Fetal and Breast - Treating the Human Behind the Ultrasound

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Dr. Hakalur: “I’m doing ultrasound everyday and I believe in technology and especially fetal ultrasound, gynecology, and breast ultrasound. I like to have the most modern equipment all the time so I deal a lot with modern technology, but I think at the same time, it’s important to see the human being behind it. For example, if you do a fetal examination and find a malformation which may sometimes take only five or ten minutes to find, we always take the time to talk to the people, get in contact, and feel what the people are feeling and thinking. We have different discussions, not just one discussion, to tell the result, which may be bad. The same happens in breast ultrasound and different methods so I think the human behind it is as important as the technical progress and the technical method. 

There are several feelings and several moments where I’ve strongly felt that this was important. For example, I’ve done a fetal ultrasound on a lady who came to me, she didn’t know me before, and she came in because she was diabetic and was afraid of malformations - heart malformations, for example, and I checked her. But the moment she came into my room, she said, “This is the right place for me, I feel good, and you’re the doctor that should treat me.” I asked her why, and she said, “First, in your department you have all these pictures, images, and photographs of North American Indians, and it looked very friendly to me. I lived for a while in the states together with North American Indians, I got pregnant, and I was afraid of the pregnancy and of the problems because of my diabetes. I was telling this to a Chief of one of these American Indians and he told me, “Don’t be afraid, I have a good feeling that you will find somebody in Hamburg, Germany” where she originally lived, “and who will treat you fine.” Then he took a stone out of his pocket and gave this to the lady. He told her to take this stone and if she found a doctor she felt was the right one, to give him this stone, and if the stone gets warm after a while, then he’s the right man. 

She took the stone out of her pocket and gave me the stone. I took the stone and after about two or three minutes, the stone was really warm in my hand. She said, “First I had this feeling coming into your department seeing all these North American Indian photographs and now I have the proof that you’re the right one and you have to treat me! You’re the right man for me, I trust in your equipment as well,” she said, “because I see it’s very modern equipment and it looks nice. I trust in the things behind it as well and I believe in the things behind it,” she said. So I treated her, and I checked her many times by ultrasound. I checked her by gynecological examination as well, and I delivered the baby. She said, “You must be there.” She believed in that, and the second feeling I had as well was with a different lady. She came to me because she had breast cancer and she said, “Now I want to have an ultrasound because I don’t trust mammography anymore.” This apparently was overlooked by mammography but she was operated on and she had to have check-ups after that. She said, “No, I don’t want to have the check-ups done by mammograms anymore, I want to have the check-ups by ultrasound. I was referred to you and now that I see your department and I see the warmth in your department, I get the feeling from this point of view it’s right. I see all this equipment and they look very modern so I trust you.” Then she asked me again if I had a stone. Months before I got this stone from the other patient so I said – yes, I have a stone because I always have this stone with me in my pocket on the left side because it’s the side of the heart. She took out of her pocket another stone and said, “Look, these stones looks similar so maybe you’re the right one.” Then she told me the story about her stones, “I was very down after the operation of the breast cancer. I was sitting in my shop,” she runs a book shop in Hamburg, “and this lady came in that I never saw before, and she took a stone out of her pocket. She put the stone on the desk and said, ‘Listen, this is the stone for your health,’ and she disappeared and I didn’t hear from her anymore. Now I have the stone,” she said, “and you have the stone and we both know I’m the right patient for you, and you are the right doctor for me.” I treat her now and look after her by all of these examinations so it’s not only that I believe in stones but I also believe in development and in medical progress. 

I believe in very modern equipment; I’m keen, I have six Doppler machines in my department. I’m keen to have the most modern equipment. I run all of these things, I do fetal therapy with laser and these things but I believe on things behind as well. I believe in the human touch, in the human relationship, and I believe in physical things that happen between different people. I think this is as important for their health as the correct modern treatment and correct modern diagnosis.”

Terry DuBose, M.S., RDMS, FAIUM, FSDMS: “That’s wonderful, Dr. Hakalur, I really appreciate that. This is from the 8th World Congress of the International Society of Ultrasound in Obstetrics and Gynecology. Thank you very much.”

Dr. Hakalur: “Thank you.”