You never know what you find when digging through old files. In one of many piles was a copy of a lecture presented at Brown Medical School in 1998 titled “Medical Humanism in Practice.” The authors were cancer patient, Pat Barr; psychologist, Dr. Bernard Bandman; oncologist Dr. Letha Mills; and me, at the time serving as a patient advocate at the cancer center in Bennington. Each of us took our turn at the podium to talk about our perspectives of illness, whether personal or professional, to a group of first year medical students, eager to join the healing profession.
I recall that the students appeared interested in what each of us had to say but Dr. Mills, with whom they most identified, got their attention when she told them, “So much of what we do as doctors is about language. We have a special language to match our specialized knowledge. The more we speak this language the more comfortable it becomes. The language we use influences our thinking. Medical language separates us from others. It forces us to objectify our impressions of our patients. This process can limit our vision.” Her words were insightful and poetic.
I can tell you that when Dr. Mills first arrived at Southwestern Vermont Regional Cancer Center, I don’t think she knew what to make of me as a writer on a cancer center team. Up until that point in her career she was on staff at an academic medical institution caring for patients and directing research. People like me were nowhere to be found. Now, she was transitioning to a community setting where her objective was to have more time in developing relationships with patients.
Over the next several years we developed a collaborative working relationship in which she championed my role on the cancer care team. During this time, we co-authored a paper for a conference at Oxford University (UK) and she wrote a research proposal to study the effectiveness on my medical humanist intervention on improving doctor-patient communication. Nonetheless, in 2005, the medical center’s CEO informed us that he intended to terminate the medical humanist pilot program for budgetary reasons. In response, Dr. Mills wrote a letter of support citing examples of my influence on humanizing the cancer center practice. She not only emphasized the value of my medical humanist’s notes in improving quality of care but also offered other examples of how I expanded her vision, which I’d like to share.
In the letter, Dr. Mills openly acknowledged frustration at listening to patients “complaining” about having an IV placed to start chemotherapy. In her view, the infusion was delivering treatment to save lives. Admittedly, she failed to recognize the patient’s perspective– numerous infusions often led to veins collapsing, representing a feeling of being worn out. I told her what patients said to me– starting an IV was not a medical crisis but a personal one, symbolizing hope but also fatigue and failure. This conversation helped her see the experience through a patient’s eyes.
In the letter of support, she talked about the discomfort of delivering “bad news.” Dr. Mills and I shared the view that doctors needed to be honest and empathetic with patients. However, there were times when I noticed that she was avoiding difficult conversations. So, I invoked the words of Emily Dickinson.
Tell all the truth but tell it slant
The truth must dazzle gradually
Or every man be blind.
Sharing a poet’s words was helpful in framing her thinking about difficult conversations.
The medical humanist program was terminated in 2005. Looking back, I am truly indebted to Dr. Mills and so many others who supported my work. It took willingness on her part to step outside the conventional medical model and trust a colleague with a background in the humanities. I know she’d agree that it proved to be a worthwhile experiment that benefitted her as a doctor and the patients she cared for. For me, it was the foundation of what was to come afterwards.