Abraham Verghese: A doctor's touch

www.ted.com Modern medicine is in danger of losing a powerful, old-fashioned tool: human touch. Physician and writer Abraham Verghese describes our strange new world where patients are merely data points, and calls for a return to the traditional one-on-one physical exam.
TEDTalks is a daily video podcast of the best talks and performances from the TED Conference, where the world's leading thinkers and doers give the talk of their lives in 18 minutes. Featured speakers have included Al Gore on climate change, Philippe Starck on design, Jill Bolte Taylor on observing her own stroke, Nicholas Negroponte on One Laptop per Child, Jane Goodall on chimpanzees, Bill Gates on malaria and mosquitoes, Pattie Maes on the "Sixth Sense" wearable tech, and "Lost" producer JJ Abrams on the allure of mystery. TED stands for Technology, Entertainment, Design, and TEDTalks cover these topics as well as science, business, development and the arts. Closed captions and translated subtitles in a variety of languages are now available on TED.com, at www.ted.com/translate.

[@PepinoMichoacan]

As a med student, this was really inspiring and enlightening. Thank you for the hindsight.

[@trackstar117]

did u graduate

[@nicholashaynes3483]

I imagine by now you’re a doctor? Haha. I’m a first year med student and just watched this - am very inspired by it too

[@SandraNevermind]

This man's comforting voice, intellect, and writing/speaking prowess are incredible. We'd all be lucky to have a doctor like this.

[@cjmatviyak6606]

Cutting for Stone is one of my top favorite books. Unforgettable read. Beyond my words of praise.

[@cokiewestfall8878]

Dr Verghese is so much more than a physician (albeit being a physician is admirable), he is a tremendously merciful compassionate human being.

[@maximosimonelli]

I´ve been a doctor for 10 years in Argentina, and I grew up as a professional inspired by great teachers and their "old school" methods... this video provides no "original" information to me (great argentinian phisician and writer Dr. Maglio always says "touch the patients!")... nonetheless is an excellent guide to youg phisicians and med students, because everything Dr. Verghese says is sadly true... as an atending phisician and med school professor I support his ideas completely. I´ll make sure my students watch this. Thank you Dr. Verghese!

[@tracyjames2046]

This moved me to tears, how beautiful, how incredibly important, how very human and wise and tender. He is a great human being in my view.

[@criscarmi1635]

He’s also a great writer. I highly recommend reading Cutting for Stone, his first book, a wonderful story filled with all the attributes you described finding in Dr Verghese.

[@nansmith8703]

Oh he is… he is. And you should read his writing - what a genius.

[@reechashreedhungana2575]

I am a final year medical student preparing for my exams and this Ted Talk is so empowering. I will never forget this message in my entire career as a doctor! Thank you so much. 🙏🏼

[@vinayak9202]

Amazing video.. .. I am a doctor from India and I must say that clinical medicine with an intense emphasis on diagnosis and touching the patient still exists in my part of the world ( thankfully) especially in the low funded government hospitals which overflow with multitudes of patient and yet effectively mananged by skilled physicians. However it will not be long before money pours in , the MRIs make their way in and we go the american way. Treat the patient and not just the disease.

[@vigneshk5915]

well said vinoth rengan...we are glad that we did medical school in india

[@sangeetharv3332]

bro how are you .are you the one in speed med institute ad?

[@sallyray515]

Please Vinayak ,don't go the American way. This is why ,I, as an American woman of a certain age have finally learned to always question before taking any long-term medications or having any surgery. I suffered from debilitating migraines for years and years and obediently took various pharmaceuticals which did nothing but drain my money and my soul. The remedy to my migraines lay in a lowly weed that grows in just about everybody's backyard. Why hadn't just one-just one of my "well paid, well educated "American physicians have known this? Now, I never go anywhere without a teabag of feverfew leaf in my pocketbook in case I feel a headache coming. Physical Cost? nothing really Real cost? A growing awareness of the American public that our "healers" seem to be becoming servants of the pharma/banking/insurance cartels.

[@chrisde28]

Very well said!

[@shalininair453]

Absolutely 💯 Unfortunately the medical field is going the corporate way..sadly it'll end up not being the "noble" profession it used to be😌

[@SharonTuckerDuarte]

If only EVERYONE could have a Dr. like this.

[@ezgi8684]

I’ve watched this in one of the times I felt desperate about my career as a doctor 👩‍⚕️ Thank you, it helped me to realize there still are good people and hope.

[@mehrnaz4288]

One of the best TED talks ever.

