Sunday, August 15, 2021

Encouragement (In Suffering, Pain, and Witnessing Both…) #17: SUPPOSED to be "Good Words From the Medical Community", But...

The older I get, the more suffering and pain I’ve experienced; and the more of both I stand witness to. From my wife’s (and many, many of our friends and coworkers) battle against breast cancer; to my dad’s (and the parents of many of our friends and coworkers) process as he fades away as this complex disease breaks the connections between more and more memories, I have become not only frustrated with suffering, pain, and having to watch both, I have been witness to the suffering and pain among the students I serve as a school counselor. I have become angry and sometimes paralyzed. This is my attempt to lift myself from the occasional stifling grief that darkens my days…from JCO Oncology Practice: An American Society of Clinical Oncology Journal, https://ascopubs.org/doi/full/10.1200/JOP.2017.026195


I tell you, finding encouraging quotes from doctors and nurses, nurse practitioners and physician assistants, and other medical personnel aimed at patients being treated for cancer – of ANY sort – was a bust! (No pun intended!)

It appears that they don’t have time to write down the encouragement that they obviously dole out on a moment-by-moment basis.

So, let’s look at the research:

“Although clinicians [the ‘front-line’ workers in cancer care, listed (by no means exhaustively) above] likely view kindness as a requisite component of providing cancer care, a number of stressors may interfere with their good intentions. The complexity of health care delivery systems, coupled with financial and institutional pressures, can create a barrier between clinicians and the care they wish to provide. Indeed, the care itself can be a barrier, as compassion fatigue is well described in providers who are routinely involved in emotionally charged conversations…”

So they MAY give encouraging support, but the brutal truth is that they aren’t getting paid to SAY nice things. They’re getting paid to do EFFECTIVE things in combatting cancer.

While the research doesn’t say much in the way of actual “encouragement”, it does lay out a plan for clinicians to follow when interacting with patients. This plan includes six “kindnesses”:

1) Deep Listening: clinicians take time to truly understand the needs and concerns of patients and their families

2) Empathy for the patient with cancer: expressed individually and by “the care culture”

3) Generous acts of Discretionary Effort: including timely care delivered by tools and systems that reduce stress and anxiety

4) Gentle Honesty: what is happening is conveyed directly in well-chosen, guiding words

5) Support for family: the physical and mental health of the supporting family (no matter what the constellation of the family is!) and their well-being are vital components of the care the patient receives

6) All of these work together as long as the clinicians are mindful both that the patients they’re treating are at a literal ALL TIME HIGH stress level, AND they understand that the clinicians themselves are also under stress

Of course this seems obvious when we’re sitting here in our own secure places, some people having sent their loved one Home, others at the very beginning of the long ordeal and are steeped in hope. But at the hospital, in the clinic, in the chemotherapy room, in the radiation suite…those are the times that the care and compassion of the CLINCICIANS can make a difference; the times when the family and loved ones can only look on in mute terror or stunned acceptance.

That is when the mindful clinician can step into both the family and the patient and create a calming, confident atmosphere that, while it CHANGES nothing, it feels hopeful, and it feels like someone knows what they are trying to do.

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