Precarity: the perfect word for our times

by Carolyn Thomas      @HeartSisters   

I learned a terrific new word recently. The word is precarity, meaning the state of being precarious, unpredictable or uncertain. Any woman who is freshly diagnosed with heart disease already knows the precarity of life following a cardiac event – a reality that suddenly feels precarious, unpredictable and uncertain as we try to make sense of something that makes no sense. And after 19 months of navigating a global pandemic, we now know yet another kind of precarity.       .          .  Continue reading “Precarity: the perfect word for our times”

Is the practice of medicine making doctors sick?

by Carolyn Thomas   @HeartSisters   

Sue Robins of Vancouver has an irresistible writing talent that’s somehow both quietly approachable and yet sneakily explosive. We see this talent in her books A Bird’s Eye View: Stories of  a Life Lived in Health Care or Ducks in a Row: Healthcare Reimagined.  We also see it in her compelling blog essay, “We Are All In This Together” as she explores the “basic lack of humanity that ails health care – a lack of humanity for patients, families, staff, clinicians, physicians and administrators.”  As Sue says:

“We are all in this mess together.    .     . Continue reading “Is the practice of medicine making doctors sick?”

“The doctors want my symptoms but not my stories”

by Carolyn Thomas     @HeartSisters

Marilyn Gardner, in her 2014 book called “Between Worlds: Essays on Culture and Belonging“) wrote about a compelling conversation she once had:

Yet our physicians aren’t trained to embrace our stories, but instead to ask right away, “What brings you here today?” to kick-start a brief Q&A that can most efficiently solve the diagnostic mystery sitting across from them.      .     .    Continue reading ““The doctors want my symptoms but not my stories””

Dear Carolyn: “People can change for the better”

by Carolyn Thomas    @HeartSisters    October 28, 2018

We know now that childhood trauma is strongly associated with chronic illness later on, including heart disease. As I wrote in a recent blog post about ACE (Adverse Childhood Experiences), researchers warn us that scoring 4 or higher on the ACE test can predict a significantly higher risk of physical or mental illness as an adult. I was stunned when I took the test and saw that my own score was 4; I was well aware of my childhood experiences, of course, but I thought that only marginalized kids from desperately poor families were at high risk – and that wasn’t me! A history of psychological childhood abuse or neglect is not what we expect our doctors to ask us about – but this research suggests that maybe they should start.

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One response to that post really hit home for me. Marie (who prefers not to use her real name here) lives with a type of ischemic heart disease called coronary microvascular disease (as I do, too). With her kind permission, I’m sharing her childhood story with you as the latest guest post in my regular but very occasional series called Dear Carolyn“:

Six ways NOT to motivate patients to change

by Carolyn Thomas   @HeartSisters 

In classic scientific understatement, U.K. researchers Drs. Michael Kelly and Mary Barker observed that “most efforts to change health behaviours have had limited success.”(1)

No kidding. Right now, even as you read this, academic researchers all over the globe are applying for (and getting) grant funding to embark on yet another new study examining smokers who don’t quit, couch potatoes who don’t get off the couch, or overweight people who don’t lose weight. I can’t be 100% certain, of course, but I’m betting my next squirt of nitro spray that these studies will no doubt conclude that, yes indeed, those people do need to change their behaviour, and “further study is required”. Continue reading “Six ways NOT to motivate patients to change”