Virginia Listens: Dr. Cowan's Story

Dr. David Cowan, Primary Care, Bainbridge Island

This feature is part of our “Virginia Listens” story series, which explores how our health care providers and patients are engaging in real conversations and individual connections that drive better care. Dr. David Cowan of Virginia Mason Bainbridge Island Medical Center reflected on the importance of being present with each person he treats.

Dr. David Cowan has always been drawn to islands, both for their natural beauty and for the “island mindset” of their residents. A full-time Bainbridge Island resident since 1991, he loves the sense of community that occurs when people in close proximity have to depend on one another.

Many of Dr. Cowan’s neighbors and friends depend on him for their primary care, and in family medicine he’s treated many multigenerational households. As with any interpersonal relationship, trust is key to being able to depend on someone. And Dr. Cowan believes that listening and understanding are the building blocks of trust. So much so that he has dedicated more and more time to studying mindfulness techniques.

“Virginia Mason’s motto of ‘each person, every moment’ is how I have tried to practice in my medical life, and more and more in my personal life,” said Dr. Cowan. “I’m trying to fend off all the other things that compete for our attention and just focus on the person in front of me. It takes some discipline, for sure, but most things that are worthwhile in life do.”

Sometimes focus on minor details can drive dramatic outcomes, as was the case with one patient who mentioned to Dr. Cowan that he had some indigestion and added as an aside, “My wife thinks my breath smells funny.” Some might blow this off as a non sequitur, especially since his wife had recently had a stroke. But Dr. Cowan realized that the wife’s stroke can cause heightened senses. He decided to investigate the early clues that his patient’s wife might be picking up on.

It turns out his patient had Stage 1 pancreatic cancer, which hadn’t spread. It’s rare to catch pancreatic cancer, which generally has a very poor prognosis, at such an early stage since significant symptoms don’t appear until much later. Dr. Cowan worked with expert colleagues at Virginia Mason Hospital and Seattle Medical Center to arrange a successful surgery, offering four years of remission until a recent recurrence prompted additional treatment of this stubborn disease.

“It all stemmed from taking his wife’s complaint seriously — of just listening and not judging,” said Dr. Cowan. “Being present allowed me to pay attention to nuance and consider all possibilities.”

Not every moment in health care is so pivotal, but they’re all important nonetheless. “Just last night, one of the nurses called me to say she had a nagging feeling that she should check on a patient after hours,” said Dr. Cowan. “Everything was fine, but I’m glad to work with someone who is present to their instincts and follows up on details.” It’s the Virginia Mason way to do the right thing, always.