It’s Been 20 Years…

It was Christmas in a pandemic.

With no big family gatherings or plans with friends, this past Christmas was the first time I’d ever watched It’s a Wonderful Life from start to finish without interruption. I’ve seen the film, but always in bits and pieces here and there, never all at once. I really enjoyed it and it stayed with me for several days afterwards. I kept thinking about the life of George Bailey and all he did and I wondered how many of us could relate. I mean, I’ve never pulled someone out of a hole in the ice and saved their life. How many of us have? We hear stories of people pulling others out of burning buildings or out of the way of a speeding car, but how many of us have actually done it? I started to wonder, “Are there any people alive today because of me? Have I really made a difference in the world?”

That was my thought one January evening as I was heading home and it occurred to me that maybe I could take credit for at least one person being alive.

I thought about my days in the mid-90s and early 2000s, working in organ donation and transplant, speaking with the families of patients who had just been declared brain dead and offering them the option to donate the organs. I know there were people whose lives were saved because of the generosity of those families. But would that have happened without me? The answer is probably yes. There might, and I mean might, have been a family that only agreed because of how they connected with me. Maybe. 

So that would have to be good enough. Not quite as dramatic as pulling my brother out of the ice, but it would do.

Now here’s where my story gets weird. 

The very next day, I got a message on Facebook from someone I wasn’t connected to, trying to send me a private message. I recognized his name immediately and accepted the friend request. It was a man I had met at a suburban Chicago hospital many years ago. His message was short, “Hi Kate – it’s been such a long time – just wanted to reach out to you and say hi – (my wife) and I will never forget you – it’s been 20 years since (my daughter) is gone – God Bless – “ 

I nearly fell out of my chair. 

And then it hit me. Does your impact on this Earth depend on those big dramatic moments or can you make just as big an impression in those tiny acts of human kindness? The simple act of being present, of staying out of judgement, of listening, of helping someone who is going through an unbelievably difficult experience… this is how we make a difference in the world. Twenty years later and this family still remembered me. Remembered me enough to want to reach out and tell me. 

This is what it means to work in healthcare. This is why I lead patient experience in healthcare systems. This is why I tell nurses, and food service workers, and housekeepers, and physicians, and registration teams, and telephone operators, and valet parkers, and security guards, and hospital presidents that how they treat people matters. 

We have no idea what our patients and their families are going through when we see them. We only know they’re scared, sad, sick and coming to us for help. How can we be anything but kind to them?

After 20 years, the kindness you showed someone will still be remembered and appreciated. Those people may not reach out over Facebook but they’ll still be grateful to you. You’re their George Bailey. And you absolutely made a difference in the world.

It’s Not Just Another Screening Test to Me

Every six months I have some kind of test on my breasts. Every summer, it’s a mammogram; every winter, it’s an MRI. 

While cancer runs in some families, it gallops in mine. There are only two relatives I know of who died of something other than cancer, and one of them really shouldn’t count. My maternal grandfather was born premature and his heart wasn’t quite ready. He had heart problems his whole life and died of a heart attack, so I don’t think it’s fair to include him in the mix. 

In fact, my father had three different kinds of cancer. Not cancers that started in one place and metastasized to another, but three different primary tumors. Very unusual. So I think he should count as three.

When every female relative of yours dies of breast cancer, you start to think it may just be a foregone conclusion. As much as I try to keep a positive attitude, I don’t really wonder if it’s going to happen, but when

So when it came time for my latest breast MRI, I was once again filled with the same familiar mix of anxiety and dread. Just six months earlier, my mammogram became an ultrasound that became a biopsy. It turned out to be nothing, but it scared the daylights out of me.

I was mentally preparing for something like that to happen again and reminding myself that whatever they find, they will have found it early. Early is good. Early is something none of my other relatives had. 

I always wonder when I go in for these tests if the people at the front desk or the techs running the machines have any idea what’s going on inside the patients’ heads. To them, it’s just another routine screening, but to me, it’s something much more.

Every time I go in, I think of my maternal grandmother, my mom and my sister. I watched breast cancer metastasize to brain cancer in my grandma. At the end, she thought she was a kid again, back on her farm in Iowa, and she didn’t know me at all. I was so mad at God for not letting her go out a little more gracefully.

I watched breast cancer metastasize to liver cancer in my mom. She went through some horrible treatments to shrink the tumors but they wreaked havoc on the rest of her. She got weaker and weaker until she couldn’t even walk and died in the one place an RN of over 50 years doesn’t want to die: a hospital. 

