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.
Comments from Ling Poliandro, Mandarin medical interpreter: Thank you also for forwarding this heartfelt article.While we often were made known of the appreciation of our work, the author strikes me as exceptionally respectful and sensitive. I often thought of becoming an onsite interpreter in the hospitals to be 'most' helpful but I realize the advantages of working at home over the phone far outweigh any in person situation at this time of my life as I can log in and out anytime when I need to, which I've used a few times after some very difficult encounters.
“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.
As a physician assistant student, I was randomly assigned to a federal prison for my psychiatry rotation. I was apprehensive and fearful, as a five-foot tall, 24 year-old woman, to contemplate spending five weeks at an all male federal lock-up. Before this rotation, I could not have fathomed that not only would I be sad to leave, but that the experience would leave a dramatic stamp on my life.
Three weeks into the rotation, I learned there were inmates training future service dogs. NEADS (National Education for Assistance Dog Services) “is a non-profit organization that was established in 1976 and is based in Princeton, Massachusetts. [Their] Assistance Dogs become an extension of their handlers and bring freedom, physical autonomy and relief from social isolation to their human partners who are deaf or have a disability.”1 I asked the NEADS liaison if I could observe the inmates in a puppy class and was thrilled when she said yes! At this class inmates received a brand new batch of three month-old puppies. I watched as grown men, some with intimidating stature, melted to the ground as they knelt and spoke in their “puppy voices.” The liaison explained to me that NEADS partners inmates with puppies as handlers to train them as service dogs. These puppies leave the prison every weekend with weekend puppy raisers (WPR) for socialization outside the prison walls.
That day, I was inspired to become a WPR myself and have witnessed the healing these animals are capable of. Every weekend I pick up my puppy for 48 hours of walks, field trips, and socialization. During field trips to stores or the park these pups bring a smile to the faces of everyone we meet. I’ve observed first-hand the ability these puppies have to brighten, not only my day, but also the days of total strangers!
As puppies, they provide “free time” and stress relief while teaching the values of patience and discipline to inmates. The puppies serve as companions and sources of constant adventure during weekends with their WPRs. As service dogs they are calming, helpful, and hardworking best friends to their owners. NEADS dogs give their companions every-day assistance and function as a social connection between their humans and the world around them.
NEADS dogs are true healers. As a PA I am inspired to take the nod from these amazing pups. I continue to learn from these pups and strive to emulate their qualities of patience, empathy, and dedication in the practice of medicine.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. Modern version of Hippocratic Oath
In this inspiring 90-minute documentary, filmmaker David Grubin takes his camera across America to focus on the challenges and triumphs in our country’s health care delivery system. The four segments that comprise Rx: The Quiet Revolution introduce us to a diverse group of doctors, nurses, and health care professionals who are transforming the way we receive our medical care: lowering costs by placing the patient at the center of their practice.
Rx: The Quiet Revolution shows us what’s happening from Maine to Mississippi, California to Alaska. You will see physicians, nurses and other healthcare professionals placing the patient at the center of their practice — transforming the way medical care is delivered while lowering costs and improving outcomes.
Filmmaker David Grubin brings you these compelling stories:
In Maine, we meet Dr. David Loxterkamp, who practices family medicine with a team of doctors working to treat patients with chronic illnesses.
In Mississippi, a state with more diabetes cases than any other, Grubin finds a rural health clinic fighting diabetes with the aid of an electronic communications device that provides greater access to medical care, helping patients take responsibility for managing this devastating chronic disease.
In San Francisco, Grubin visits a health care facility for seniors called On Lok, dedicated to making it possible for frail, elderly Americans in need of nursing home care to live with dignity in their own homes.
In Alaska, the documentary follows Native Alaskans who own and operate their own health system, caring for 65,000 people across 107,000 square miles. In spite of the number of patients and the vast distances between them, they are determined to foster an empathetic relationship between patients and their health care providers.
