Tag: Minimally Disruptive Medicine

Kindness in health care: missing in action?

~ Carolyn Thomas ~ 38 Comments

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 “Kindness in health care: missing in action?” →

Do you fear change? Then don’t have a heart attack

~ Carolyn Thomas ~ 12 Comments

by Carolyn Thomas  ♥  @HeartSisters

For the freshly-diagnosed heart patient, the immediate and sudden change from “being well” to “recovering” cuts directly to the core of self-concept and self-esteem, according to Dr. Wayne Sotile. He offers a surprisingly familiar list of seven sudden changes commonly observed after a cardiac event. When thinking back on the new reality of my own early post-heart attack days, I was able to tick off his list, point by point. If this had been a midterm exam, in fact, I’d score a perfect 7/7.  On his list of seven stressors that newbies often face, how many ring true for you, too? Continue reading “Do you fear change? Then don’t have a heart attack” →

“I’m just not a pill person” – and other annoying excuses

~ Carolyn Thomas ~ 20 Comments

drugs hands

by Carolyn Thomas  ♥  @HeartSisters

Dr. Lisa Rosenbaum writes in the New England Journal of Medicine about a friend who is worried about her father since two of his sisters have recently died following strokes.  She asks her friend:

“Is he on aspirin?”

“Oh, heavens, no,” the friend replies. “My parents are totally against taking any medications.”

“But why?”

“They don’t believe in them.”

Curious about what she calls this instinctive non-belief, a commonly observed reluctance to take the medications their physicians recommend (aka non-compliance or the slightly less patronizing non-adherence), Dr. Rosenbaum wanted to understand how patients feel about taking cardiac medications. The consequences of not taking one’s meds can be deadly, yet almost half of all heart patients are famously reluctant to do so.(1)   Dr. Rosenbaum, a cardiologist at Boston’s Brigham and Women’s Hospital, wondered: Are there emotional barriers? Where do they come from? Can we find better ways of increasing medication adherence if we understand these barriers?*

So she interviewed patients who’d had a myocardial infarction (heart attack) – first at the time of the initial cardiac event, and again months later.  Their answers fell into five distinct themes that might be surprising to doctors feeling frustrated by their non-compliant patients. Continue reading ““I’m just not a pill person” – and other annoying excuses” →

When we judge the poor the way we judge the chronically ill

~ Carolyn Thomas ~ 15 Comments

by Carolyn Thomas  ♥  @HeartSisters

There’s an old joke about a woman who is successfully losing weight by following a very strict diet. But one day, her hubby returns home to find her sitting at the kitchen table finishing off a Hershey chocolate bar. He says to her: “Honey! You’ve been doing so great on your diet until now! How could you eat that chocolate bar?”

And her reply:

“You don’t know how many I wanted . . .”

That response sums up a profound message that goes beyond mere diet-cheating to how swiftly we rush to judgement based simply on what we see.  Mostly, we rush to judge other adults based on actions or behaviours that are none of our business (sometimes criticism is thinly veiled as “caring”:  I care about you so I have to mention the chocolate bar I see you eating. . . )  We judge others because they are not like us, because they make choices we wouldn’t, or because they make choices we might secretly want to make, too – but stop ourselves from doing.

Dr. Lisa Wade’s provocative essay on how we judge those living in poverty recently reminded me of how those living with a chronic illness diagnosis like heart disease can feel similarly judged.  Continue reading “When we judge the poor the way we judge the chronically ill” →