Hope for a change
by Andrea Powell, HPCCR Marketing Manager
There are often stereotypes that accompany surgeons. I can’t say for sure that the stereotypes hold any weight because I simply haven’t met many surgeons. But isn’t there usually a reason that stereotypes exist? Who knows. Anyway, this is what I’ve heard about surgeons: brash, cold, confident (verging on cocky), brilliant, terse, aggressive.
The surgeon I listened to last night was none of those things. Except brilliant.
Yes, Dr. Atul Gawande is a surgeon. But he’s also a professor (at Harvard) and an author. His most recent book, Being Mortal: What Matters in the End is on the New York Times Best Seller’s List and has been for months. The man knows his stuff.
He came to Charlotte to participate in the Learning Society of Queens (University) lecture series. HPCCR was one of the presenting sponsors for his presentation last night and I was lucky enough to score a ticket.
Dr. Gawande has been thoughtfully considering end-of-life issues since he was a junior surgical resident. Over his many years in medicine, he has seen various outcomes for patients, ranging from aggressive measures to comfort care. He believes that everyone has a right to make their own decisions about what they want to do in the face of terminal illness — that was not the focus of his remarks last night.
What needs to change, according to Dr. Gawande, is the approach of physicians.
Physicians need to be better about asking patients what their priorities are, he says. They come in and talk to the patient but, in reality, their time talking needs to be cut in half. What should doctors be doing instead? Listening.
These are the questions that should be in their arsenal: “What is your understanding of your illness right now?”; “What are your goals if time is short?”; and “What are your fears?” Getting the answers to those questions will help determine the best course of treatment. It will get to the root of what kind of quality of life is acceptable. Because, in our job, it’s all about quality of life.
Dr. Gawande told the story of a hospice nurse who said something to him one day that stopped him in his tracks. She was in the room, doing a million things at once — adjusting pillows, adjusting meds, taking vitals, changing lines. In other words, she was totally focused on the needs of the patient. When Dr. Gawande remarked on her level of activity she said, “You’re a surgeon. Your job is to sacrifice time now for time later. My job is to give people their best possible day today.”
Ultimately, it was an inspiring evening. Dr. Gawande gave the room hope that we, as a society, are moving into an age where we can be comfortable with death. He talked about a new generation of physicians who won’t accept practicing medicine in the “traditional” environment we’ve had for so long. Dr. Gawande believes that we will soon see an entire cadre of young clinicians who believe they can be part of the solution rather than part of the problem. And we, as future patients, can do better too. He ended with, “If we define clarity about our goals and we all respect them, I think we can have extraordinary change.”
It’s happening, folks. Change is coming. The sheer fact that a surgeon talking about end of life sold out a one thousand-person theater speaks volumes about our current appetite on this topic. And those young clinicians our renowned speaker anticipates? They are going to smash the surgeon stereotypes; they are going to rewrite the job description. They will be like Dr. Gawande– thoughtful, kind, compassionate, communicative. They’ll be all those things and more. They’ll be brilliant.
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