Monday, July 21, 2008

An Open Mind

I was asked recently what one thing I would like to tell physicians, nurses, and other health care providers. I just wrote a book about interacting with the health care system, and its content ran the gamut of emotion: gratitude, optimism, frustration, skepticism--clearly I’m not one for brevity.

In the end, though, the answer was succinct, and the more I think about it, it is something that applies to patients and practitioners equally:

Keep an open mind.

In terms of diagnosis, the flash point for so many patients with chronic conditions, keeping an open mind works in several ways. For physicians, it means remembering that the obvious, logical diagnosis may not always be the correct one, something I can attest to personally. I am forever grateful to the physicians who looked beyond what “should” have made sense for a diagnosis and found the diagnosis that actually reflected both my experiences and my symptoms—even if it was an exceedingly rare one. For patients, it means remembering that even if you’ve been dismissed before, it is possible to start fresh with a physician or nurse practitioner and work towards a correct diagnosis.

In daily life, keeping an open mind means, quite literally, being open to new or creative ways to adapt to illness. Whether it means trying techniques like yoga or meditation, incorporating new foods and recipes into meal planning, or very pragmatic things like switching your exercise schedule or working out a flex time arrangement with an employer, keeping an open mind means recognizing there are many different approaches towards accomplishing a particular wellness or lifestyle goal.

If you’ve been reading this blog regularly, then you know how important I think an open mind and a willingness to try new ways of solving existing problems are to meeting some of the universal challenges in health care: better disease outcomes, increased compliance, and, yes, of course, more accurate and efficient diagnoses.

That’s why I’ve posted about the value of expressive writing, and why I developed a creative writing program for chronically ill pediatric patients. It’s also why I think programs like Dancing with Parkinson's or Loolwa Khazzoom's Natural Pain Relief that use dance and other forms of the arts to relieve pain, increase strength, and otherwise address symptoms of debilitating disease are incredibly valuable.

It’s also why I was so interested in "Monet? Gauguin? Using Art to Make Better Doctors" from Sunday’s Boston Globe, which discussed a class at Harvard Medical School that encouraged medical students to use art to improve that most fundamental and most complex of interactions—the patient exam and diagnostic process.

The article quotes Dr. Joel Katz, who first proposed the class five years ago, as saying, "We're trying to train students to not make assumptions about what they're going to see, but to do deep looking. Our hope is that they will be able to do this when they look at patients.”

Turns out, new research in the Journal of General Internal Medicine supports this. The article goes on to say that the students’ ability to make more observations increased by 38 percent. In age where physicians rely heavily on CT scans, MRIs and other specialty diagnostic tools—some argue too heavily, and at too high a cost for the health care consumer—helping medical students learn to see the many possibilities inherent in one situation is a valuable skill indeed. More precise observations yield more precise diagnoses.

Sounds pretty good, doesn’t it? The course was a stark departure from the required core courses at Harvard Medical, but all it took was a few open minds…


Unknown said...

i love hearing about cool course like that. too bad they are not mandatory.

(I will get around to reviewing your book soon I swear)

Leslie said...

Hi Laurie,
Thanks for all of your comments on my blog. I'm so glad you're reading my blog! I love reading yours. I just bought your book last week, but have yet to read it. Once I do, I'll post about it. I do enjoy Chronic Babe, so I'm glad you mentioned letting Jenni know about my call for submissions. I haven't done that yet. I don't know if you saw, but I posted about a post of yours a few weeks ago:
Stay well and please keep reading!

britta said...

I finished the book awhile ago...maybe last week? I can't remember now, but loved it. Are you thinking about a second one in a few years? I would buy it right away and read it too..;-)

Mark H. said...

This is great post! I think another thing for being proactive and keeping an open mind is blogging - I have found that one of the most healing things we have done is created our blog about living with chronic disease. What has happened is a community has formed and we no longer feel alone in the extremeness of our situation, but also we know we are giving back to others as they are giving to us.

Thanks for all your awesome work, especially when you've talked about young spousal caregivers (such a misunderstood and serious situation).

Take care,
Mark & Megan

Laurie said...

Hi Everyone!
Becca, no worries! :)

Leslie, happy to hear from you. Hope the submissions process is going well. I'll check out the link, thanks!

Britta, so happy to hear you enjoyed the book! I'll keep you posted on more projects!

Mark, thanks for stopping by--I totally agree, blogging is another way of being open-minded. And yes, I think younger spousal caregiving is one of the most important issues out there. Thanks for reading!

Anonymous said...

Hi Laurie, I just discovered your blog. Wow, you can write...

Twenty years ago when I first became ill I dreamed of medical schools teaching such classes, of doctors minds opening to see the "medical mystery" of my a puzzle to be solved, not as a judgment to be made.

What a joy and affirmation to read that medical courses such as this one are now a reality. Hopefully the next generation who becomes ill with CFS and other "mystery" illnesses, will not have to go through the torment of being both seriously ill and not believed.

Foret de Michelle said...

Love your blog, adding you to my blogroll to keep up...I have FMS and all sorts of other crap and can genuinely empathize with you.

Will keep an eye out for your book. Great work, again, on the blog!!!

A said...

I just wrote about this article today on my blog! (I should have checked yours sooner). I always have my nose in the NYTimes so I tend to be behind on the Globe. :)

Sherril said...

Have you heard about The 2008 APF Pain and Creativity Exhibit?
Last year's exhibit is up and this year's is in the works... I think it's pretty cool.

I am in the process of savoring your book and will also be putting a review up as soon as I finish it.

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