Rx - Be a Blessing

“It is not doing the thing we like to do, 

but liking the thing we have to do, that makes life blessed.”

Johann Wolfgang von Goethe

Blessed be the Lord,

    who daily bears us up;

    God is our salvation. Selah

Psalm 68:19 (NRSV)

Patient engagement is a “hot topic” for health care planners.   It is part of the “meaningful use” prerequisite for electronic data management and access to information technology.  Underlying these ideas are how physicians, nurses, allied health connect with patients.  Here is my understanding and experience of that connection.

I would regularly meet a woman on entering the hospital who would respond to “Good morning, how are you?” with a smile and a consistent response, “Blessed”.  It immediately started my day with another vision of my work.  Recently, I read a tribute/eulogy to a teacher and mentor where the author discovers the source of his relationship with patients…”You are a blessing”.  

These two observations remind me of the opportunity we have been given when we are at our best as physicians.  We have that wonderful privilege of being with and standing by patients and their families at critical times in their lives.  

We have duties that we have sworn to uphold, but there is a larger dimension of what we should be and prescribe, “Be a Blessing”.  It means that even in the midst of a difficult illness or procedure, our patients should leave with the belief that you and your team have provided comfort and have been a blessing.

Students will see if this virtue is a reality in the life of the physician/teacher when it happens at the bedside and in the consultation room.   So besides the physician, those who are members of the teams of caring will also be blessed and leave thankful for the opportunity to be a recipient of a blessing.  Sometimes the new communication tools will make that happen.

Marvin

References

http://content.healthaffairs.org/content/32/2/223.abstract

Carbone L. You are a blessing. Annals of Internal Medicine.  150(4):276, 2009 Feb 17.

Verghese A;  Brady E;  Kapur CC;  Horwitz RI.  The bedside evaluation: ritual and reason.  Annals of Internal Medicine.  155(8):550-3, 2011 Oct 18.

Hage, M. L. (2012). Rx Ubuntu. Retrieved from http://healingagents.blogspot.com/2012/04/rx-ubuntu.html

Hage, M. L. (2013). Selah. Retrieved from http://healingagents.blogspot.com/2013/04/selah.html

Healing Grandparents

“I love you, You love me.”

Grandchildren are the crown of the aged,

    and the glory of children is their parents.

Proverbs 17:6  (NRSV)

He said to them, “Let the little children come to me, 

and do not hinder them, 

for the kingdom of God belongs to such as these.

Mark 10:14b (NIV)

Like parenthood, the skills and activities for grandparents are difficult to describe and perform; at least it was for me.  In the United States, there is a growing population of grandparents.

I always knew there were high expectations of grandparents, but what I did not know was the impact of grandchildren on the lives of grandparents.  We get to see “life again” through “new eyes”.  We also see the early versions of caring and empathy and we are  the fortunate recipients.

So what initially looked like a “one way relationship” is in reality a dynamic one.  These grandchildren bring healing to grandparents!

Marvin

References

Lumby J.  Grandparents and grandchildren: a grand connection. [Review]

International Journal of Evidence-Based Healthcare.  8(1):28-31, 2010 Mar.

Hage, M. L. (2013). Residential Learning. Retrieved from http://healingagents.blogspot.com/2013/03/residential-learning.html

Hage, M.L. (2014) Ancestry Gift.  Retrieved from http://healingagents.blogspot.com/2014/12/ancestry-gift.html

The Challenge

Homeless Jesus by Timothy Schmalz

Blessed are the merciful,

    for they will be shown mercy.

Matthew 5:7 (NIV)

“[ Jesus] understands human sufferings, 

he has shown the face of God’s mercy, 

and he has bent down to heal body and soul. 

This is Jesus. This is his heart”. —Pope Francis

I first entered private medical practice at a hospital that had as a part its name, “Mercy”.  That name was part of a religious ethic that reached out to the suffering even when the resources were very limited.  That is still the case in many parts of the world.

This week, Pope Francis is visiting the United States with a message of “Mercy”.  How will we hear that word and more importantly, how will it impact our actions?  In a recent JAMA editorial, we face a current challenge to that ethic of care when we are faced with those who have been rejected.

“These clinical moments lay bare the normative and moral work of physicians, endeavors that have historically provided the foundation for sustained therapeutic activity between patients and physicians. They also reveal a larger truth that if the arc of medicine is to ultimately bend toward healing, mercy will be its fulcrum.”

Maybe we can rediscover the critical component of mercy as we move toward a revival of healing in modern medicine. 

Marvin

References

https://en.wikipedia.org/wiki/Homeless_Jesus

Pope Francis (2014-04-20). The Church of Mercy . Loyola Press. Kindle Edition. 

Daaleman TP. A piece of my mind. The quality of mercy: will you be my doctor?.

JAMA.  312(18):1863-4, 2014 Nov 12.

Healing Work

Also, seek the peace and prosperity of the city

 to which I have carried you into exile.

 Pray to the Lord for it, 

because if it prospers, you too will prosper.

Jeremiah 29:7 (NIV)

Whatever you do, work at it with all your heart, 

as working for the Lord, not for human masters,

Colossians 3:23 (NIV)

Today is Labor Day in the United States.  The irony is that this holiday is one that most people escape from work!  

I just finished reading Tim Keller’s,  Every Good Endeavor: Connecting Your Work to God’s Work, that makes the argument that it is critical to integrate faith and work.  As you can imagine, I agree with the premise and enjoyed reading how the church has embraced this ministry.

