The C2S blog draws on the arts, the social and biological sciences to explore the many meanings of health and "dis-ease." Designed to be a locus where patients, their families and professionals can meet on a level playing field, it is the natural off-shoot of the Cell 2 Soul Online Journal. We encourage the submission of ideas, essays, poems, stories, humor, and timely reviews relating to the humanities and health care.
Trying to make a doctor’s appointment with a group practice, 13 minutes of nonstop recorded repetition (3-4 times each sentence).
“Your call is very important to us and we look forward to speaking with you. We know your time is valuable and assistance is just a moment away. We apologize for the delay. We’re experiencing a high call volume. A representative will assist you momentarily.” And this nugget of intimidation: “If you choose to hang up, you’ll lose your place in line.”
They say the call may be recorded. Oh yes, oh please, oh yes!
Jane Seskin is a clinical social worker and the author of Witness To Resilience: Stories of Intimate Violence. Her experiences calling a doctor's office led to this fine piece that appeared In the NY Times, May 23, 2016. Jane is a C2S reader, and her piece is published with her approval.
As a patient, you have the right to read the notes your doctor or clinician writes about you during or after your appointment. Having the chance to read and discuss those notes with your doctor or family member can help you take better control of your health and health care.
As a healthcare professional, you may build better relationships with your patients and take better care of them when you share your visit notes.
OpenNotes is a national initiative working to give patients access to the visit notes written by their doctors, nurses, or other clinicians.
Evidence suggests that opening up visit notes to patients may make care more efficient, improve communication, and most importantly may help patients become more actively involved with their health and health care.
"Too often in medicine, you feel like part of a machine, a cog in a massive bureaucracy. We cover each other’s shifts, we maintain a hospital’s patient flow — and at the end of many days, you feel nothing would have been different if another doctor had stepped in.
But standardized care, by definition, is not personalized care: it fails to acknowledge patients’ individuality. [In this age of the electronic medical record, there are still things] only doctors — as humans — can offer: critical thinking, clinical intuition, empathic care, exploring what’s important to patients so they can make the decisions that are right for them."
Dhruv Khullar’s moving Op-Ed piece articulates this with clarity and eloquence.
Ranjana Srivastava has a memorable essay in the New England Journal of Medicine about listening to patients. Her piece, entitled “Nourishment” speaks to all of us in health care.
She writes that a patient, former pastor, told her “The gift of silent communion is the greatest gift you can give someone.” She learned that with some patients “instead of listening in order to reply, I [now] listen to understand, shielded temporarily from the pressure of performance.”
This reminded me of some lines Andre Dubus wrote in a short story that described how often people confessed their problems to him “and I listened and talked a lot and and never helped anyone at all. So now if someone comes to me I offer what I know I can give: the friendship of a listening face.”* Srivastava has some remarkably insights in her Perspective piece in the November 26, 2015 New England Journal of Medicine. It’s a keeper! Download Nourishment.Srivastava
*Andre Dubus, “We Don’t Live Here Anymore” appears in the collection “Separate Flights.”
“Are you not giving me any medicine?” her patient asked?
Ms. Shahab was silent for a moment, and then said with a sympathetic gaze, “Medicine for you will not cure your abusive husband.”
"The therapist was born in the isolated Afghan village she still lives in, in 1987 or 1988 — she is not sure. Her father was shot and killed at his mosque shortly before she was born. The reasons for the killing remain unclear, but it shattered their family and forever changed life for Ms. Shahab and her two siblings.
Ms. Shahab and Client (NY Times)
"A marriage was arranged to a man almost 20 years her senior when she was only 13. But the marriage did not stop her from completing her education. She took two of her youngest children with her to school, placing them at the kindergarten as she attended classes."
She is now a therapist in the village, caring for women battered by family and war.
It didn't occur to me to worry when Dr. Blumberg's* first letter arrived on a Saturday in October. I opened the envelope and was surprised to learn that Dr. Blumberg was doubling her concierge fees and cutting down on the number of patients in her practice. She said to let her know if we wanted to continue with her by November 15th, still a month away. "Well, that gives us plenty of time to consider what to do," I thought, fending off the vague anxiety generated by the phrases "increase in fee" and "reduced number of patients." To continue: Download Doctor Loss - cell2soul
We read a lot about concierge medicine, but rarely from a patient's standpoint. It seems wrong to specialize in "disease of the rich." It's enlightening to hear about concierge medicine from a consumer.
Susan Kaplan, Ph.D. is a clinical psychologist practicing in the San Francisco Bay Area. You can reach her at: email.
There’s an old French saying: to cure sometimes, to relieve often, to comfort always. It could serve a mantra for all health care professionals. It reminds us that it can be more important to treat the person who has the disease than it is to treat the disease the person has.
Two recent vignettes were sent to us that illustrate these points.
“Most of our mundane ailments – the average aches, sprains or viruses – are not amenable to much in the way of treatment. Each will run its course in a predictable arc of misery sometimes made a little better by rest, heat, ice, fluids, soup and various pharmaceutical pats.” So argues Abbie Zuger in her insightful NY Times essay, No Cure for Bad Timing. (March 10, 2015).
This fine piece explains why some patients are forever dissatisfied with their medical care and other praise their caregivers.
Meghan. O’Rourke is a writer and poet who has suffered with an obscure autoimmune disorder for over a decade. Her reflections on American medicine are important and iinstructive. This article is available as full free text.
O'Rourke writes: This essay is about why it has become so difficult for so many doctors and patients to communicate with each other. Ours is a technologically proficient but emotionally deficient and inconsistent medical system that is best at treating acute, not chronic, problems: for every instance of expert treatment, skilled surgery, or innovative problem-solving, there are countless cases of substandard care, overlooked diagnoses, bureaucratic bungling, and even outright antagonism between doctor and patient. For a system that invokes "patient–centered care" as a mantra, modern medicine is startlingly inattentive – at times actively indifferent – to patients needs. To my surprise, I have now learned that patients aren't alone in feeling that doctors are failing them. Behind the scenes, many doctors feel the same way. A crop of recent books was a fascinating and disturbing ethnographic of the opaque land of medicine, told by participant-observers wearing white coats.