I recently stumbled upon a writing exercise completed by a patient who participated in the “Writing is Good Medicine”TM, program, which I created to help patients put words to their experience of living with illness. Participants were encouraged to share their writing with family and healthcare providers in order to open communication about issues and concerns. For one exercise I posed the question, “What do you expect from your doctors?”

A patient, who I will refer to as Diane, wrote, “Some patients seem to have unrealistic expectations but a real need to know that someone cares about them and their problems. In a way they may be asking their doctor to create the illusion that he or she cares. Although this concept has an element of comic relief, the effort and time a doctor spends listening to a patient and creating a sense that the patient has been adequately cared for develops a win-win situation for both doctor and patient. Especially, if the patient believes that he or she has been cared for and the doctor feels fulfilled in that the patient has been helped. The initial thought of creating an illusion becomes an actual act of caring.” 

Diane’s words made me think about basic elements for building a meaningful doctor-patient relationship. She seems to be implying that the act of listening can create an illusion of caring, which may be enough for her. Yet, Diane’s view overlooks aspects of a doctor-patient relationship that may be important to others. Of course, satisfaction or disappointment with care would depend on your expectations. Is the act of listening enough? If not, what do you expect from your doctor?

In the early 2000’s the Center for Communication in Medicine created a program for physicians at Southwestern Vermont Medical Center titled “Doctors Conversation Hour.” (more…)

UNCERTAINTY IS THE REFUGE OF HOPE
The Journal Intime
Henri Frederic Amiel

Recently, I was reminded of a patient from time passed who had asked me, “How does one live with uncertainty?”

In The Wounded Story Teller writer and patient Arthur Frank notes, “When a doctor tells us we are sick they are not just diagnosing us—they are initiating a new chapter in the story of our lives. What would it be like for patients to tell their stories and doctors to read them?” (more…)

In Man’s Search for Meaning Victor Frankl said, “The quest for meaning is central to the human condition, and we are brought in touch with a sense of meaning when we reflect on that which we have created, loved, believed in or left as a legacy.”  (more…)

Recently I was asked if I had read “The Well-Tempered Sentence: A Punctuation Handbook for the Innocent, the Eager and Doomed” by Karen Elizabeth Gordon.

I confessed that I often ignore the rules of punctuation. (more…)

Who said, “Poetry is language writing itself out of a difficult situation?” I’m not sure. What does come to mind is the poem “Late Fragment” by Raymond Carver, who was a patient at the time.  (more…)

In a recent KevinMD blog the term “doctor’s emotional switch,” was used by Dr. Mark Abrams to describe the protective coping mechanism ingrained in medical training to objectify their patients and thereby maintain emotional distance. He notes that this approach can have both positive and negative effects.  (more…)

THE SCENT OF WORDS

“In illness words give out their scent…
if at last we grasp the meaning, it is
all richer for having come to us…”

Virginia Woolf
On Being Ill (1930)

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One of the things I’ve heard many patients speak about is how their diagnosis resulted in what felt like an identity crisis—it seemed to change “who they were” nearly instantly, and in a very fundamental way. (more…)

Each month I receive an online newsletter from “Cancer.Net”.  The newsletter provides approved information to help patients and families make informed healthcare decisions. A recent issue titled “What is Tumor Board?” catapulted me back in time. (more…)