The paradigm of healing should be broader than just curing. We can help people by simply being there. I think we can work toward an ideal, and for me I think that ideal would be of a healer who sees healing much more broadly than just curing.
And if the book in some way can help to promote that kind of shift of paradigm, I would be thrilled. That being said, I have to emphasize that there are people in the profession who are really pushing this kind of paradigm change.
There are experts in end-of-life care throughout the country who have spearheaded reform efforts in our profession. I think their efforts have begun to take hold. In the last year, palliative medicine has become an official medical specialty. That is a really important value statement by my profession as a whole because it shows that the profession is starting to view our job as more than just curing. Easing suffering is an important component of what doctors should be able to give their patients.
Even the language you just used—this idea of easing suffering or providing this end-of-life care—has a completely different feel, both connotatively and denotatively—than curing. That seems like a radical statement. Nobody has questioned me on that. The data shows that 90 percent of us will die from some kind of chronic illness. Most doctors already see this in practice. They have, for the most part, really embraced the book. Some of the younger doctors and doctors about my age have talked about how my experiences have resonated with their own.
The sense that someone else has had these experiences with dying patients has given some of the physician-readers a sense of relief and of hope. And so when I talk about hoping the book will help to inspire discussions about mortality, I know fully well that those discussions are really hard to do. Writing those narratives was just so. It was really painful and really, really difficult.
I realize having these discussions is much easier said than done. When you were writing the first drafts of the essays did you ever find yourself holding back and being afraid to reveal the kinds of personal details that ultimately give the book its shaping narrative? Because without those personal details, I think the book would just be another treatise on what doctors could do better. Yes, it was very hard because it required looking at myself and being critical of myself and critical of the very thing that drove me into medicine.
With the narratives, the first few drafts were really hard. I wept a lot. They required going back and reliving a lot of things, many of which I was ashamed of, and they required opening up grief that I had kept bottled in. I would be working on a chapter and I knew what I had to write, but I would write everything else but the narrative parts.
I knew that once I started them, I would go on this journey that would be really hard to extricate myself from. There would always be this period where I would be skimming around the real issue at hand. I think, in many ways, that very process of pushing myself mimicked, in some ways, what I did clinically.
I saw several themes around this issue of fallibility emerge in Final Exam. One was the inability to let go and the other was the inability to call or speak with someone who was dying.
She was inspirational and the comments I heard were all very enthusiastic. In medicine and medical education we often speak of the importance of role models. The keynote address given by Dr. Pauline Chen as part of the Spirituality in Medicine conference provided a glimpse into an extraordinary role model for all of us. I feel blessed to have met her and to have been part of this important conference. Pauline Chen gave a genuinely moving and inspirational talk on how her patients and their families have touched her over the years.
Her presentation brought the audience to their feet with a standing ovation. She is an outstanding speaker! I was astounded that she would be willing to make this kind of sacrifice for folks she did not know. After hearing her speak, however, her motive became clearer. Chen is passionate about her cause; she is determined to share her most intimate reflections about her emotional experience as a physician with those who might be touched or changed.
Our audience was in awe of her presentation. At several points during her recitation, I was convinced that the room was so quiet that others near me could hear my heart beat. Chen was disarmingly human as she described her emotional metamorphosis during her surgical career and the ethical, moral and emotional questions she has taken to heart, quite literally. Read more…. When it comes to public health, bad personal choices can have potentially devastating effects on others.
A recent analysis found the farther patients lived from a Veterans Administration liver transplant center, the more likely they were to die waiting for a transplant. Each July at teaching hospitals across the country, freshly minted M. Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
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