I watched breast cancer take my sister just six months after her diagnosis. She thought she was merely experiencing really bad back pain but it was actually compression fractures from the cancer eating away at her spine. As an unmarried woman who had no insurance, she needed someone to navigate the healthcare system for her, and I, as her only sister, did just that. She, at least, had the ending she wanted, on her terms. But it was still an ending.

So when I go in for these tests every six months, they aren’t just routine maintenance for me. They are a reminder of how devastating this disease is, not only for the patients, but for those who love and care for them. I am terrified every six months. It hasn’t gotten any easier.

And I’m on high alert for service failures. I am extra-sensitive to how I’m spoken to, how things are explained, the tone of voice they’re using with me, the degree of kindness and gentleness they show, all of it. 

This was a place I’d not been to before and I didn’t know what to expect from them. I’m very happy to report they did a wonderful job. Although they couldn’t possibly know what was going through my head or how anxious I was, they did a great job of caring for me from the moment I walked in to the moment I walked out. 

If you’re working in imaging, please keep this in mind. For you, it’s just another day at the office. For the rest of us, it’s something much, much more.

Tell Me Again What it is You Do?

It’s funny trying to explain to people what I do for a living. 

I get a lot of blank stares, puzzled looks, or people who ask if I’m a decorator. (Decorator? Really?) But mostly, people think I’m the complaint department. And I am to some degree. Complaints and grievances are a big part of the job, to be sure. But there’s so much more to it than that.

In several hospitals at which I’ve worked, there’s a patient relations team and a patient experience team. The patient relations team handles the complaints like poor service, lost belongings, and miscommunication. They do the internal investigation, follow up with patients, and resolve the grievances within 30 days. There is always more than enough to keep them busy. The patient experience team is there to change the culture with the hope of one day making the relations team obsolete. 

The experience team puts together the Standards of Behavior for the entire organization. They overhaul new employee orientation to be primarily about service. They do one-on-one coaching for staff and physicians. They create and lead a Patient and Family Advisory Council. They look at all the shiny new technology aimed at improving patient satisfaction and make recommendations about which ones to invest in and which ones to avoid. They analyze the survey data and devise plans for improvement. And they take the heat if scores don’t go up.

Culture change is hard. It takes a really long time and yet so many executive teams are results-driven. They want to see the numbers move right away. I don’t blame them, but that’s really not how it works. I once had a CEO who wanted daily patient experience scores on his desk every morning. Daily. I obliged, but told him I wasn’t going to take any action on daily scores, only the things we saw as trends over time. I didn’t last long there. 

But it gets back to what I do for a living. The short answer is, “I create systems in healthcare designed to provide the very best in service excellence.” That includes a lot of things, most of them proactive, rather than reactive. 

When the systems are designed well, the right people are in place, and they have the tools and support they need, great things happen. That’s what I do for a living.

Reach Out and (Virtually) Touch Someone

It’s been a month and a half and we are, for the most part, still sheltering in place and working remotely. There are those who have grown weary of the restrictions and are anxious to get outside and back to work; I’m observing fewer people wearing masks and keeping a six foot distance from others, but most experts agree it’s still too soon to open everything back up. 

I’m concerned for those who are truly struggling; whether it’s because of isolation or working in intense conditions caring for the sick. COVID-19 is taking its toll on us, emotionally and physically, and many of us are running out of coping mechanisms. 

Which is why it was such a wonderful surprise to get a message from a friend I had in junior high. She and I didn’t go to the same elementary school and we ended up in different high schools, but for two years in Emerson Junior High, she and I were inseparable. 

We’d kept in touch over the years through various social media channels and even met for lunch several years ago, but hadn’t actually spoken for quite some time. Then, out of nowhere, she sent a message asking if I wanted to do a video call and catch up.

It was wonderful. 

It was so wonderful, in fact, that it prompted me to reach out to friends I see fairly regularly (or used to, before all this started) and set up video calls with them, too. I’m calling my brothers more often than I did and am much more active on sites like Facebook to keep in touch. 

And this is significant because I’m not a person who generally craves a lot of social interaction. I love my alone time and need some peace and quiet in order to recharge. But this pandemic has made me realize that, when all is said and done, I’m not going to look back on my life wishing I’d spent less time with my family and friends. 

Our patients, their families, and our staff are no different. 

When trying to provide the very best experience, nothing beats a personal connection: someone reaching out to you, asking how you are, what they can do to help, and offering a shoulder to lean on. 

It isn’t always our clinical and technical expertise that makes an impression on people, but the way in which we interact with them that they remember. Taking a moment to reach out with genuine concern, actively listening, and giving people a non judgemental space to talk can make a world of difference. Even after 30 years.

