Tag Archives: doctor patient communication

Dear Carolyn: “Breaking up is hard to do”

3 Aug

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

When patients feel like hostages

22 Jul

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 you’re about to become a hospital patient

17 Jun
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

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

10 Sep

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

Informed consent: more than just a patient’s signature

13 Aug

by Carolyn Thomas    @HeartSisters

The cardiologist was called to the ER and told me that he could tell by my T-waves and other diagnostic test results that I was having a heart attack. From that moment on, I could see his lips moving. I could hear sounds coming out of his mouth. I think I may have signed something before I was urgently moved upstairs to have what turned out to be a 95% blocked coronary artery unblocked. I was so stunned and overwhelmed, however, that I simply could not comprehend anything that was happening around me once I heard him say the words “heart attack”. He may have been speaking Swahili. . .

Yet I’m now pretty sure that the fact I signed a piece of paper somehow meant that I had participated in the informed consent process required of most hospital patients.

Does informed consent actually mean that it’s informed at all?  Continue reading