by Carolyn Thomas ❤️ Heart Sisters (on Blue Sky)
When I recall moments of kindness I’ve encountered in my hospital experiences, two stand out. Both moments happened on May 6th, 2008 when I was finally admitted for what doctors call a “widow maker” heart attack. That was when the Emergency physician called in a cardiologist (something the Emerg doc two weeks earlier hadn’t done despite my alarming textbook symptoms of central chest pain, nausea, sweating and pain down my left arm). On that awful earlier morning, a man with the letters M.D. after his name told me clearly: “You’re in the right demographic for acid reflux!” before sending me away.
But on that memorable May 6th morning, the cardiologist arrived almost immediately to see me in the Emergency Department. He reviewed my diagnostic test results, then introduced himself, sat down beside my gurney, leaned in, took my right hand in both of his own hands – and quietly told me:
“Mrs. Thomas, I can tell by your T-waves and other cardiac tests that you have significant heart disease.”
Compared to the dismissive reception I’d had at this same Emergency Department two weeks earlier, his reassuring manner while gently holding my hand seemed so careful – i.e. “full of care” – I almost burst into tears. Not because I’d just been diagnosed with “significant heart disease”, but because I’d been believed.
Two weeks earlier, I’d felt humiliated by the dismissive lack of kindness from that first Emergency doc and a mean-spirited Emergency nurse. I couldn’t get out of there fast enough.
Even though another nurse had called out as I was being sent home: “Come back if those symptoms get worse!” – there was no way I was going to embarrass myself further by returning to these people if my symptoms worsened (which, of course, THEY DID). So I refused to return, instead popping useless Tums and Gaviscon non-stop while enduring two hellish weeks – until my symptoms were no longer bearable. I had to force myself back to that Emergency Department on May 6th.
In medicine, the opposite of kindness is not cruelty – it’s dismissal.
Yet male heart patients rarely have to beg their doctors to believe them. A Cornell University study for example, found that heart attack symptoms presented in the context of a recent stressful life event were significantly more likely to be identified by physicians as psychological in origin when presented by women, but cardiac in origin when presented by men.
I cannot accurately express in mere words how demoralizing being abandoned by the experts you have turned to for urgent help can be.
During my second trip back to that same Emergency department, I experienced an avalanche of relief when I realized that these Emerg staffers were not going to send me away this time.
This past week, I’ve spent two days watching the 5th Canadian Women’s Heart Health Summit in beautiful Ottawa (virtually, here at home in my jammies). Speaker after speaker at this conference sang from this same hymn book:
“Female heart patients are still UNDER-diagnosed, UNDER-treated, and UNDER-researched compared to our male counterparts. “
I’ve been writing Sunday morning posts on implicit bias and male-centric medicine in women’s cardiac care since 2009 – essentially the same breaking news with every newly published study. Why is this still happening in 2025? As the Summit speakers repeatedly reminded their audience: “Women are NOT just small men!”
Compared to that first dreadful Emergency experience of being dismissed and sent home in mid-heart attack, my second visit two weeks later to that Emergency Department (different Emerg doc this time, thank goodness) meant a remarkably different reception.
That morning, my newly correct diagnosis was immediately followed by a trip to the cardiac cath lab to have a metal stent implanted in my Left Anterior Descending coronary artery, the so-called “widow-maker” heart attack. After that procedure, a cardiac nurse walked my gurney down the wide bright corridor on our way into the CCU (the intensive care unit for heart patients). As she walked alongside me, she placed her hand on my shoulder and said:
“You’re in the right place now, and we’re going to take good care of you.”
Isn’t that how frightened patients want to be greeted when we’re sick, or scared, or need help? What struck me about each interaction with these two different people was how simple and effortless such kindness can be.
The cardiologist’s “full of care” gesture when placing both his hands over mine required no extra time or planning. The cardiac nurse’s kind words as she walked alongside my gurney were so reassuring that I will never forget them.
Do healthcare professionals realize what a meaningful impact even the smallest kindness can have on an overwhelmed patient? If they did, I believe they’d do lots more of it, with every patient.
My experiences with kind healthcare professionals aren’t restricted to cardiology. They also include a recent note from my Nurse Practitioner, after a scheduled 30-minute mammogram to monitor a newly discovered breast lump morphed into five exhausting hours of diagnostic testing (including biopsies) in our local hospital’s Breast Imaging Clinic last month. This is what my NP wrote to me (while she was away on her family holiday, I might add).
