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)