Tag Archives: Dr. Iona Heath

Pain vs. suffering: why they’re not the same for patients

19 Feb

by Carolyn Thomas      @HeartSisters

I’ve written a lot (here, here, and here, for example) about cardiac pain, because I live with a lot of cardiac pain called refractory angina due to a pesky post-heart attack diagnosis of coronary microvascular disease. This pain varies, but it hits almost every day, sometimes several episodes per day, and it can feel very much like the symptoms I experienced while busy surviving what doctors call the widow maker heart attack in 2008.

But there’s pain, and then there’s suffering. The two are not the same.

I spent many years working in the field of hospice palliative care, where we all learned the legendary Dame Cicely Saunders‘ definition of what she called total pain”.(1)  This is the suffering that encompasses ALL of a person’s physical, psychological, social, spiritual, and practical struggles. Although addressing total pain is an accepted component of providing good end-of-life care for the dying, the concept seems to be often ignored in cardiac care for the living. Continue reading

Kindness in health care: missing in action?

14 Jun

by Carolyn Thomas    @HeartSisters

I don’t remember much of what happened during that fateful visit to the Emergency Department.  I remember the on-call cardiologist saying something to me about my “significant heart disease”. After hearing those words, I felt so stunned that – although I could see his lips moving and could hear sounds coming out of his mouth – he may as well have been speaking Swahili.  (Doctors, please remember this in the future when delivering life-altering diagnoses to your patients!)

What I do vividly remember, however, is a small but profound act of kindness later that day when I was brought to my bed in the CCU (the cardiac intensive care unit). Continue reading

Just not listening – or “narrative incompetence”?

22 Mar

by Carolyn Thomas  @HeartSisters

The Radical EarI’ve been reading lately about something called the patient’s narrative in medicine. Although it’s basically defined as patients telling the story of what originally brought them to see the doctor, it’s actually much more.

Doctors, for example, all too often may see “the story” as an unnecessarily lengthy distraction from getting swiftly to diagnosis and treatment.

But as U.K. physician Dr. Jeff Clark describes it, connecting with and understanding the patient requires a doctor to appreciate each person’s unique perspective. In the December 2008 issue of The British Journal of General Practice, he asked other doctors to consider how not listening to a patient’s story can be compared to his colleague’s golf game:  Continue reading

Empathy 101: how to sound like you give a damn

24 Feb

by Carolyn Thomas    @HeartSisters

During the first follow-up appointment with my (now former) family doctor a few weeks after surviving a heart attack, I noticed something unsettling right away. First, she seemed utterly preoccupied with her own possible part in missing some magical sign that I’d been at risk for this surprising cardiac event. She reviewed lab test after lab test while I sat there watching her claw through a thick file (no electronic charts there!) of my lipid and blood pressure results going back years. It struck me that this follow-up visit was somehow all about her – not about ME at all!

Hey! Remember me? The one who actually had the frickety-frackin’ heart attack?   Continue reading