“Hi Carolyn, I was just wanting to check in and see how you were doing, as today’s procedure was more extensive than just an ultrasound. I will keep an eye open for the biopsy results and give you a call as soon as I see them.“
Dr. Iona Heath is a British physician and former president of the Royal College of General Practitioners in the U.K. As she reminds us in her BMJ book review of “
“Anyone who has been seriously ill knows that it is the individual acts of kindness, thoughtfulness and sensitivity on the part of healthcare staff that make it possible to cope.
“Kindness helps healing.”
And kindness can take many forms – from compassionate little notes to the reassuring phonecall this past week from my breast cancer surgeon. She wanted me to know that she’d just met with her Breast Cancer Team to discuss my case with colleagues in cancer surgery, medical oncology, radiology and pathology. This team now wants to meet me after my MRI test results are in to discuss the best possible treatment options. Having this access to a team of doctors – each one offering their expertise to help make future treatment decisions is the ultimate kindness of reassurance.
In an editorial called “Kindness: an Underrated Currency”(2) published also in the British Medical Journal (BMJ) , six types of professional kindness that can improve outcomes for patients were identified:
1. ♥ deep listening
2. ♥ clear empathy
3. ♥ generous acts of effort that go beyond what patients/families expect (e.g. inviting me to a Breast Cancer Team meeting!)
4. ♥ timely care that reduces stress and anxiety
5. ♥ gentle honesty in discussions and conversations
6. ♥ thoughtful support for families and carers
All six examples of kindness, as the authors urge their medical colleagues, “should be at the heart of health care, giving us purpose, meaning, satisfaction and joy in our work.”
Dr. Mark Britnell, author of the book “In Search of the Perfect Healthcare System”, drew on his own experience working in 77 countries while researching this book. He argues that, despite our enthusiasm for technical innovation in medicine, “the kind touch and warm heart of a human being is the essence of good care.”
Dr. Britnell also suggests that urgent and sustained action to reconnect staff with patients and with each other “will help develop the fulfilled, productive, and motivated healthcare workforce we need.”
I don’t know about you, but I think that’s just the kind of healthcare professionals we should all have.
That BMJ editorial concludes this about kindness in medicine:
““Patients can concentrate on recovering when they feel comfortable. Genuine care for the feelings and welfare of others is demonstrated by kindness.”
♥
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1. Heath, Iona. Editorial, “Kindness in healthcare: what goes around”. BMJ, December 2019.
“Kindness: an underrated currency”
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“I’ve been searching for ways to heal myself, and I’ve found that kindness is the best way.” ~ Lady Gaga
NOTE FROM CAROLYN: I wrote more about doctor-patient relationships in my book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press). You can ask for it at your local library or bookshop (please support your favourite independent neighbourhood booksellers, or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Image: Tylijura at Pixabay
♥
Q: Which of the six kinds of professional kindness is most important?
NOTE FROM CAROLYN: I wrote more about communication in medical care in my book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press). You can ask for it at your local library or bookshop (please support your favourite independent neighbourhood booksellers, or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Heart Sisters 
Carolyn, this is more than kindness. This is extraordinary medical care.
“…to the reassuring phonecall this past week from my breast cancer surgeon. She wanted me to know that she’d just met with her Breast Cancer Team to discuss my case with colleagues in cancer surgery, medical oncology, radiology and pathology. This team now wants to meet me after my MRI test results are in to discuss the best possible treatment options.”
I hope the meeting is or was not overwhelming for you.
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Thanks Teri – I think so too. “EXTRAORDINARY!” My surgeon’s phonecall seemed so far removed from my 17 years of heart patient experience (do they even have weekly Heart Disease Team meetings where cardiac specialists do group brainstorming??)
I wrote about something called “Survivorship” several years ago here – a common concept in the field of cancer that defines a cancer survivor “from the time of diagnosis and for the balance of life” – But where is this concept of ‘survivorship’ for heart patients and our families? And why haven’t we found it yet?”
Almost all of my experiences in the short time since April 1st, when I was told I had a malignant breast tumor, have been beyond my expectations so far. But this phonecall from my surgeon about the weekly Breast Cancer Team meetings (and my participation in a future Team meeting to discuss my case) is so reassuring.
I suspect that not only is my surgeon a careful and smart doctor, but the fact that there’s been a discrepancy in determining the actual size of my tumor (dueling ultrasound report vs radiologist’s report) makes getting advice and wisdom from her Team reassuring for my surgeon as well.
