Hemming provides narrative essay for JGIM

Thursday, December 1, 2016

Post submitted by John Patrick Hemming, MD, Medical Instructor, Duke General Internal Medicine.

As physicians, most of us regularly hear experiences from patients that are intensely personal and may be challenging to our own worldview. Just published online in the Journal of General Internal Medicine, I have written a piece about one such personal encounter. It is entitled “A Gay Couple meets their Mormon Doctor.” I wrote this piece to highlight how larger societal debates enter into our exam rooms in surprising and unexpected ways and how important it is that we react with sensitivity and understanding.

In this essay, I describe an encounter with two of my patients where it becomes clear that we share one particular element of our life story: the religion in which we were raised. This came as a surprise to both of us—him, a married gay man who finds himself at odds with the religion, and me, a married straight man who remains religiously active. In the essay, I examine a multitude of simultaneous contradictory possible reactions before settling on my response. Likely, each reader will come to a different conclusion about my interaction with Sam and Tom. I believe this diversity of reaction is a good thing.

"As physicians, most of us regularly hear experiences from patients that are intensely personal and may be challenging to our own worldview."

I wrote the essay after attending a great workshop at the annual SGIM meeting about writing narrative essays in medicine. I felt compelled to write because of two factors:

First, I wished to address the place for religion/spirituality in medicine. I have studied and written original research and a review regarding the ways in which enquiring about patients’ religious or spiritual beliefs helps foster understanding and trust between patient and provider. This trust comes in part when we acknowledge and validate the beliefs and practices that are most important to them—even when we do not share the same world view. We ask about these beliefs because they often guide patients’ decision-making, help patients cope with their illness, and help them make meaning out of their lives. I believe in welcoming and affirming patients’ beliefs as they relate to their medical care. This applies to patients who are not overtly religious, and requires sensitivity to those who feel that they have been harmed by religion.

Second, I wanted to add my voice to the very important current public discourse over the rights of Lesbian, Gay, Bisexual, Transgendered, and/or Queer (LGBTQ) individuals. I feel that our society has benefited greatly from reversing longstanding marginalization and stigma over sexual orientation and sexual identity. I respect and support those LGBTQ individuals exercising their right to live free of discrimination, marry, and start families. I also understand and respect many traditionalists who worry about the societal impacts of these changes, positions that may be informed by their religious beliefs. I am not excusing anyone’s actions or advocating a particular public policy. Rather, I am advocating for dialogue that rejects caricatures and stereotypes and is open to the complexity that each of us brings to this discussion.

I hope that you’ll take a moment to read “A Gay Couple Meets Their Mormon Doctor.” I look forward to reactions from you, my General Internal Medicine colleagues.

Email: Patrick.Hemming@duke.edu

Full Citation: Hemming, P. J GEN INTERN MED (2016). doi:10.1007/s11606-016-3925-6
This article appeared online November 23, 2016, as ePub ahead of print in the JGIM section "Healing Arts: Materica Medica". [Link

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Learn more about Dr. Hemming in this faculty spotlight from October 2015 or in this DukeHealth video