Back to Basics: Emphasizing the Compassionate Side of Medicine

Steven K. Shama wants your doctor to give you a hug.

The Boston dermatologist just left his job as Instructor in Dermatology at Harvard Medical School (HMS) and scaled back his private practice to write a book and travel around the country as a motivational speaker.

Shama says that, stressed by HMO's, malpractice suits and regulations, physicians have forgotten the joys of medicine. He wants doctors to remember what their job's are all about: compassion and humanity.

"We're doing less of the caring kinds of things we should be doing in medicine," he says. "We look for the broken part, we don't look at the whole."

Now, he aims to reverse the trend--one inspirational speech at a time.

Shama, who has been affiliated with HMS for over 20 years, has given more than 100 workshops and speeches around the country since he started in the motivation business five years ago.

He now has a promotional brochure ("Dr. Shama's inspirational, fun-filled programs will give you hope and teach you constructive, easy ways to make positive changes in your life as a health care provider," it claims), folders of testimonials from satisfied customers and a growing draft for a book on his philosophy of medicine. His suite of prepared talks and role-playing workshops now go for $1,000 to $3,000 a pop.

The Philosophy

Judging from a keynote address Shama gave at the annual meeting of the College of Osteopedic Surgeons in Boston on Sept. 21, his speeches are a mix of personal storytelling, inspirational quotations and warm fuzzy rhetoric.

In "Rediscovering the Joys of Medicine," he describes how he lost--and rediscovered--the satisfaction of practicing medicine and how his colleagues can learn from his experience.

In his rousing conclusion, Shama leaves behind his gentle, fatherly style in favor of a more spirited outcry. "At the end of your life if someone should say to you 'Have you lived your life out loud,' I hope you say, 'OH YEAH!' " he says.

Along the way, the audience hears stories of his work at Harvard hospitals, such as the time he called a colleague just to tell him that a patient said he had a friendly bedside manner.

Dr. S. "Jay" Jayasankar, an instructor in Orthopedics at HMS who leads workshops with Shama, says doctors listen to Shama because he understands their difficulties.

"Many people connect easily at the disenchantment level," he says. "He reaches people through the empathy factor. Then he shows them that there is so much to enjoy; there's so much that we do that's fun."

Catharsis

The talks are certainly crowd pleasers.

Three months after hearing Shama talk in Hawaii, Dr. Lawrence J. Eron can still rattle off each of the three strategies Shama preaches for enjoying medicine more. He says Shama reached him personally and made him part of the presentation.

"He could make you feel a part of things even though I think there were between 50 and 100 people in the room," said Eron "I think what you see is what you get also. He doesn't just seem to have a facade of warmth."

Participants say Shama's smaller workshops, which teach doctors how to deal with difficult patients, allow them to explore the material in an even more personal way.

"The workshop had a really very cathartic and therapeutic quality," said Dr. Frederick A. Pereira '64, a New York dermatologist who attended a Shama session at a meeting of the American Academy of Dermatology. "It's very, very funny to laugh at yourself and laugh at others in this very safe role-playing environment where no one is threatened. It has a certain touchy, feel-good quality about it."

The Pro-Circuit

The number of full-time medical motivational speakers is hard to estimate--less than a dozen, say a number of doctors on the professional speaking circuit.

Many doctors give speeches part time, like Dr. Andrew T. Weil '63-'64, the alternative medicine expert and Dr. Fred Allen Jr., son of the comedian. But the number of part-time speakers is also small; only 12 of the 4,000 professional speakers registered with the National Speakers Association describe themselves as giving motivational talks on medicine.

Karen Buckman, a registered nurse who has worked full-time as a speaker for 10 years, says doctors who attend medical conferences expect to learn practical medical skills for the their conference fees.

"Doctors will pay big dollars [to learn] how to read a reading off of a ventilator or how to read an acid-base imbalance, something that's a measurable, hard concrete kind of skill," says Buckman.

But she says the same trends that create a need for motivational speakers also make it hard for doctors and nurses to find time to attend their sessions. She cites a speaking visit to a hospital when she had to give 20 separate five-minute presentations at nurse stations, because the nurses did not have an hour to spare for her lecture.

Those on the circuit say they must counter the impression among doctors that they're selling snake oil, says Carl A. Hammerschlag, a New Mexico psychiatrist and motivational speaker.

"There are motivational speakers out there who do this...holy roller routine," Hammerschlag said.

But Hammerschlag says motivational speakers offer doctors a much-needed chance to get in touch with their emotional sides.

"Doctors tend to be heavily into the scientific modality," he says. "Medical audiences tend to have a great reluctance to think about the ephemeral, intuitive feeling aspects of being."

Part-Time Teacher

These days Shama continues his work at the Medical School, instructing residents in his office and giving lectures. For instance, next Wednesday he teaches 60 second-year students the basics of dermatological diagnosis. He also maintains an active part-time private practice.

In his office study near Beth Israel in suburban Brookline, Shama is far from the "6 foot 6 big hulk of a guy" that he claimed to be in his recent Boston talk. He is balding, well under six feet and a little goofy looking in the picture of himself in a clown suit that he keeps near the window.

His desk is covered with a collection of inspirational books. The bookcase is filled with dermatology texts, and the walls hold his degrees, including a Master's of Public Health conferred by Harvard in 1974.

Shama now spends half of his time in his study preparing his speeches and his book, Stories from the Doctor's Dining Room as Recorded on Paper Napkins, which he hopes to have finished next year.

He eagerly lays out enormous, pink paper napkins, on which he has scrawled his book notes, as he explains that every motivational speaker has to have a book, but he writes from the heart.

"I have to write the book because it's an expression of who I am," he says. " It's not the book that's gonna get me places, it's who I am."

The long-time doctor now says his true aspiration is to give sterling speeches that will affect his colleagues' lives.

"A good speech is like a beautiful piece of music," he says. "It will last forever. People will want copies of it--want to listen to it over and over again. I wish most of us had no time for idle conversation. I wish everything we said was recordable."