Each Patient Is a Unique Human Being, Not a Disease or a Group of Symptoms

Physician Louis P. Voigt is a specialist in critical care medicine and a member of Memorial Sloan Kettering’s Anesthesia and Critical Care Medicine Service.

In October, Dr. Voigt was the MSK winner of the 2014 MSK Wholeness of Life Award. This honor is presented annually by the HealthCare Chaplaincy Network to individuals “who demonstrate respect for human beings as whole persons” in their treatment of patients, families, and colleagues, and who practice medicine “with an appreciation for the interrelated functioning of body, mind, and spirit in illness and recovery.”

Dr. Voigt is a strong believer in the holistic approach to medicine that the Wholeness of Life Award celebrates, and shares his expertise through his roles as doctor, colleague, teacher, and mentor.

Here, he talks with us about his work and his commitment to his patients and their families.

Can you tell us a little about what you do in critical care medicine?

As a critical care medicine specialist with a background in internal medicine and pulmonary diseases, my work focuses on patients in our Intensive Care Unit (ICU) with life-threatening conditions who are in need of close monitoring and frequent interventions.

How did you come to do this work?

I believe it began early in life. I grew up in Haiti surrounded by family — four sisters and two loving parents — all of whom instilled in me a profound awareness of the importance and the need to serve others. In my crowded but caring home, I also learned the benefit of having someone nearby, if only as a witness to your experience — someone with whom to share a moment in time. So I think I have an understanding of the great value inherent in simply being present and available to another human being, especially during moments of suffering.

This is obviously particularly significant when it comes to working with patients and families in the ICU.

It absolutely is. Patients and families often feel overwhelmed in the ICU by the respirators and other life-support machines, the infusion pumps, the monitors, the wires, and the alarms. I’m committed to helping patients and their loved ones through this difficult and emotionally trying time.

Suffering is a process that is similar whether you’re a poor person in Haiti or a patient at MSK. It’s a contradictory process; moments of joy and laughter sometimes appear in the midst of pain. But for the person suffering, there is generally a sustained need for the presence of another human being. And I believe in treating emotional distress as a true emergency.

Can you elaborate a bit more on that?

Certainly. I think it’s vital to engage all the resources we have to help patients and families when they’re in crisis. So, for example, I ask our social workers to meet with families to “make a diagnosis” — and by that I mean to try to understand how a family is coping when their loved one is in the ICU and what their needs may be.

I also ask our nurses and therapists to develop treatment strategies for our patients that go beyond dealing with their physical symptoms; in other words, strategies to support the people they are beyond their particular illness. In our ICU, each patient is a unique human being, never just a disease or a group of symptoms.

Finally, I encourage our ICU nurse practitioners and my fellow doctors to spend as much time as they can in the unit so that they’re as available as possible to both our patients and their loved ones.

A colleague who nominated you for the Wholeness of Life Award said of you that you “empathize with patients and help them see the end-of-life journey with clarity and less fear.” In the ICU you and your colleagues are confronted with death. Can you talk about this?

Possibly most important to patients and their loved ones during this final, singular event is that I make myself available to them. So in meetings with patients and families, my first question always is, “How can I help you?” And I listen to their answers with an open mind and heart.

People reach their comfort zones with the prospect of death at different speeds — and that’s true for my professional colleagues as well as for patients and their families. Sometimes staff members have a hard time letting go of patients who have come to the end of their journey. You can’t ignore or minimize these emotions. Instead, you need to focus on what was achieved during that person’s time with us. And, in fact, on what is achieved every day at MSK.

Although I am a frequent witness to the end of life, I also need to say that there are numerous times when we see a patient turn a corner, respond to treatment, and leave the ICU. There are definitely happy endings, and there are many survivors.

Any other thoughts?

I think it’s important to remind ourselves that at the end of the day, we’re all finite. However, in my opinion, none of us is simply an accident of nature. We’re far too interesting and complex to be random. Indeed, my father was a professor and taught me to look deeper, to see beyond the obvious and the immediately knowable, to look for what’s hidden and, often, quite significant.

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