At 90 minutes, this may seem a daunting investment in time, but Rx: The Quiet Revolution will speak to you in powerful and compelling ways.
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.
Treadway teaches medical students about the patient-doctor relationship
at Harvard. She will give a free talk in Lenox, MA next week.
Heart Matters: The Patient-Doctor Relationship Thursday, October 11, 2012 at 6:00 p.m. Shalespeare and Company Founder's Theater 70 Kemble Street, Lenox, MA Sponsored by BMC
Treadway has written extensively on this topic. "I watch the second-year students file into the Ether Dome for their
first day of my “Patient–Doctor 2” course. For me, this course marks
their true entry into medical school. Here, they will refine their
history-taking skills, building on their knowledge of pathophysiology
and disease; they will learn how to perform a physical examination; and
they will touch a living stranger's body as clinicians for the first
time. For them, right now, these are just skills to be learned. They do
not see how they will be transformed by them. They know that these
newfound abilities will open the door to clinical medicine. They do not
know how utterly changed they will be by crossing that threshold." Full Article
If you wish to attend, please email Sue Kelly at BMC or call 413-447-2775 by October 9
Treaway’s advice to students: As
you acquire more medical knowledge and responsibility, there will be times you
will focus more and more on the problem and forget the patient attached to it.
As you strive to take a good history, get the facts straight, perform a good
physical exam, and put it all together into a comprehensive clinical picture,
you will find that with all the anxiety involved in wanting to do it right, the
patient becomes further and further away... While
I am busy treating the bodies of my patients, I try to remember to treat the
patients as well — to touch them in small ways as well as large.
A fine essay by David Watts appeared in a recent issue of the New England Journal of Medicine. Unfortunately, it is not available free to the public. It begins with this paragraph.
image from migraine-livinginpain.blogspot.com/
"Rumor has it that the medical profession suffers from too many cold and
distant doctors. Studies have attempted to subject this notion to the
scrutiny of science,
and although we could argue over their degree of success, we know it's
true. We need only ask our patients in order to be regaled with stories
confirming the accusation. Cold. Yet we didn't start out that way."
Some of you will have access to NEJM, but those who don't can contact Dr. Watts for a copy. Congratulations, Dr Watts! This is an article that all of us will mull over and benefit from reading.
Cure for the Common Cold David Watts New England Journal of Medicine, September 27, 2012, p. 1184-85
Daryl Potyk, a physician in the state of Washington, shares a cautinary tale with us. His essay, "In Search of the Story," is important for patients and care-givers alike. As physicians get busier, as care gets more fragmented between primary care doctors, PAs, NPs, hospitalists, ER docs, specialists and sub-specialists, the person as patient often becomes an invisable man. Dr. Potyk's insight is essential.
"How could we have been taking care of Mr. Jones for as long as we had without knowing him? We knew his blood counts, we knew about his kidneys and his liver, we had stuck needles into his abdomen to obtain fluid samples; we knew a lot about him. We focused on his medical problems, treated him, took care of him, all without ever knowing him." Download Potyk In Search of the Story
Author Bio: Daryl Potyk, a board certified in Iinternist and geriatrician, has been teaching at the Internal Medicine Residency in Spokane, WA since 1994. He lives in Spokane, WA with his wife and three children. Email: DKP.
This talk will resonate with many of you. It discusses what should occur whenever two people meet. Sadly, it is not at the core of medical encounters. It could be. If you have a few minutes, listen to roshi Joan Halifax's talk. (You might prefer full screen.)
Sam Richards starts this important piece on empathy with these words: "What is sociology?" And I tell them, "It's the study of the way in which human beings are shaped by things that they don't see." And they say, "So how can I be a sociologist? How can I understand those invisible forces?" And I say, "Empathy. Start with empathy. It all begins with empathy. Take yourself out of your shoes, put yourself into the shoes of another person."
This talk is 18 minutes, and really helps me when I interact with others, be they family, patients, strangers. If you have a few minutes, visit "A Radical Experiment in Empathy." You will be enlightened.