[@umerbinshabir9819]

There is magic in his voice,the moment you start watching his lecture you never want it to end❤️

[@youreokay7888]

My third time watching. Tears streaming down my face at the end, as always. Thank you, Dr. Verghese.

[@JanieJustice]

WOW this doctor is totally right on. Before I was diagnosed with stage 4 cancer last year, I spent the 2 years prior to my diagnosis, going to at least 8 health care providers in an attempt to find out why I was having increasing and eventually crippling fatigue. Nobody got my diagnosis correct, and when I was diagnosed, it was by accident when I was getting a CT scan of my lungs. During the scan, it clipped my liver which showed 16 metastatic liver tumors. Each time I would go for a medical visit, I felt like they weren't truly listening to what I was saying, and often entered the room with a diagnosis already in their head. I was rarely touched. Nobody could enter the room with a clear mind, to find out my true story that was unique to me. I think the biggest lesson I learned from this personal experience and working as a RN for 30 years, the pace of office visits need to be slowed down, patients should be touched a lot more, and providers truly need to listen to their patients.

[@Oddismo79]

Amazing, a lot of strength and remember that you will never be alone

[@jkstubbington]

Thank you so much for sharing and I hope you are well 🙏🙏🙏

[@Safiya0759]

I'm a PA working in South Sudan where we can't rely on electronic gadgets to diagnose a patient's disease. I'm fortunate to have been gotten a good education at Hahnemann University where we learned to narrow down a diagnosis by doing a thorough physical exam and taking a good history. I would not want to work in a hospital in the US today as it seems so impersonal on so many levels. All to CYA in case the patient wants to sue. However, we all have learned that a good medical care combined with good bedside manner and showing true care and concern for your patient will be the best way to protect yourself from being sued.

[@theywalkinguptoyouand4060]

I don't believe in practicing defensive medicine. BUT unfortunately, care and concern is not always the best way to protect yourself. As a doctor, I have had so so so many patient whom I have worked hard on, cared for, lost sleep over, and yet they treat me as if I do nothing, they blame me if they don't see perfect results. It is now popular in my country for patients to post their doctor's personal info, pictures and badmouth them on social media if they are not happy with them. As doctors, we treat and care for people whether they are good people or not. Be good to your patients, but make sure you have a good lawyer on hand as well.

[@davidsmith318]

As a current patient in a neuro ward after 7th spinal surgery for tumour. This is a very powerful listen and I would love to share this with everyone. ❤

[@sharmakvinod]

CONGRATS DR VERGHESE.You are really a wonderful GEM

[@suneilkumar]

4th year medical student here: despite the new rules and regulations, this video reminds me to never lose sight of true medicine.

[@henk-3098]

how's life as a doctor?

[@eduardomacedo7126]

I ask that as well!

[@sangeetharv3332]

Being a upcoming doctor , I look up to this man .loving His book "cutting for stone "

[@infectdiseaseepidemiology2599]

Sangeetha RV I so agree, as a professor in a major medical school.

[@mutation64]

My Boss made me to watch this extraordinary video when I was resident, been watching every now and then, it's so powerful and changes the way we understand the medicine...and now I tell my residents to watch this on their first day and I made it a " ritual "

[@homerilias]

What a human being this is and how deep he sees into the heart of a suffering person.

[@donnaterrell938]

I love this man, he is a wonderful writer and human being, I hope to meet him one day,

[@QenLeadership]

Be Present: works not only in medicine but in all corners of life. Great speech.

[@tarsila6406]

One of the most beautiful lessons I've listened to. Congratulations!

[@jennifer4625]

A remarkable speech! I am teary in the coffee shop where I am listening to this.

[@kimberlykaminski2115]

14:15 Rituals are all about transformation... this is powerful... wonderful talk

[@TiticatFollies]

O Excellent! Wonderful human and physician, eloquent speaker and thinker! A beautiful testimony.

[@sashakid]

just beautiful ... wish all the doctors felt and understood their patients the way Abraham Verghese does :]

[@karraralgburi8937]

This what I always feel and encounter as a doctor, all of these advances in diagnostic imaging and laboratory tests has striped us from the very one important thing in our job, which is the bonding and communication with our patients

[@ashtontacey2735]

