Cell 2 Soul: The Humane Health Care Blog

Halloween Cadaver Palaver

"The cadavers gather in early September.  After a cold, dark, lonely summer,  each alone on a gurney, stiffened by cold and formalin, they are glad for the well-lit anatomy laboratory, though one or two express exasperation at the fluorescent lightening which gives their skin a bluish pallor." 

Tonight, Halloween, is their special evening.  Larry Zaroff presents a story about sentient ghouls with heart:  Cadaver Reunion.  Chill out and Download CADAVER REUNION

Author Bio: Larry Zaroff has had five careers: cardiac surgeon, mountaineer, teacher of the medical humanities, writer, and volunteer family doctor.  You may contact him at: Larry Z.

The image is from the New Yorker Cover, 10/31/2005                                                                                  

Goldengrove Unleaving

Are you grieving, over golden grove unleaving? 

"Spring and Fall" by G.M. Hopkins

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

Truths

The Good Death: What Matters?

by Sue Mayfield Geiger

“If I could give one night back to you,” she asked, “which one would it be?”
“Are you my wife?” he replied.
“Yes,” she stated. “I'm Louise.”
“Then it would have to be that night in 1938 when I was stationed at Ft. Crockett in Galveston. The night at Mennard Park where we had all those dances."

For full story: Download TheGoodDeath

Bio:Sue Mayfield Geiger writes and edits for regional and national publications, and lives on the Texas Gulf Coast. Her first book of prose and verse (with photos) is now available. www.gibbonsstreet.com.  You can email comments to her at:  SMG

Maple Leaves

A Grisly Narrative of Love

"Nobody asks [us] dragon parents for advice; we’re too scary. Our grief is primal and unwieldy and embarrassing. The certainties that most parents face are irrelevant to us, and frankly, kind of silly. Our narratives are grisly, the stakes impossibly high."  So writes, Emily Rapp in an Opinion piece about her child with Tay-Sacks disease.

Wilh all the fanfare about Tiger Moms -- Ms. Rapp's essay is an important glimpse of reality, far from the ivied halls of the Academe.

See Notes from a Dragon Mom.

Gambling with Your Life and Health

If you have questions about the value of screening (especially for breast and prostate cancer) here is a link to an important article by one of the most respected workers in the field.

You Have to Gamble on Your Health
by H. Gilbert Welch
NY Times, October 11, 2011

Confession of a Professional Patient

One of our members, Beth McKim, works as a simulated patient (SP).  Her essay, Confessions of a Professional Patient, gives a rare insight into a SP's mind-set.

"Three young doctors, their necks splotched crimson with fear, come up one at a time, to deliver the same, life-changing news to me. Their hands tremble and voices shake in these encounters as they disclose that my tests indicate I am facing a potentially serious, or even fatal, disease." Read more: Download Professional Patient

A simulated patient (SP), standardized patient or sample patient (also known as a patient instructor), in health care, is an individual who is trained to act as a real patient in order to simulate a set of symptoms or problems. Simulated patients are used in medical education, nursing education, evaluation, and research.

Author Bio: Beth McKim resides in Houston, Texas with her husband, Buddy, and their Labradoodle, Lucy. After working for twenty four years as a Staff and Parent trainer and Director of Volunteers for Child Protective Services, Beth currently enjoys studying Creative Writing and Spanish. A former marathon runner and triathlete, she is now an avid swimmer, Yoga enthusiast, and overall fitness devotee. She feels particularly rewarded by her part- time job as a medical actress. Email Ms. McKim.