They’ll need to see my MRI results before we’re able to meet (I’m booked for that scan on May 8th) to get an accurate picture of that tumor size. I’m expecting to be overwhelmed (I’m used to knowing lots about cardiology and my own diagnosis but everything about breast cancer is new and overwhelming to me!) – but I plan to raise my hand if things get too jargon-y for me… I sure hope my daughter will be able to come with me for that meeting (she takes excellent notes, aside from being a lovely support person…)
Take care. . . ❤️
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I hope that your daughter will be able to go with you! It would be so overwhelming for me. Having someone to help remember things would be really great for you. May 8th seems so far away, but it will be here before we know it.
I met with my general doctor yesterday and did labs for full bloodwork. Everything! I’m having an assortment of issues that I can’t explain or easily describe to the doctor. Yesterday I started 10 days of Doxycycline Mono 100 mgs which I’ve never taken before. Dr placed Imaging Order for a Fluoroscopy Esophagram that I’ve also never have had. I’m taking generic Tylenol one every 4-6 hours for pain. I’m doing what I can to figure it all out and keep track of what’s going on. I see my Cardiologist next week as my six month follow up after being diagnosed with A-Fib.
Just typing this note to you… I’m feeling overwhelmed already!
Best to you! ❤️
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Hi Terri – I too sure hope my daughter Larissa will be able to go with me to this Breast Cancer Team meeting! She’s not only very efficient at excellent note-taking during doctor visits, but she’s such good company, too!
you are facing a wallop of upcoming lab tests and several unknowns. Interesting that you mentioned both a drug and a procedure that you’ve never experienced before: I think that ‘first time’ feeling can be a major factor in feeling overwhelmed. As Bruce Springsteen once sang: “Sooner or later, you get used to anything…”
That helps to explain why events or symptoms or procedures that I’ve experienced many times by now, no longer feel as ‘overwhelming’ to me as they did that first time. You’ve not yet had a “first time” with your new drug or this new procedure – so NO WONDER you are feeling overwhelmed –
Good luck with your lab results and your new procedure – I hope it helps your doctor solve some mysteries.
Take good care. . .❤️
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It is so true that simple acts and words of kindness can make all the difference to patients.
I too experienced a ‘widow-maker’ heart attack, about 6 months ago. I was 47, with gestational diabetes as my only prior risk factor, so it was quite a shock. During my hospital stay, it was often the small gestures – a reassuring word, an effort to ensure my comfort – that made the most significant difference.
I was also a virtual attendee at the Women’s Heart Health Summit. I deeply appreciated the valuable research shared and the inclusion of lived experiences. However, I couldn’t help but notice that the majority of the speakers were women. In my own work as a mental health researcher, any time there is a meeting or event on women’s health, it is predominantly women speaking to other women. It makes me wonder – was the male cardiologist I saw initially, who dismissed my symptoms as a minor previous cardiac event when in fact I had full occlusion of the LAD with all the classic symptoms of heart attack, in attendance at the Summit? I think it is doubtful.
How do we effectively engage men, the very people who are more likely to misdiagnose and under-diagnose women, in these discussions? Their perspective and understanding are vital for improving women’s heart health outcomes.
On another note, I recently read your book, and I found it immensely helpful in my journey toward processing and accepting my heart condition. Thank you for your dedication and impactful work.
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Hello Kerry – first, thank you for your kind words about my book. So glad you found it when you needed it! I’ve been writing about implicit bias and male-centric medicine as it affects women’s heart disease care since 2009, and I’ve also spoken at several medical conferences over the years, so I’m guessing – based on years of maddening conversations with docs – that your male cardiologist was very very likely NOT present at the Summit conference!!
When I heard Jackie Ratz present her talk on “I wear the Crown” at last week’s Summit, I was thrilled when the audience responded with a standing ovation! That is very rare in cardiac conferences.
There ARE male cardiologists out there who are very keen on learning (and teaching) more about women’s unique cardiac research, diagnostics, treatments and outcomes – but they’re sadly few and far between, in my observation. You and I both heard speaker after speaker at the Summit talking about how women are UNDER-researched, UNDER-diagnosed, UNDER-treated compared to our male counterparts. You’d THINK that male docs would be intrigued about why that is, and attend conferences like this Women’s Heart Health Summit specifically to educate themselves.
I wrote last year about an interesting study by researchers reporting that female heart patients who had been treated by female physicians had better survival outcomes than women treated by male docs.
But their most interesting findings were certain specific exceptions reported – for example, a male physician does better when he has had considerable experience working alongside female colleagues. It seems that male docs can improve patient outcomes if surrounded by a team of females. Is this because the way women work or listen or treat their patients rubs off somehow on their male colleagues?
Maybe all of the female docs we saw at the Summit should bring along at least one male doctor to next year’s conference – or better yet = bring a male med student!