I completely agree with Abraham. With the advances in technology over the years, it seems that that there has been a loss in the patient/physician relationship. More often than not, patients are briefly speaking to doctors that are staring at a computer screen. Patients need the type of doctor that will not rely purely on the machines (such as MRIs and CT scans) to do their work, they will also use the tool of touch and communication to diagnose patients. If I were a patient I would want a doctor that makes me feel comfortable, well-informed, and taken care of. One of the quotes from this video that will stick with me is, "I will never abandon you. I will see you through the end." This perfectly describes the type of doctor every patient should be dealing with, someone that will always be looking out for their best interest and that will do everything they can to help them. In order to do this, we do not have to take technology out of practices/hospitals but we do need to begin treating patients as we would want to be treated. The Occupational Therapy field exemplifies this well. An occupational therapist can help a patient recover by getting to know them, using "hands-on" practices, and gearing each therapy session toward the specifics patients needs and interests. This helps a patient engage and feel optimistic about their health condition. I have seen this type of work first hand when my brother was in a car accident. He was paralyzed from the neck down and the doctors told my parents that he would never walk again. By hearing this my brother was discouraged but when the therapists came to help him, they told him they believed in him, they began bringing in his favorite things to aid him in therapy sessions (such as a guitar to try and re-learn how to use his hands again). The positive communication and hands on therapy gave my brother the strength and courage to move forwards. He is now walking today, despite what the doctors said. I firmly believe in the power of touch and communication and how it positively affects the health of patients.

[@Bubbles-lp2cv]

I definitely support Dr. Verghese and his perspective on our doctor-patient relationships in healthcare, today.

[@Bubbles-lp2cv]

+Bubbles 007 He makes a valid point when he mentions that doctors, today, spend more time attending to the needs of the patient on the computer rather than examining the patient physically. I feel communication has been lost between our doctors and patients. This lack of communication creates uncertainty as many doctors rely on new technology and software to find answers instead of asking the patient. Dr. Verghese noted that when he made rounds in medical school, numerous physicians were surrounding the patient and consulting with the individual. Today, many physicians consult with each other in a completely separate room. In my mind, the patient is essentially being left out from the medical experience and consultation that the doctors are engaging in in another room. I personally believe that we need to build stronger doctor-patient relationships by promoting more physical examination and consultation of the patient, rather than solely relying on technology and numerous tests to find all of the answers. In order for a patient to get the most out of their medical experience, they must be involved in the process. Don’t get me wrong, technology is a very important aspect in the healthcare system. I just feel that doctors have become so absorbed in the technology, that they forget the basic roots of what a doctor should do with their patient. Therefore, the healthcare system needs to establish a balance between medical technology and personal patient examination.

[@kashmeera6786]

Wow, deepest blessings to you; such love and integrity

[@fazulmohamed7627]

Thank You, Professor! ❤️👏

[@mary-alisonblackwell7737]

It is enlightening to see such a passionate insight on a physician-patient relationship; something that is not popular to talk about. Great video! Inspiring.

[@ahmedal-obaidi8305]

This video is so inspiring to all the younger physicians out there! Thank you Abraham.

[@traceysouth1047]

I pray that remains with you , always.

[@DhanurBalagere]

Very beautiful talk ..... well articulated and clear in its message

[@DrMichaela28]

Thank you for reminding me of this 💛 God bless you!!!

[@TimmyInTarky]

This was so awesome speach. Wished my doc was like him.

[@AoneDitirwa]

Kept snapping my fingers throughout this presentation like its spoken word. So powerful and profound. Watching in prep for a medical ethics final exam tomorrow based on this clip

[@traceysouth1047]

AWESOME ! I hope there are people in the health care professions that see this video and think of ways to incorporate at least some of it , in their roles as caretakers of patients.

[@mimalavi00]

Nice speech. This is the part of the medicine we have lost. The best TED talks I've seen

[@popaddict]

Remarkable talk and so good to see that there are physicians out there who care about the patient as a human being. Here in Sydney, where I live, medical centres are full of doctors that "process" patients like cattle. The GP I used to go to barely even let you finish explaining your symptoms before he was filling out the prescription.

[@mtsds7799]

As a physician of 33 years I have lived through some of the transition that Dr. Verghese describes. His final example was an interaction with an AIDS patient in which the patient physician relationship was of primary importance and value. With the scourge of opioid addiction which we are currently experiencing, that same patient centered approach will serve us well as we come to the side of our patients while we work to re-define the generators of their pain, explore alternatives and adjuncts to treatment and down-titrate their opioids to improve our patient's safety. We may provide comfort as we convey that we understand them and will be with them through their journey toward wellness.

[@lucindawilson5510]

thank you

[@Mehmet-Kim-Yon]

My life is never gonna be the same anymore. Thank U

[@salmatayeb39]

As a practicing physician,I see this an empowering experience, thankbyou

[@cindyhalpern3187]

Just perfect!

