Cell 2 Soul: The Humane Health Care Blog

Medicine Men by Elaine Zeichner

I have an otolaryngologist
Who treats my sinusitis.
An orthopedic surgeon who’s
In charge of my bursitis;
A gastroenterologist
Who probes and writes Rxs
Whenever my complaints are lodged
Around my solar pìexus.
A trusted ophthalmologist
who sees to how I'm seeing,
A psychiatric expert for
Emotional well being;
A noted rheumatologist
To manage my arthritis,
And yet another specialist
For warts and dermatitis;
A leading cardiologist
To regulate the heart of me,
A team of radiologists
Who've pictured every part of me.
And yet, with all their wherewithal,
They heal themselves, I’m told,
With aspirin, tea, and chicken soup
Whenever they catch cold.

Download Zeichner Poem

Author Bio:  Elaine Zeichner was born in New York City and is a graduate of Hunter College.  While at Hunter, she honed her creative talents writing lyrics for “Sing.”  She and her husband lived in Fresh Meadows, Queens, NY where they raised their two children.  After 25 years as a NYC schoolteacher, Elaine and her husband relocated to South Florida. She continues to enjoy dabbling in poetry and creative writing.

Photo is on Jainworld.com site.

Ms. Zeichner's poem reminded me of the parable of the blind men and the elephant.  Each of her specialists sees only a part of her.  Where is the generalist of old?

Silver Dragons by Phil Delrosario

Stanford undergraduate, Phil Delrosario, does an amazing job of getting into the mind of a four year-old at a doctor's office.

"Momma, why is she hurting me? Momma wouldn't say anything. She just held me there. The lady stabbed me again with another silver dragon. Stop I yelled out. I was still crying. Why are you hurting me I screamed. She said she needed to give me two more and then she'd be done. She came closer and closer. I kicked her in her face. That's what Aladdin would have done..."  Download Silver Dragons

 

Author Bio:  Phil Delrosario is a junior in Human Biology with a concentration in Psychological Development in Children and Adolescents at Stanford University in California.  He enjoys writing, making short films, and playing his violin/piano/ukulele. He can be reached at pdel@stanford.edu.

Pediatric practitioner Brian Maurer has this comment:  "This unfortunate scenario is repeated daily in pediatric primary care practice.  An interesting twist: told through the eyes of a 4-year-old as imagined by a pre-medical student. see Brian's full comment"  Download Maurer
 

Patient Directed Mental Health Care

Comments from Brian Maurer and David Elpern:

Ivan Illich, in the introduction to Medical Nemesis, tells us:  "The medical establishment has become a major threat to health.  The disabling impact of professional control over medicine has reached the proportions of an epidemic. Thoughtful public discussion of the iatrogenic pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal.  Indeed, what is dangerous is a passive public that has come to rely on superficial medical housecleaning.  My argument is that the layman and not the physician has the potential perspective and effective power to stop the current iatrogenic pandemic."

To us, Illich's observations ring true in our modern approach to the treatment of mental illness. Patients suffering from psychiatric maladies often receive fractured care from a variety of clinical professionals who rarely take time to view them from a holistic perspective -- or to communicate with one another in an attempt to improve quality of care.
 
Psychiatrists -- more properly known these days as "psychopharmacologists" -- seem to have sold their birthright in the medical marketplace.  In our opinion, these clinicians have compromised many marginalized people in our society through the widespread practice of prescribing of largely ineffective drug cocktails that rarely contribute to the betterment of the patient. With less medication and a bit more caring and compassion, any number of these patients might enjoy more productive lives.

Elyn Saks shines a light in the darkness with her memoir, "The Center Cannot Hold." This remarkable woman documented her life with schizophrenia and the message is that psychotherapy (sometimes six days a week) plus a few drugs work in concert to keep her productive and sometimes happy.  Also, a recent article in the NY Times "A High Profile Executive Job as Defense Against Mental Ills" is a valuable addition to the literature on patient-centered care for persons with mental illness.

