Years ago, I attended college near the home of a favorite great aunt. Aunt Lucy lived alone in a tidy apartment with a tiny courtyard balcony, overlooking a busy Pasadena street. Sometimes, I would make the short, chaotic drive through the tangle of LA freeways in order to spend a few days visiting my aunt in her neatly arranged home.
I visited Aunt Lucy when I was in need of a …
An excerpt from Now It’s Funny: How I Survived Cancer, Divorce and Other Looming Disasters.
What am I supposed to tell Luke? When do I even tell him anything? How do I tell him? I remember when I was a kid and my mother was hospitalized with some problem (to this day I’m not quite sure what it was) and she was gone for a few days and then back …
It’s easy for those with health problems to complain about what we don’t want to hear others say to us, but I thought it might be helpful to let others know what we wish they would say to us.
“You look so good, but how are you really feeling?”
It’s hard for us to respond to comments like, “You look so good” (or …
When I got my phone call with the diagnosis of mantle cell lymphoma (MCL), my instinct, like so many of us, was to Google. Today, 3 years later, I have learned about what to look for, what to avoid, and how to manage my natural wish to know as much as possible.
The following are suggestions to help others faced with a cancer diagnosis.
Google wisely. Google (and Wikipedia) are a reflex. …
I talk with lot of physicians about the need to improve the quality of communications between physicians and patients. Regular followers of my work will know that I am an advocate for the adoption of patient-centered communication skills by the physician and provider community.
Physicians with whom I talk seldom disagree as to the need for better physician-patient communications. They know that physician communication skills top the list of patient complaints …
“Here is a prescription for pain medication. Don’t drive if you take it. Call your surgeon if you have a temperature or are worried about anything. Go see your doctor in two weeks. Do you want a flu shot? I can give you one before you leave. If you need a wheel chair to take you to the door, I’ll call for one. If not, you can go home. Take care of yourself. You are going to …
Do you feel connected with your doctor or other health care providers? Do you partner with your providers? How important is patient engagement to you? What words do you use to define patient engagement? Do you consider yourself an empowered patient or health care consumer?
What is patient engagement?
Here is how I define patient engagement.
Patient engagement is a connection between patient, caregiver and health care provider. An empathetic and trusted relationship …
I recently returned from four days of training in evidence-based healthcare (thank you, AHRQ and Colorado School of Public Health). I was honored to work side by side with journalists and decision makers as we learned to ferret out systematic bias in medical research.
Before I went to the workshop I re-read “Lies, Damned Lies, and Medical Science,” a 2010 article from the Atlantic which begins, “Much of …
Risks are not certainties. They are the possibility that an activity will end badly. Risk is a handmaiden to almost everything we do.
Life itself is risky. Every decision is associated with the possibility of harm. Risk can’t be avoided, but it can be managed. Let’s talk today about the chances we take while living our everyday lives.
Risks are subject to a variety of misconceptions. What’s risky and what’s not is …
Turns out that while most of us (90%) would like be able to make a doctor’s appointment and check lab results online. 85% of us also still want the option of be able to talk to our physician face-to-face. These are the finding from a recent 2012 study conducted by Accenture.
These finding will no doubt come as a surprise to many of those high tech newcomers to health care looking …
The news of my wife Elaine’s primary peritoneal cancer 27 months ago began a fevered effort to learn all we could about her disease and our options. Peritoneal cancer, which is close in form and behavior to ovarian, is rooted in the abdominal lining. “Gold standard” treatments notwithstanding, the prognosis isn’t good. After a 12-36 month remission in which tumors are inactive, the disease generally returns, and a high percentage …
I once had a patient in whom I found a small breast lump. She was only thirty-two, and the lump was soft, non-tender, and mobile. But it was new. She examined her breasts monthly and was certain that she hadn’t felt it the month before. And she had a family history of breast cancer.
So, I asked myself, what to do? Her age—as well as the lump’s characteristics on exam—made the …
Recently I was privileged again to be on the faculty for the Summer Institute of the George Washington Institute for Spirituality and Health in Washington, DC which draws participants from several health care disciplines, including medicine, chaplaincy and nursing.
One afternoon, we break up into interdisciplinary teams and interview patient actors as if we were a palliative care consultation team. For those who have not experienced patient actors in this context, …
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If you want to identify me,
ask me not where I live,
or what I like to eat,
or how I comb my hair,
but ask me what I am living for,
in detail,
ask me what I think is keeping me
from living fully
for the thing I want to live for.
– Thomas Merton
As a patient waiting to see my health care provider, I would adapt Merton’s template …
One magical thing I see while working in health care is the love story. Each and every child who encounters a diagnosis or illness spawns a collection of love stories around them. The stories come spontaneously from parents, siblings, friends, nurses, doctors, community, and peers. It all happens organically and sometimes it happens without notice. Babies cling to their parents when they ache; parents cling to their children when they …
We are a new generation of physicians and physicians in training. The words “stem cell therapy,” “Robertsonian translocation,” and “artificial tracheal transplant” were part of our vocabulary from the first day of medical school. At the astounding speed at which scientific advancements are made, our ability to incorporate new material is in a constant state of change.
Slowly, the heavy textbooks became relics, as we migrated towards a mobile knowledge, a …
Supreme Court Justice Potter Stewart famously said he could not define hard-core pornography, but “I know it when I see it.”
We in health care seem to have the same reaction to the phrase, verbalizes understanding when it comes to patient education. Patient medical records, including electronic medical records now include free text notes or check boxes indicating the patient verbalized understanding without actually defining this phrase.
In a world where ambiguous …
A year ago, KevinMD.com was kind enough to post my piece, 10 Tips from 10 Years Sick. Well, a year has gone by and I’m still sick. So, I’ve re-visited that post, changing several of the tips and adding to others. And, of course, there are now 11 tips, not 10! At the end of the piece, I hope you’ll share your own experiences.
1. The onset of chronic illness …
My mom passed away last December to Stage V breast cancer metastasized to her liver. During this battle she developed ascites (an accumulation of fluid in the peritoneal cavity) as her liver failure progressed. This accumulation of fluid was not only extremely uncomfortable but painful as well. In an attempt to find symptomatic relief for the last months of my mom’s life, the oncologist presented us two options: we could …
Mirrors reflect, and give us pause for reflection. Not always eagerly sought after or welcome, this reflection does not always reinforce the image one has of oneself. For a physician, publicly-posted patient ratings that contradict the doctor’s perception of his or her standard of care can be jarring.
Through “How Does Your Doctor Compare?”, the physician practice rating collaboration between Massachusetts Health Quality Partners (MHQP) and Consumer Reports, patients can access …
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