[@qurat-ul-ainmunawar921]

It was so good and each and every doctor needs to understand this

[@mediconotes5599]

As a final yr med student, this was really enlightening and inspiring... Thanks a lot, Sir!

[@Oddismo79]

Fuerza en tu vida de medico

[@antoshahorosha]

Brilliant, brilliant, brilliant.

[@alokvkulkarni]

Sheer brilliance of Dr. Varghese. Such concern for his patients! May his tribe increase.

[@TheVaibhav2489]

wonderful.discovered the power of touch.

[@nickynick11111]

Excellent!

[@drrameshpunjani9523]

awesome ! impressed to find someone emphasising on clinical examination when the whole world is mad after modern gadgets,

[@KenRoberts4KenTheRoad]

Bravo! Spot-on! Thank you! ---Ken

[@tenaciouswho]

Wow... That was excellent!

[@Wangari_Kinyanjui]

Wow!!! Now I know. Thank you!

[@rinkumodern43]

wonderful

[@mianmenu]

In my medical school in Croatia rounds still look like the ones from dr. Verghese's student days. I always thought that to be a harsh practice for the pacients, listening about his disease and all possible diagnosees and prognosees. But now I see that is not the case. Thank you dr. Verghese, you opened up my views.

[@MonkeyRecords]

I've always been quite healthy and I probably go to a medical doctor about once every ten years - I hope next time I get someone like this.

[@kumarswamymc433]

"..the ritual is cathartic to the physician, necessary for the patient" fantastic words, Abraham Verghese was born in Ethiopia, his parents are from Kerala, India, studied at Madras medical College, Chennai, India.🙏🙏🙏

[@chicochulo101]

Really inspiring

[@elisabethfahlmann9823]

Wow, what an amazing speech.

[@seherandac]

As a medical doctor, thank you very much with all of my heart. I really understood what you said. 😌

[@bolosgerges9485]

well said!

[@ptrottershoulders3474]

Amen! The power of the human hand !!

[@saudisandawy]

i'm a medical student and that is so much very freaking inspiring.....i'll try to adapt these rituals ^^

[@heis959]

Beautiful :)

[@nahal056]

I wounder why the dislikes.... I'm no doctor and I found it inspiring! Thank for sharing...

[@biancamallet8063]

Abraham also has a novel called "Cutting for Stone" and it's one of the best books I've ever read.

[@infectdiseaseepidemiology2599]

I use “My Own Country” as required reading for a class with 250 undergraduate students in a course on the intro to medicine and health at a major university. It is always so very well received by the students. I also highly recommend his novel, “Cutting for Stone.”

[@nan_c77]

Inspiring ...

[@juniperjean7508]

In one sense, this speech is very inspiring. In another, you can tell that the rhetoric used is very catered toward those whom appreciate physical touch. To have his entire Modus Operandi consist of including very interpersonal physical touch - regardless of the nature of the visit - without the least caveat to when (almost described as intimate) physical touch is not warranted, is to use rhetoric to its highest degree.

[@fernandatralala]

wonderful...........

[@ethelridajuanson5359]

I shared this with my brother, an endocrinologist with 3 sons who will be future doctors.

[@Hallibutbouy]

Exceptional. A doctor of the very highest calibre.

[@brazilianirishcomedy]

very good

[@7andrea2]

His first novel "in my own country." is a must-read

[@clintonelliott6673]

1st Year Medical student - Just got put onto this by a lecturer, and highlights the importance of the ritual and the doctor I want to be. :)

[@cameronchappell8265]

This is an excellent video, and something that, as an osteopathic medical student, really resonates with me. As healthcare professionals, it is our duty to ensure that our patients receive the best possible care. This principle is called beneficence, and it’s something that we are obligated to abide by when we decided to become physicians. I believe we can accomplish that obligation by using and becoming proficient in palpatory and interpersonal skills. We’ve come incredibly far with modern medical technology, but even the best algorithms depend heavily on the physical exam done by the physician. The future might hold smarter computers and AI, but I genuinely believe my job is safe because a robot can’t perform a physical exam. The physical exam is so much more than just using a tool to listen to a chest or look into eyes and ears. It includes listening to the way a patient speaks. How they interact with you and others. Even the perceived feelings you get from a patient. We as a species have evolved to read each other over millions of years, and that is a valuable skill we need to incorporate into our practice. I just want to add my voice to Dr. Verghese in saying that truly fulfilling our duty to our patients requires that we perform skilled physical exams on each of our patients.

