the privilege we’ve been given as physicians
- Respect the privilege we’ve been given
- Learn to be humble about it
- The power of listening: “Learning is speaking, teaching is listening”
Follow Dr. Fuks & recommended resources
- The Military Metaphors of Modern Medicine, by Dr. Fuks (2010) (Available as a PDF below)
- Joining the club: Student stories collected by Dr. Fuks (2018) (Available as a PDF here)
- Keep an eye out for Dr. Fuks’ book, The Language of Medicine, coming up by the end of 2021
The Mindful Medical Learner 