Two Trips to the Urgent Care

This past week, I found myself in the throws of one of the worst head colds I’ve had in quite some time. I don’t get sick easily; all the years of working in hospitals has made my immune system pretty tough, so when I do get sick, it’s usually something major. I had been a little congested for a few days, but woke up one morning with an excruciating sore throat that made it nearly impossible to swallow. My primary care physician didn’t have an opening for me that day and I simply couldn’t wait to get some relief so off I went to the local urgent care clinic in town. 

I got in almost immediately and saw the nurse practitioner. She was great. Very kind, very thorough, and very sympathetic to my pain. My rapid strep test came back negative (surprisingly) as did the influenza test, so she didn’t want to prescribe antibiotics but, rather, manage my symptoms. That made sense to me. All I really wanted was some relief from the throat pain.

I picked up the prescription for viscous lidocaine, which did help the sore throat but tasted like motor oil, and stayed in bed for the next two days. 

I started to feel like I was getting better but three days later, not only was my sore throat back with a vengeance, but now my right ear felt like someone was sticking knives in it. My husband said I turned an eerie shade of white and insisted we get back to the urgent care right away. I didn’t argue.

We arrived 10 minutes prior to closing time and the receptionist told us they weren’t taking any more patients. I told her I had been there a few days ago and my symptoms had gotten worse. She apologized and said we could either come back in the morning or go to the Emergency Department tonight. The ED for a sore throat? No way.

I was contemplating how many boxes of popsicles to buy to hold me over to the morning when my husband suggested the urgent care about a half an hour away, which was open later. As much as I’m a fan of continuity of care, I knew there weren’t enough popsicles in the whole town to get me through the night so off we went.

The other urgent care center doesn’t look like much from the road, but inside it’s quite lovely. The receptionist was very nice, as was the tech who took my vitals, but the real star was the nurse practitioner. Her main concern was getting me some immediate relief, especially after she learned that I’d been suffering for nearly a week. She gave me a steroid, decadron, along with an antibiotic for the ear infection I’d developed. By the time I picked up a box of popsicles at the grocery down the street, I was feeling 100% better. 

I slept better that night than I had in several days and the pain in my throat never returned. It was amazing. That shot of decadron may have been slightly outside the usual course of treatment, but it was exactly what I needed. 

I’m not saying anything bad about the nurse practitioner at the first center; she did exactly what she should have. No antibiotics for a virus, I get it. But when it comes to relieving suffering, the second center knew just what to do.

Incidentally, I asked them how close to closing time they stop seeing patients. The tech said they don’t turn anyone away if they get there before 7pm. Even if it’s 6:59, if they need care, they get it that night. Admittedly, it can get a little tough on staff who are eager to get home after a 10-hour day, but the mission, the reason they’re there, is what keeps them going. They know they are there to help. And they did.

The Doctor-Patient Relationship

The relationship you have with your primary care physician can mean the difference between life and death.

How’s that for an opening statement?

My parents had my eldest brother, Chris, in 1959, then 14 months later had my other brother, Andrew, and 18 months later had my sister, Mary. It was just the three of them in this tight cluster until 7 years later when I came along. Those two were full of energy, into everything, and had non-stop energy. She, on the other hand, was an introverted sensitive soul.

She also had a weight problem. For as long as I could remember she was extremely self-conscious about it. My brothers were skinny, especially Chris, and poor Mary got picked on. A lot.

It didn’t help that our primary care physician was a scary looking old man who spoke in a thick German accent and used to tease her about her weight every year at her annual school physical. She dreaded those visits and even as an adult hated going to the doctor for fear that they’d say something unkind.

Those early pediatrician visits made a big impression on her. She thought every doctor was an old man who said things like, “Vell younk lady, you ah putting on some veight, again, yah? You haff to shtop eating so many cookies.” And always in front of my brothers, giving them plenty of ammunition for teasing.

She never got over it. This was a woman who, in her late 30s, refused to go to a doctor when she clearly and unmistakably had gallstones. Incredibly painful gallstones which she insisted on treating with over the counter tylenol. They either resolved on their own or she just adjusted her pain tolerance, I’m not sure which. But it infuriated my mom who was a nurse and me who worked at a hospital. We begged her to go to a doctor but she absolutely refused. She told us didn’t want to go because she was sure they’d get on her case about her weight. Exasperated, Mom and I finally gave up.

Fast forward to the fall of 2012. Mary was suffering from some insanely horrible back pain. Nothing over the counter could touch it. She’d gone to a chiropractor, a massage therapist, and an acupuncturist, but got no relief at all. I remember her telling me that driving over railroad tracks made her see stars.

