In previous blogs I described my role as a medical humanist at Southwestern Vermont Regional Cancer Center (2002-2005) where I documented the patient’s understanding of their diagnosis, prognosis, treatment plan and the impact of their illness on themselves and family. My note was read by the cancer care team and helped facilitate doctor –patient communication about what may have been misunderstood or unspoken during the medical encounter.
During my tenure I also offered patients (individually or group) an opportunity to write about their inner most thoughts and feelings. The exercises chosen for the Writing is Good Medicine® program served as prompts for personal reflection and could be shared with loved ones and the cancer care team. On one occasion I posed the question, “What Do You Want Your Doctor to Know About You?”
One patient wrote.“I want to know all the things that will help me broaden my concepts of possibilities!
I want you to know—I know that I am seriously ill. Sometimes it feels as if I am more vibrantly alive, that at any other time in my life…
I want you to know that I trust your good judgment and I value your knowledge, experience and creative intellect as I value my own breath and heartbeat and all of you…
I want you to know that I fully realize that you are willing to see and hear all of me and that makes a difference; fueling my desire to dedicate my abilities and energy to the task of co-operating in the process of getting well…
I want you to know that in spite of my diagnosis…you have helped me to continue to live…to reclaim more of my life.
I want you to know that when I speak and write I hear my own voice…that when what I say is true to my spirit I feel in touch with myself and more real…I know I am still here…I have not been disempowered by my illness.”
As I re-read this writing exercise it reminded me of many patients who described their treatment experience as physically and emotionally debilitating while at the same time remaining hopeful of possibilities. It was important for this patient to let the doctor know how his “good judgment” was helping “reclaim more of her life.” In spite of increasing demands on time, I still believe doctors need to hear more of these stories from the lived world of illness to help guide a plan aimed at true patient-centered care.