Cell 2 Soul: The Humane Health Care Blog

Caregiving's Imperative

Arthur Kleinman's recent Perspective piece in the New England Journal of Medicine deserves a wide audience.  Unfortunately, full access is open to only NEJM subscribers or those affiliated with academic institutions.  If, after reading the following quotes, you want to read the entire article, please email me and I'll send you a copy.

picture from http://kennonsburgumc.com

"Modern medical practice's greatest challenge may be finding a way to keep caregiving central to health care. The moral core of medicine may seem abstract, until you see health professionals passionately struggling to be useful, compassionate, responsive, and responsible while working with the indifference of bureaucratic rules, the cold counting and costing of institutional audits, and hard-to-balance personal demands on their time and concern. 

Looking at medicine [as a caring vocation] reinforced my belief that the structure and demands of medical schools and hospitals create obstacles to caregiving. How to revivify caregiving in medicine became the issue. Teaching about illness experiences remains important. Yet the moral–emotional core of those experiences deserves greater primacy — as does the social suffering that affects everyone, but especially marginalized people already injured by poverty, isolation, and other forms of structural violence."

From Illness as Culture to Caregiving as Moral Experience
Arthur Kleinman, M.D.
N Engl J Med 2013; 368:1376-1377April 11

Dr. Rakesh Biswas alerted us to an article in the Stanford Medical Alumni Magazine about Kleniman and his work -- especially his recent epiphany.  See:  Medicine: A Love Story.  The past few paragraphs are especially important.

Story Telling and Dementia

Lisa O'Brien, of Williamstown, alerted us to an NPR piece which reports on how getting people with Alzheimer's and other forms of dementia to tell stories can be therapeutic.

"Storytelling is one of the most ancient forms of communication — it's how we learn about the world. It turns out that for people with dementia, storytelling can be therapeutic. It gives people who don't communicate well a chance to communicate. And you don't need any training to run a session."

See: "Alzheimer's Patients Turn to Stories Not Memories."

In our era of high tech medical care, here is another example of a low-tech intervention that holds promise without increasing the cost of care.

For more background about this program see:  TimeSlips.