The Optimized Doctor



There is little to want for living in San Diego, America’s Finest City. The weather here is 72 and sunny year round. Yet, there are shortcomings. For one, there are no Forsythia. Forsythia are the deciduous shrubs that act as the harbingers of spring, blooming brilliant yellow across cold gray damp parts of the United States right now.

forsythia KiHoon/Getty Images

I grew up in New England where Forsythia bushes flower this time of year – a most welcome sign that the winter’s worst was over. Along with the purple crocus plants popping up in the warm bits of grass that breaks through the snow, seeing the Forsythia bloom always evoked that most appealing of feelings, hope. Hope that the discomfort of winter has passed. Hope that the beauty of nature will return. A promise that this year’s cycle of life will continue.

Hope is what we give our patients every day. Whatever their disease, their cancer, their distress, we can see a future that is better for them. A future with less suffering or with more joy. And as their doctors, we can help them get there.

A newly insured patient came to see me today. She had severe psoriasis. Her face, masked with red scaly patches, was heavy with the burden of the long winter she had endured. She was itchy and flaky and so embarrassed as to struggle to make eye contact with me. When I told her that we could help her, that there are treatments for her that would clear up the psoriasis and relieve her symptoms, she started to cry. Her husband intervened, apologizing for her. “I’m sorry. She has had this for so long, and you are the first person to tell her that she can get better. You have given us hope.”

Rhode Island flag, hope Milenius/Getty Images

When I walked back to my office I noticed the Rhode Island flag that I have mounted. Under the stars and blue anchor on it is the word “hope.” In 1664, when the state seal was created, it was the most important of ideas. It is why the settlers of Rhode Island risked their lives to cross an ocean to start anew, why my ancestors came from Italy two centuries later, why my parents sent me to college, why I decided to try for medicine. It is what most of us give every day. Hope, the ability to see into the future and bring that feeling back to the present. The belief that whatever and wherever you are, soon it will be even better. It cannot, however, be commanded. You can’t insist a patient hope any more than you can make them love. You must first understand what they see and feel, then show them how things might be better through trust.

Dr. Jeffrey Benabio, director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego.

Dr. Jeffrey Benabio

Throughout life, hope creates possibilities. It unites us. It motivates us. It is the destroyer of winter and of burnout and of disease. It is one of the most important gifts that we give patients, and we do it everyday. Tomorrow in your practice, notice how often you foster it. Pay attention to how your patient changes the moment you give it to them. Watch the Forsythia bloom as you reassure them that their spring will return again.

“We must accept finite disappointment, but never lose infinite hope.” – Martin Luther King Jr.

Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at

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