[@DrThepandrex]

As a med student, this is really an excellent example of what you have to do as a Doctor, this was really inspiring and i will follow all this steps

[@jaytaylor7998]

How in the world do you down vote this? Such great wisdom that doctors need to hear!

[@TheJorjj]

That's a doctor very passionate about his work.

[@jane170]

I liked highlights you mentioned but sometime patients don't like to be touched !!

[@entdrferozkhan]

"Rituals" a deep thought connecting us to the reality of the virtual world and teaches the virtues from the real ones.

[@cowpacino]

good talk about the dehumanizing aspects of modern medicine

[@KobeB24]

This was very interesting.

[@user-kh6ur3ow1c]

What an incredibly inspiring talk. I agree with the idea of considering medicine a ritual and a practice that does not need to be heavily reliant on technology, imaging, and complex treatments. From its very beginnings, like Dr. Verghese mentions, medicine has surrounded the patient and put the patient at the center of it all. There is something to be acknowledged about modern medicine, and that is that thanks to its advancements, we have been able to diagnose, treat, and even eradicate the most rare conditions, improving the patient’s quality of life. Many of the treatments we do today can help reverse certain conditions, and bring hope and life to many patients. At the expense of these advancements has come the physical disconnect between the clinician and the patient. With advancements and ease of imaging and ultrasound, clinicians perhaps don’t need to touch the patient any more to get a feel of what diseases they might have. Again, although extremely powerful and even more precise than the human examination, we are missing a key component of human interaction, touch. Touch has a healing power, and to those who are in a vulnerable state of being, tough is perhaps the one treatment they are in most need of. It is sad to hear stories, like the one Dr. Verghese mentioned, about patients discontinuing their care at prestigious institutions because nobody intently touched them or contacted their body. I think touch has the ability to communicate without using words and to display the patient that they are seen, further, felt. This is a powerful technique and one that most likely strengthens a relationship with a patient in a way that tears down mistrust and disconnect. On an ethical lens, I think the healing powerful of touch promotes a sense that the patient is being seen and considered more than just their symptoms. At times in medicine, we get carried away by the signs and symptoms and forget that who we are trying to help and heal is the patient, not the symptoms. With touch, we are identifying that who we are working with is the patient, not a folder filled with imaging slides or lab results. In my opinion, this illustrates the ethical principle of beneficence, in that as a physician the power of my touch may convince my patients that I will do everything in my power to do good and to positively impact my patient’s life. As an osteopathic student, what sets my training apart from my allopathic peers, is that we spend countless number of hours having skin on skin contact that allows us to palpate and truly understand the underlying ecologies that might be presenting, just with the power of palpation. I believe this is a powerful technique that allows a physician to not only connect with their patients on a deeper level, but also gives the physician another tool to better diagnose a patient. I would encourage the viewers to seek more information on the osteopathic practice, if they are looking for a holistic approach to medicine.

[@toufuuu108]

Why no one recommended me this before, 😭 okay it's never late to start and realise and to learn.

[@Kestrelbubba]

Have been watching TED lectures for several years now and this is THE BEST I have seen. He makes the points, backs them with evidenciary material and nails every turn. This is not emotion,... it is logic applied to what is a deeply emotional issue... medical care... something between a doctor and a patient. Not being political... just a warning to DOCS... ya wanna be treated that way... then TREAT that way.

[@gilvanfilho1]

I'm hearing many times in the last few months since I started practising in a poor region in the Brazil Northeast: "I've never been examined like this before". When I hear this I realize we're being praised for just doing our obligation. That's sad

[@euclidesrobertonovaesdesou1591]

Excelent.

[@zirbat16]

wow this is a great idea

[@warforglory]

that's why kids you should listen to your patients and always do a thorough history taking / physical examination

[@cammameil]

i cried.

[@lohithtejasvi808]

In India we do still practice the same way

[@JLangx]

soooooooo very very very true

[@lovelittlecats]

I have just qualified as a nurse. In England hospital consultants are abrupt, snappy, and patients are an irritation between spending time with their mates on the golf course and their lucrative medicolegal work. My father lay dying in hospital. The doctor came in already angry, she bodged around roughly, couldn't find a vein then spoke rudely to my elderly mum and me. We wept together over my poor father's bed. How could she be so cruel. I will never forget her.

[@ZombieX13]

It makes you think what things we do now in medicine that will be considered absurd in 20 or 30 years or even longer.

[@54jb3r7]

I'm a medical student and all of this sounds really nice and ideal, but at least in Sweden where I'll most likely end up working there's typically no time for this.I hope it changes, it's quite frankly one of the main reasons that make me question my ambition to become a general practician.