Synchronistically, a recent submission to Cell 2 Soul, "A Patient Request," covers similar terrain.

All of these pieces are a beacons of help for patients with mental illness and their families.

A Patient Request

by Zena David

The night my brother, Steve, a long-time resident of a nursing center, was sent to the emergency ward, I expected him to be admitted to the psyche ward of a Chicago hospital.  It wouldn't have been the first time.  Occasionally, the medication he took to stabilize his schizoaffective behavior didn't hold. Medicare hadn't approved the new medication that might have helped in a timely fashion.   He walked the halls, refused to eat, had difficulty urinating, descended into a deep depression and heard voices.  This time, he would be a patient on the medical floor until his prerenal azotemia (impending kidney failure) and a blockage in the bladder could be treated surgically. He could not, in this state, enter the psyche ward. 

By the time I flew to Chicago from California, I saw my brother pulling out the IV's before being physically restrained. The psyche ward did not have the capability to handle patients with certain medical conditions so even though Steve's  doctors tried to get him into the ward, they were unable to do so. Never having been operated on, confused as to what was happening to him, and often being addressed in the third person, my gentle and gentlemanly brother became uncooperative and at times belligerent, ripping off the bandages protecting the fistula. Two operations later, my brother left the hospital having taught the staff that a smile and a kind word are as crucial to the healing process as the medicines that were injected into his veins.

“Whoever survives a test, whatever it may be, must tell a story.  That is his {her} duty,” said Nobel Peace Prize winner and Holocaust survivor Elie Wiesel.  My brother, Steve, never won a prize, but he is noble. And his story must be shared.  Within his living nightmare, he found his voice sounding it out so that it could make a difference to those who heard him.  I wanted him to know what he went through. I wanted him to know how proud I was of him.  I wanted him to know what he taught me.

 Robert Frost said, “The only way out is in.” Steve orbited in and out of consciousness and sanity and into traumas that frightened me.  Then he surfaced to a place where our words could meet and be understood not only by me but also by the medical staff.  This is our story.  See: Download A Patient Request

My Brother Steve

Author Bio: Zena David, a former public school educator, was awarded several Los Angeles Educational Partnership Grants which enabled her to develop interdisciplinary projects  and publish articles about the programs for middle school students.   She encouraged her English and drama students to share her philosophy, “love what you do and feel that you matter.”  The English Council of Los Angeles honored her for her achievements as outstanding English classroom teacher in 1986.  The next year, she received a Global Teaching Award for her children's Museum exhibit and her production of  The Diary of Anne Frank led to a correspondence and an invitation to visit Miep Gies at her home in Amsterdam. She became an assistant producer for a Dramalogue award winning theater and an associate director for the UCLA extension musical production about the second half of life.  Zena also has also written plays  and acted in several small theater as well as community productions.  She has facilitated a creative writing workshop in a women's prison. Her most recent speaking engagement was this year at the Yom HaShoah Observance and Photo Exhibition, “Through Your Eyes:  Holocaust Memorials Around the World.” As a writer, actress, and director, she is most interested in using the creative arts to integrate issues and heal traumas. Email:  Zena

Introducing... ePatients

Patient driven care is an idea whose time has come.  Some years ago, I read an amazing book about patient empowerment, "Making Miracles Happen."  Every day, I see patients who need to be partners with their physicians, but can't conceive of doing that or are not given the opportunity.  This is especially true for the elderly.  Ideally, the patient, not the doctor, should be "captain of the ship."

Yesterday, on TED, I watched an amazing video on ePatients (18 minutes).  Viewing this will empower you or help you to empower a family member or friend.

The ePatient network is growing.

See:     

The Society for Participatory Medicine

Interternational Journal for User Driven Health Care

Institute for Healthcare Improvement

This is just for starters.  There is much  more...