Taking time to show compassion

On an ICU rotation an elderly women was admitted and in serious condition. She had a very supportive family visiting at her side and on morning rounds the ICU team discussed that she was critically ill and there was a risk of her not surviving her stay in the hospital  They voiced understanding and we moved on with rounds but about 20 minutes later a daughter of the patient came out of the room hysterical, calling out for a doctor to help her mother. Watching her mother struggle to breathe was too much for her despite our discussions that there was nothing else we could do at the time. Ancillary staff attempted to sit her down but she wasn't listening, attempting to force her way past them to find our rounding team. Without a second thought - Yasmin Ali, a neurology intern on the MICU team, took herself out of rounds and spent over a half hour consoling and educating the daughter.  This allowed ICU team and ancillary staff to return to their duties and brought calm to the unit but cut into the time she had to get her own work done, and time for a busy intern is a rare commodity. Though many people enter medicine hoping for these personal interactions, the day-to-day red tape of medicine hurries us through the day, forbidding this use of our time. It's refreshing to see an a physician, in her intern year no less, taking the time to show compassion and guiding a family member through a terribly stressful time.

And to make this all the more impressive, this was not even her patient. 

Ryan Gore

M4 Medical Student

A special doctor on stroke service

Strokes are never foreseen, anticipated events. The devastation of these catastrophes are evident enough when assessing the patients themselves, but the shock and confusion experienced by the families can often go unnoticed. Walking by the Neurology Intensive Care Unit is a daily occurrence, and I would always see family members of patients standing outside, and their expressions were always quite varied. Some were sad and crying, some anticipating good news and hopeful, some simply trying to console those closest affected by the tragedy, but it seemed that they all shared a look of confusion, of being lost. It wasn't until I began my stroke rotation and I had a chance to speak with these family members that I realized how their sense of facing the unknown was truly bearing down on them. On the very first morning of service I was overwhelmed by the amount of questions I received from the first family I spoke with. I didn't have all the answer, but I assured them that the attending physician would be able to accurately deal with any questions they would have. 

Unfortunately, this is where the information flow will, all too often, stop. Whether it is because of overall forgetfulness, the rapidity of events, the respect and paradoxical fear that the families have for the attending physician, or whether they become overwhelmed by the short tidbits of information the physician provides the families with, the families will not ask the physician any questions. A common quote heard by patients and their families is 'I've got no questions for you now, but I'll have a million questions as soon as you walk out.' Only to return the next day to hear the same thing. Even when questions were asked, the answers are seldom remembered.  

It was under this trend that I had started stroke service, and I didn't expect any deviation from the status quo. There was one doctor, however, that seemed to be able to get families to talk, to ask questions, to be involved. After meeting the doctor and going on rounds with him for the first time, I was surprised at how he was able to talk with and explain difficult concepts to the families about the condition, prognosis, and everything else that the families usually were curious about. He seemed to know exactly what it was the families wanted to hear, and he told them everything in an understanding, calm, and collected voice. One of the more remarkable things I witnessed was that he would refer back to questions asked on previous days to realign his previous answers with current information. And while the mood of the families depended mostly on the status of their loved ones, they realized just how special it was to have a doctor that would take the time to do so much for those not even physically hurt by the diagnosis.  

I as well am grateful to have met a doctor of his caliber, and I can only hope to maintain the same level of empathy, understanding, and patience he showed day in and day out during my future years as a physician. 

UICOM-P Student, Class of 2012

Every Patient Has a Narrative

Every patient has a narrative ... the tale of how they became sick, and how their life changed forever, right down to the most mundane bits. For me, the key to humanism in medicine lies in remembering these stories. Working in health care, constantly surrounded by disease, it's sometimes easy to forget that the vast majority of people are not born sick, and live years of beautiful, full life before we meet them in the hospital. They had crushes on the boy next to them in geometry, were best friends with the family dog, or wanted to be astronauts and/or the best parents ever. They have favorite foods and favorite shoes; favored chairs, songs, and weather. In fact, the more you get to know them, the more they might start to remind you of an uncle, or perhaps a best friend, or perhaps - even you.