I hope you’re feeling better – take care. . . ❤️
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The importance of Kindness cannot be emphasized enough.
In my medical history I have mostly experienced kindness, but one occasion of thoughtlessness stands out.
When I had been admitted to hospital routine chest X-rays had been taken, about which I had heard nothing. A week later, the cardiology resident, who had seen me every day and with whom I thought I had a good relationship, came in to discharge me.
He turned to leave and paused. Over his shoulder as he left he said, “Oh your x-rays showed a few spots on your lungs”, and he was gone.
To no one I called out, “I want to speak to the radiologist!” I have had cancer and metastasis, with 2 surgeries, radiation and chemotherapy. The news of spots on my lungs terrified me.
My nurse came in and I explained to her that I wasn’t leaving until I talked to someone about my lung X-rays. It took some time because I had been discharged but I was adamant that I would not go without knowing more about the x-rays that had been available for 7 days!
Eventually the cardio resident came back, explained that the spots were tiny, where they exactly were, and that given the size of them they were not usually followed up on.
I reminded him of my history and said I wanted follow up, which he arranged to my satisfaction. Then I told him that I thought this was a teachable moment. I explained why I had been so upset about the way and the timing of his giving me the result of the x-ray. He apologized profusely and said it was an important lesson to learn and that he would not forget me. I accepted his apology and we parted in a friendly way.
A year later a CT scan demonstrated that the spots were gone.
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YOIKS! What a surreal experience that must have been! Your lung x-rays had been available for SEVEN DAYS but nobody followed up? Of course you would be terrified considering your medical history! Good for you for speaking up and being clear about what you needed and wanted.
Best parts of your story: you framed this as a “teachable moment” for that cardiology resident, and then his positive response: “I will not forget you!” You did that young man a big favour that will help him become a better doctor.
Great news that those spots disappeared! Good luck to you. . . ❤️
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Thank you for bringing up the concept of simple kindness.
It is SO needed in the world today – not just in Health Care. We can so easily become jaded and fearful, with defensiveness and self-protection becoming primary motivators in our lives.
Whereas kindness may have come naturally to us in simpler times, it now requires a concerted effort. Something as small as remembering the telemarketer whose call I picked up is another human being trying to make a living.
As a nurse, I can’t even remember how many hours I spent with patients and families who had a physician drop a medical bomb on them and then walk away.
I believe that the majority of health care workers, doctors included, are kind caring individuals at their core. But what is missing in their education are the finer sciences of emotional intelligence, how to self nourish and how to remain human while working in intense, emotionally wrought circumstances without burning yourself out. I know I had to learn that all on my own.
When I feel like a physician is just talking to me from his head, and not connecting with me heart to heart, I have a technique I use to break through the facade: I ask them a personal question….this forces them to access a different part of their brain and quite often makes the rest of the conversation softer….kinder.
When I had the first meeting with my cardiac surgeon at Mayo. I could feel the cool nature of his automatic repetition of technical facts. At the end of his educational talk, he asked if I had any questions. I said “Yes, what music do you play in the operating room?”
I saw his whole demeanor change as he related his love for jazz music. This changed our entire relationship going forward human to human.
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Hello Jill – you mentioned two different examples here – one that made me want to cry, and one that made me smile. Sadly, many of my readers have told similar nightmare stories (not that they were the health care professionals picking up the pieces afterwards, but worse – the ones holding that bomb while their doc abandoned them and their families.
The late physician Dr. Kate Granger was a young physician in England who was diagnosed with cancer, and died on July 23, 2016 – five years after her diagnosis. But during those years, she not only went through cancer treatments, but also left a global legacy directly sparked by the doctor who told her that her cancer was incurable. She explained:
“Imagine my position: I’m 29 years old, I know I’ve got cancer, I think it’s confined to my abdomen so I’m expecting to have an operation, maybe some chemotherapy and possibly a cure. I’m in pain and alone. A junior doctor comes to talk to me about the results of the MRI scan I’d had earlier in the week. I’d never met this doctor before. He didn’t introduce himself. He came into my room, sat down, and then looked away from me. Without any warning or asking if I wanted anyone with me, he just said, “Your cancer has spread.”
“He then could not leave the room quickly enough, and I was left in deep psychological distress. I never saw him again.”
Dr. Kate was so appalled by this doctor’s behaviour that she started a movement called “HELLO MY NAME IS…” that reminded all health care professionals the courtesy of introducing yourself to patients.
Thank goodness you also balanced my shock by telling us about how you helped that Mayo cardiac surgeon treat you (and his other patients) “human to human”. What a concept…
Take care . . . ❤️
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