The audience for this ministry are the young. They are at the beginning of their careers when the demands of their jobs are overwhelming and faith questions seem to be an added burden.  However, the reports are that the integration of faith with their work provides a deeper understanding and meaning in their lives!  

A reasonable assumption is that the questions of work would end with retirement. Paradoxically, I find the questions more acute as I see the increase in stress in the environments of healing.  We need places of celebration where work is healed like the Schwartz Center Rounds.  

Have a blessed Labor Day!

Marvin

References

Keller, T. (2012). Every good endeavor: Connecting your work to God’s work. Penguin see also http://www.faithandwork.org

Hage, M. L. (2010). The “Telos” for Christian Healing Agents. Retrieved from http://healingagents.blogspot.com/2010/12/telos-for-christian-healing-agents.html

Hage, M. L. (2012). “Burnout” and a “Path Report”. Retrieved from http://healingagents.blogspot.com/2012/08/burnout-and-path-report.html

Hage, M. L. (2012). Vocation & Retirement. Retrieved from http://healingagents.blogspot.com/2012/07/vocation-retirement.html

Zero-Sum Healing?

Irresponsible talk makes a real mess of things,

    but a reliable reporter is a healing presence.

Proverbs 13:17The Message (MSG) 

Recently, I attended a local “Schwartz Center Rounds” (See website) and heard a wonderful story of healing.  The audience of caregivers left the room energized!   Add to that the experience of reading the novel by Jason Mott, The Wonder of All Things, and it was a good week. 

The plot of the novel hinges on the protagonist, Ava, becoming progressively sicker each time someone is healed by her miraculous power.  It is a wonderfully written story that helps us all see our hopes and fears. 

Novels and movies that explore the nature of healing are wonderful ways of addressing the limits of our lives.  It is a challenge to hear the stories and relate them to our own lives and vocations. 

For me, the experiences of being part of a healing story is that of inspiration that is more like the Schwartz Center Rounds.   We were all able to clearly see the difference between healing and cure!   For me, real healing is not a zero-sum experience! 

Marvin

References

http://www.theschwartzcenter.org/supporting-caregivers/schwartz-center-rounds

Mott, J. (2014). The Wonder of All Things. Mira

Short list of other favorite healing stories and movies:

Cassella, C. (2010). Healer: A Novel. Simon & Schuster.

Patchett, A. (2011). State of Wonder HarperCollins.

Verghese, A. (2010). Cutting for Stone (1st ed.). Vintage Book

Lourdes (2009) Movie  

Sympathy for Delicious (2010) Movie 

Presence

"The Doctor is Here"

I just finished reading a collection of “doctor stories” of physician’s practicing in Appalachia.  I had the opportunity to practice in a location not far from the author’s home.  There is no question that rural America, like much of the world, has issues of access to care.  The responses are not always obvious.  

Telemedicine with robots may be one solution.  Can we “robotize” medicine?  The good news is that these technologies may help us refocus on the nature of medicine and hopefully the nature of healing.  Is it an adjunct or a replacement?  Is it a new way of expanding the outreach of care?  How will we know?

The answers are likely to be confusing to patients and societies.  We will need help to assess the impact from those who live and work in very different environments.  So for me, the answer is not about the technology, it is about the healing agents who deploy and use these tools!

Marvin

References

 http://www.intouchhealth.com/

Jourdan, C. (2012). Medicine Men: Extreme Appalachian Doctoring (11.6.2012 ed.)

 e-book

Medical robots in action: Ivar Mendez at TEDxToronto ...

https://www.youtube.com/watch?v=FQU2w-OPz90

Hage, M. L. (2011). Minds, Bodies, Machines and Souls. Retrieved from http://healingagents.blogspot.com/2011/07/minds-bodies-machines-and-souls.html

Well Being

“Let me give you a new command: Love one another. In the same way I loved you, you love one another. This is how everyone will recognize that you are my disciples—when they see the love you have for each other.”

John 13:34 (The Message)

The students were amazed by the joy we saw when we first visited and lived in a small rural poor community in Honduras!  It was obvious that most of the metrics used to assess need would not capture the well being of this community.  

More recently, we heard again from Jean Varnier, the 2015 Templeton Prize winner and founder of L’Arche communities of the disabled.  His big ideas find their reality in small acts of kindness and communities that value the most rejected.  

This last week, we where all amazed by the forgiveness given by the relatives of those murdered at Emmanuel AME Church in Charleston, South Carolina.  What was the origin of these great acts of forgiveness in that community of faith?

The message for me of these examples of “Well Being” starts well before the suffering and pain.  It happens in small ways that are practiced over and over again.  It becomes a way of being well in a welcoming community.  The practice of healing is found in this practice!  It requires a focus and faith that is lived everyday.  It means that we need to be present with those who suffer even before we try and “do something”.   It is for Christians the basis of our healing mission.  

Thanks be to God for all who build communities that care for each other and bring “Well Being”.

Marvin

References:

http://www.jta.org/2015/06/19/news-opinion/united-states/op-ed-this-is-not-the-charleston-i-know

http://www.presbyterianmission.org/ministries/missionconnections/wheeler-tim-and-gloria/

http://www.jean-vanier.org/en/home

http://www.nbcnews.com/nightly-news/video/charleston-comes-together-in-stirring-show-of-unity-469621827911