And every so often your patients are just the opposite: mean-spirited, bitter, contemptuous of any advice given or prescription written, and furthermore completely absent of any intention of changing, hospitalization after hospitalization. No matter what benign intentions you may have, looking into those hostile, unyielding eyes will do a number on anyone's patience. In these more trying situations, I prefer a change of scenery: I picture the patient at home, in his favorite easy chair, watching his favorite TV show. I picture him playing with the dog he's told me he has, or the grandson that lives 3 hours away. Does he hobble over to the kitchen - slowly, since you know he's got arthritic knees - and survey his pantry before settling on his favorite cereal? Maybe it's Cap'n Crunch, which you used to love. And suddenly, there it is: your similarity. And therefore the likelihood that there may be others; perhaps after a 30-year-history of illness and constant frustration, you would be just as "difficult."

... In our most honest moments, we must acknowledge that the landscape of illness is oftern murky and considerably lacking in home-run solutions; although treating the sickness is certainly part of the deal, it's in treating the person that doctors actually find most of their utility. Because, cure or no cure, patients will always remember the doctor that looked them in the eyes - that treated them as a human.

Cindy Koh
UICOM-P Class of 2012

Blue Glove Dance

About the Blue Glove Dance

Don't miss our post of the Blue Glove Dance by the Pediatric Physicians and staff of UICOMP-OSF St. Francis medical center.  Their original video raises awareness of the need for colorectal screening and honors Dr. Mary Schultz, a role model for compassionate care.  One of our GHHS members, Dr. Sarah Creighton, is right in the middle of the action.

Read more about the Blue Glove Dance at http://peoria.medicine.uic.edu/departments___programs/GME/residencies/pediatrics_res/

PeoriaCares!

Residents remember birthdays

Every morning, the internal medicine residents at OSF St. Francis in Peoria, IL, are in a wild frenzy to see all their patients before rounds. They look up their patients’ information:  vitals, daily labs, and images to better the care of their patients. However, there comes a time when patients are found to be ill and hospitalized on the day they celebrate their own birth. On multiple occasions, residents will take the time to visit the gift shop or the cafeteria and spend their own funds to purchase a little something to give to their patients on their birthday. During rounds, they will present the gift and have the staff sing them “happy birthday.” The nursing staff at OSF is no different. They are at the forefront of making patients stay a little more special as well. This is one of many examples which make medicine in Peoria, IL at little bit more personal.

UICOM-P Medical Student, Class of 2012

The Importance of Lending a Hand

I was fortunate to have been raised by a physician - my mother - who treated her patients and their families with not only the best medical care available, but also with compassion and undertanding that seemed only natural for what a relationship between a doctor, a patient, and concerned loved ones should be. My earliest memories of her as a physician are of reading the many cards and gifts she received from patients and their families thanking her for her thoughtfulness, care, and most importantly, for the gentle and wise way she'd helped them through the difficult times they'd experienced.

While the patient is the preeminent focus of a physician's concern, my mother taught me yet another invaluable lesson in assuring the best quality of care: the importance of those on 'the other side' of medicine, namely, the nurses, office administrators, janitors, fellow physicians, medical residents, students, phlebotomists, security guards, and everyone else who contributes to the patient's well-being. If someone you work with, however tagentially, has a problem, lend a hand!

At my current level, when I have ample amounts of time compared to the residents and nurses working beside me, it can make a huge difference simply to assist them with the little things. If a patient can't grab a cup of water because it's too far away, move it closer or hold it for them. If a nurse needs help transporting a patient to another room, grab hold of the bed and start opening doors. If a physician needs help tracking down a patient's records from another hospital, make the call yourself. If a resident needs someone to pick up their cleaning, then ... wish them the best of luck as they drive to get it themselves!  There is a line, after all!

