Denial? Or doctorly deference?

by Carolyn Thomas     @HeartSisters  ♥   June 2, 2019

Last week, the British Medical Journal (BMJ) ran a compelling opinion piece from Boston physician Dr. Abraar Karan on why some patients just don’t seem to understand what their doctors are telling them.  Here’s how he opens his essay:

Why am I here?’ Mrs. S looked up at me for the first time since I had entered the room and begun speaking to her. I had spent the past five minutes talking about the need for her to start new medications for her heart failure. She had nodded along for most of the conversation, but I wondered if she had heard, or more importantly understood, anything I had been saying. She had had three admissions for worsening heart failure in the past few months. And yet she looked at me and said, ‘Do I have heart problems? No one ever told me!'”   . Continue reading “Denial? Or doctorly deference?”

The medical apology: have you ever received one?

by Carolyn Thomas    @HeartSisters     August 26, 2018

I’ve been invited to participate in an academic study on an interesting concept: the medical apology. My first reaction was to decline the invitation, explaining that never once have I had a healthcare professional apologize to me when something went wrong. And I’ve had a few things go very, very wrong.

I could have used an apology at age 16, for example, when the infirmary nurse at my convent boarding school repeatedly refused my pleas to call the local doctor for my severe appendicitis symptoms, instead blaming them first on the flu, the next day on my period, and the third day on exam anxiety. I was finally hospitalized with a ruptured appendix and near-fatal peritonitis that required a month-long hospital stay. A little “I’m sorry” would have been nice. . .

But I’m thinking that some of you might have some interesting personal experiences about receiving a medical apology to share on this subject. If you’d like to get involved, here’s how to contact the researchers: Continue reading “The medical apology: have you ever received one?”

Dear Carolyn: “Breaking up is hard to do”

by Carolyn Thomas    @HeartSisters     August 3, 2018

Breaking up is hard to do. That’s how my blog reader Tommie O’Sullivan described to me the sad news that she lost first one, and then a second trusted cardiologist. It’s nothing personal. Important family reasons. Retirement. She understands these things. But still. . .

As part of my occasional and ongoing “Dear Carolyn” series of guest posts written by women who have learned firsthand what becoming a heart patient is all about, I’m happy to share this, with her permission. Tommie’s words reminded me that, so far, I’ve been lucky in never experiencing the loss of a favourite physician. I suspect that – in this age of increasingly empowered patients, critical doctor reviews online, and second opinions from Dr. Google – her sentiments are what every physician longs to hear one day from their patients: “I will really miss you!”  Continue reading “Dear Carolyn: “Breaking up is hard to do””

When patients feel like hostages

by Carolyn Thomas    @HeartSisters    July 22, 2018

When his 6-year old son became very ill and was hospitalized, Dan Beckham observed how his own behaviour in the hospital began to dramatically change compared to his real life. Although he would readily send a restaurant meal back if it weren’t properly cooked, now when his son received poor care (e.g. a healthcare professional who did not wash his hands), Dan hesitated to be assertive “for fear of alienating the physicians and nurses whose goodwill he needed to maintain.” Here’s how he explained this:

“I felt dependent and powerless, as if my son was a hostage to the care he received and the system that delivered it. It was as though I was compelled to negotiate for his safe release from potential harm.”

Such a reaction is an example of what’s known as Hostage Bargaining Syndrome (HBS), as described in the medical journal Mayo Clinic Proceedings.(1)  Continue reading “When patients feel like hostages”

When you’re about to become a hospital patient

A guest post by Karen Friedman MD and Sara Merwin MPH, authors of The Informed Patient: A Complete Guide to a Hospital Stay (Cornell University Press).

Linda was having a busy day: 9 to 5 at the office, and now grocery shopping. But she wasn’t feeling right. She was a little warm and dizzy and felt heart palpitations. She finished shopping and hurried home because she knew something was wrong. But what had her doctor told her? Chew an aspirin if she ever had heart attack symptoms.* Call 911. Linda wasn’t taking any chances: too many people depended on her. She called a friend to meet her in Emergency, grabbed her pill bottles and her printed medical history, and stuck them in her purse.

Linda is savvy. She had symptoms that could have been confused with any number of things, but she made a series of wise decisions: she followed her doctor’s advice, called a friend to help out, and went to the hospital armed with her important records.
Continue reading “When you’re about to become a hospital patient”

The shock – and ironic relief – of hearing a serious diagnosis

by Carolyn Thomas    @HeartSisters

I vaguely recall my gurney being wheeled very quickly down a wide hospital corridor after I heard the words “heart attack” from the cardiologist who had been called to the E.R. I stared up at the ceiling lights flicking by overhead, feeling strangely calm. Here’s what I recall thinking in my strangely calm state: when I’d first come into this same E.R. two weeks earlier, scared that my symptoms of chest pain, nausea, sweating and pain down my left arm might be due to a heart attack, I had been right!

These symptoms had never been because I was “in the right demographic for acid reflux” (despite what the Emergency physician who’d sent me home that first day had confidently pronounced). But now, after two weeks of increasingly horrific symptoms, popping Gaviscon like candy, I just felt relieved that all of the people around me now would know how to take care of me. The shock of hearing my new (correct) diagnosis of heart attack was subsumed in that moment by a wave of profound relief. Continue reading “The shock – and ironic relief – of hearing a serious diagnosis”