Having a team of individuals who feel supported will not only grease the wheels fo the medical machine, but it will allow patients to receive care from people who are happy, which I believe really does make a difference.

UICOM-P Medical Student

Student Helps Parents Cope with Distress

During his rotation in Galesburg, medical student Ryan Gore (class of 2012)  helped treat a young girl in respiratory distress. It was decided to airlift the girl to Peoria. Although medically the physicians gave great care and faciliated the transfer quickly, Ryan observed that the parents seemed lost. He came back later to speak more with them and realized they weren't from the area and didn't know where they were going. Ryan took the time to explain to them what to expect at the Children's Hospital of Illinois and in the Pediatric ICU. He talked with them about his experiences in following the course of care for another child, and warned them that their daughter's recovery could last weeks and involve being intubated for a time.

Ryan soon forgot about this conversation, which seemed a "small thing" to him.  Weeks later, however, the parents asked another student to pass along their thanks to Ryan for helping them make sense of some of the chaos they were experiencing, and for giving them realistic expectations. Commenting on receiving their thanks, Ryan said, "So often in medicine we get a chance to go beyond what is required but unfortunately we rarely get to see the impact it makes. We can only remind ourselves that it is worth the effort."

Linda Rowe, EdD
Assistant Dean for Student Affairs
UICOMP

Living Through the Emotions of a Patient

"You have cancer." A the age of 20, these words pierced through me and effectively dismantled life as I knew it. Leaving behind my world as a health college student, I plunged head first into the world of medicine, meeting more health care practitioners than I can remember. I was young, strong and had a positive prognosis, but like many patients I was scared and lost in unfamiliar territory. Living through the emotions of a patient allowed me to experience the power of the relationship a patient has with providers. I decided in my ICU bed that my forced exposure to medicine could only strengthen my resolve to enter the field of medicine, and I would take away all that I could from my time there.

People are hardly themselves when undergoing illness. Frustrations, fatigue, worry, and pain distort our normal personalities, challenging physicians to remain objective. In my clinical rotations I have seen how outbursts and harsh words from patients affect healthcare providers when they fail to put those words in context. In the emergency department I saw a patient demanding narcotics who was quickly dismissed by some staff as an obnoxious drug seeker. The physician I worked under, however, was patient and gave her the benefit of the doubt. We gave her something for pain and took a thorough history. After a CT scan we realized she had every reason to be screaming in pain. Days, and a trip to the OR later, she was a completely different person, thankful and polite.

Personally I can remember lashing out at staff as they woke me early in the morning after a trying two weeks of treatment with terrible side effects. Moreover, I ws alone and depressed. Staff avoided me or got in and out of my room as quickly and quietly as possible. This only furthered my slump. An easy choice is to look at the objective data in the chart to see that a patient is doing fine, and dismiss the patient's actions. One nurse, however, entered my room each time similing and undaunted; by taking the time to speak with me she realized there was more than met the eye. She boosted my mood and sped my recovery.

As clinicians we cannot be strayed from the right path by what is in the chart or what is only on the exterior. Taking the time to delve deeper can make all the difference even though, sometimes, that discussion may be uncomfortable for the practitioner. We need to step back from the rush of our work to remind ourselves that patients as well as their families are truly lost in our world.

Stephen Ryan Gore
UICOM-P Class of 2012

My Patients Have Taught Me How to Become a Better Future Physician

I consciously seek opportunities to practice the values that encompass humanism. During each of my rotations, I would visit my patients on my breaks to check on them, especially if their families were unable to be with them in the hospital. I would simply ask if there was anything I could do for them. Interestingly, many of my patients wanted to talk, though not about their disease states, for that had been the topic of conversation with every nurse and doctor that had stepped into the room. My patients would tell me about their lives, books they had read, and would want to talk about sports, especially baseball!

During my medicine rotation I befriended a pateint who had suffered several TIAs. She was a very sweet elderly lady but very concerned and confused. She told me she did not know what was wrong with her and that even though the doctors told her in plain language, she remained perplexed. I visited her every day for the following seven days and in that time she told about her family, and eventually I got to meet and know her family as well. On the seventh day of her admission she was diagnosed with basilar artery stenosis. The stroke team rounded that morning and I happened to be in the room when they were going to explain her options. She called my name and asked me to sit next to her; with great effort she lifted her hand and placed it on top of mine. Unfortunately, her options made decision making very difficult and the family asked to speak with me separately after the doctors had left. Even then she continued to hold my hand. I tried as best as I could to answer her and her family's questions and concerns, though I explained that I was still a medical student. I felt honored that the patient and her family trusted me to that extent.

I feel that because I was able to build a relationship with my patient and her family that involved integrity, respect, altruism, and empathy, I was able to connect successfully and help during a very difficult time. My interactions with my patients have taught me how to become a better future physicians.

UICOM-P Medical Student (who asks to remain anonymous)

GHHS Member Jason Kam

Before starting medical school GHHS member Jason Kam volunteered in a leper colony in South Korea – an experience that he says taught him “how to come out of my comfort zone and open my heart.”  Last year Jason won the Anthony Parisi award for being the student who best exemplifies the Golden Rule. In a survey of peers conducted as part of the GHHS selection process, Jason was widely acclaimed for his compassion, trustworthiness, friendliness, service to others,  and professionalism.  A member of the clinical faculty has said that, “Often Jason would bring up aspects of the patient’s social situation, or personal points about his patients that clearly showed he had taken the time and effort to not only learn their medical problems, but also learn what made them who they were. This is a sign of a well rounded, empathetic and truly humanistic student physician.”    

Linda P. Rowe, EdD
UICOMP GHHS Chapter Advisor

GHHS Member Cynthia Koh

Cindy Koh volunteers with several community service projects, has written for and organized an online medical student literary journal, and has sung with the student a cappella group. Faculty members comment regularly on her extraordinary empathy, respectfulness, and patience with even the most “difficult” patients.  The Gold Humanism Honor Society selection committee was impressed by Cindy's profound understanding of the ways that illness can sometimes obscure the personal "narrative" that makes each individual unique and beautiful - and by her ability to see past illness and empathize with the person within the "patient".

Linda P. Rowe, EdD

UICOMP GHHS Chapter Advisor

GHHS Member Stephen Ryan Gore

Ryan Gore's active profile of involvement in leadership and service with school and community played an important role in his selection for the Gold Humanism Honor Society. Ryan's classmates have elected him to represent them on multiple committees, including student government, budget advisory, and curriculum evaluation. He volunteers with the Exergaming and Friendship House programs, and is a co-president of the Medicine-Pediatrics Interest Group. Ryan’s experience of surviving a serious illness during his early twenties contributed to his insight that humanism in medicine requires that physicians “put themselves in the patient’s gown.”

Linda P. Rowe, Ed.D.

UICOMP GHHS Chapter Advisor

Every emotion will be shared

OSF Saint Francis Medical Center has definitely given me the change to see a plethora of different cultures, races, sexual orientations, and ethnicities.  I believe the secret behind honest humanism comes with treating every patient in the same manner, with the same respect and the same quality of care no matter if the patient is a friendly or difficult person.  With this in mind, I know that I am able to make a special connection with every patient. The connection is nver the same either, which makes medicine such an exciting career. I'm not afraid to (and am actually ecstatic to) laugh with my patients (like the patient who jokes about leaving the hospital every time I see her), educate my patients about their illnesses, talk with my patients about their lives (like my patient who confessed to me of a drug addiction), share with my patients' families when they are in room (like my comatose patient in the MICU), and even shed a tear with my patients (like while hugging my patient who decided to make her baby comfort measures). I understand that every emotion will be shared while practicing medicine,and no matter what the emotion is, the patients and their loved ones will always need someone there for them. I'm excited to get the chance to be that person.

Matt Howard, UICOMP Class of 2012
GHHS member

GHHS Member Sabrina Gerkowicz

The mini-biolgraphy of Sabrina Gerkowicz presented at the GHHS illustrates the characteristics of a compassionate physician. Sabrina says that she had “wonderful role models” in grandparents who endured the hardships of post-WWII Poland and communist Cuba with their values intact, and parents who met the challenges of immigration with determination and hard work. Sabrina is involved in numerous volunteer and leadership activities and is currently the co-chair of the student advocate program.  In nominating Sabrina for this award, a community preceptor wrote, “I was impressed with Sabrina the very first day she knocked on the first patient’s door. … [she] clearly understood that patients may have some reservations about medical students and her explanation [of her role] and her gift of listening, truly listening, quickly put the patient at ease. At the end of each visit, Sabrina would shake the patient’s hand and thank them. I was impressed by her open display of respect and gratitude.”

Linda P. Rowe, Ed.D.

UICOMP GHHS Advisor

GHHS member Alex Cantrell

Alex Cantrell has won many academic honors, but was tapped for GHHS in recognition of his compassion. One of Alex’s professors wrote that “you can see from Alex’s CV [that] he is known for his research and volunteerism. What cannot be discerned from his CV except indirectly is his genuine empathy for those around him, his integrity, and his wonderful endearing kindness and humor.  … He is one of the smartest and kindest students that I have had the pleasure to work with.” 

Linda P. Rowe, EdD

UICOM-P GHHS Chapter Advisor

An ambition to simply help care for patients

Humanism, respect, understanding and compassion are at the very core of being a medical professional.  From a very young age I knew that I wanted to be a medical professional. The science behind medicine definitely intrigued me, but it was the particular bond with a patient during care that intrigued me the most. in the coming years I found myself gravitating toward volunteer positions and community outreach programs.

After my first year of medical school I volunteered at Banos Hospital in Ecuador. The hospital had limited supplies and resources, and the community itself was impoverished. I understood the hardships that the citizens faced, but I was excited to wake every morning to help serve them in the emergency room, the operating room, or even serve as a translator for visiting American physicians. Although my Spanish was very broken, the patients' smiles and enduring chuckles at my grammatical errors were a perfect example fo why I wanted to volunteer in Ecuador. Even in a different language, I was able to realize my ambition to simply help care for patients. I shared my compassion with the people and their families who graciously invited me to live with them for a month.

Once I became a third year medical student, I could not wait until I was able to see patients and be able to identify with them, help them, and, most importantly (to me), just simply take a few minutes of my day every day to find our something new about my patient. Multiple patients have told me how much they appreciate me just talkign to them for even 10 minutes because they feel as though they have no one else with whom to talk. One homeless patient informed me that he had shared more with me in our 30 minute conversation than he had shared with anyone in many years simply because I lent an open ear.

Matthew Howard, UICOM-P Class of 2012
(excerpted from Gold Humanism essay)

GHHS Member Matt Howard

Matt Howard, UICOMP Class of 2012,  is well known for his warm, outgoing personality, his energetic contributions to a wide range of volunteer service programs, and his harmonizing with fellow students in their a cappella singing group.  Matt’s second-year classmates elected him to receive the Gloria Arndt Award for being the “kindest, most compassionate, and most altruistic” of their peers. In his fourth year, those same classmates selected him to receive the Merck Manual Award - also known as the "doctor's doctor" award.  Many factors contributed to Matt's being selected for the Gold Humanism Honor Society, but I think these comments from a physician in a community clinic through which Matt rotated say it well:  “[Matt] did an excellent job of communicating …. He always seemed to be able to anticipate the needs of the people around him and provide for those needs. He is a genuinely caring person. Oftentimes he could be found helping an elderly person out to the waiting area or even out to their car. … Weeks after Matt had successfully completed his rotation my patients would ask where he was.”  

Linda Rowe, EdD

Peoria GHHS Chapter Advisor