Finally, I said, “That’s it. I’m getting you an appointment to see a doctor. We have GOT to get this looked at.” A few days later, I was able to get her in to an internal medicine physician with the medical group I worked with. Although I turned my head when he asked her to take her shirt off, there was no way not to notice the giant lump she had on her breast. It was huge. Softball size huge. I couldn’t believe my eyes.

A few imaging tests later and it was confirmed. The pain in her back wasn’t a bulging disc or muscle spasms. It was stage 4 breast cancer with compression fractures in her spine. The cancer had spread from her breast, through her rib cage and into her back. There was nothing they could do. They gave her six months.

I was as supportive as I knew how to be but I had to ask why she didn’t go see a doctor as soon as she found the lump. It all came down to her fear of ridicule. She truly thought that her doctor would spend more time chastising her about her weight than addressing the lump in her breast.

Now I’m not going to blame my sister’s death on her childhood physician; at some point, we all have to grow up and do the right thing. But she was truly traumatized as little kid and those scars stayed with her well into adulthood.

Sometimes we say things and we don’t mean anything by it. We’re joking, we’re trying to inject humor in an uncomfortable situation, or we’re just not thinking about how the other person is hearing it. Whatever the reason – it matters. Doctors, believe me, we listen to what our physicians say to us. It may be a throwaway comment to you, but it’s gospel to us. Venn you vant to make a shatement about your patient’s veight, pause. Think about how that may impact their relationship to the medical field.

I loved my old PCP. There was nothing he could have advised me to do that I wouldn’t have done. And not because it was good advice; other doctors gave me the same advice, it was because I liked him. Liking him made me much more inclined to do what he asked. When he addressed issues about my weight, it was always with compassion and sensitivity

Doctors, you’re more than just the treating physician. Inspiring behavioral change doesn’t really happen without relationship. Get to know your patients. Be kind when you have to deliver some unpopular or sensitive news like needing to lose weight. The words you choose can make all the difference.

When Your Husband is the Patient

“Honey. Honey, wake up. We have to go to the hospital right now.”

My husband has had his share of health problems, but I’ll never get used to being awakened from a sound sleep to those words.

I somehow managed to get myself out of bed, brush my teeth, and throw on some clothes before braving the several feet of snow and merciless winter wind to get to the car. As he was doubled over in pain in the passenger seat, I pulled out of the driveway, into the dark and headed toward the local emergency department.

Walking in the front door toward the registration desk, I took notice of everything around us. Having worked at my share of hospitals, I was on high alert. Was the person at the desk looking up as we walked in? Was the waiting area clean? Were there signs telling us where to go and what we needed to do? I noticed everything.

It’s funny how we’re so much more vigilant when it’s a loved one as opposed to ourselves.

I got him over to the front desk and smiled when the woman told us her name and said she was going to walk us through the registration process. She was patient while he took a few extra moments to pull his wallet from his back pocket. The pain in his stomach made it hard for him to straighten up but she didn’t seem to mind.

We got back to the treatment area almost immediately and I noticed that everyone we passed on the way to his room acknowledged us in some way, whether it was a smile, a hello, or just eye contact. I started to relax. A little.

It wasn’t long before the physician came in and asked one simple open-ended question, “Hello, Mr. Kalthoff. What brings you in tonight?”

Anyone who knows my husband knows he can’t ever answer a question with a simple answer. If you ask him what time it is, you’ll learn all about the history of watchmaking.

I watched this doctor’s face as he relayed his entire medical history and that of his father’s and was truly impressed that she didn’t interrupt. She asked very focused questions to get him back on track but it never came off as rude or impatient. I could use some of that, especially when I ask what he’d like for dinner.

She got to the heart of the medical issue that brought him to the ER and in no time he was back in imaging getting a CT scan. They even let me go back with him, which I didn’t expect, and told us it would be about an hour before we’d get some results. I looked at the clock and started the countdown.

While we waited, several people came in to check on him, including a student who had anticipatory service down to an art. Without having to ask, he brought me a glass of water and a pillow for the uncomfortable chair I’d been sitting in and an extra blanket for my husband. I was impressed. He was oblivious. The pain meds had kicked in.

Which brings me to the point. Often, patients don’t notice the things family members notice. And even if they do, they’re less likely to be upset by them. I can make excuses for doctors and nurses all day if I’m the patient, but if it’s my family, that protective instinct kicks in and I’m ready for battle.

Thankfully, that night in the emergency department, there was no need for battle. Everyone was marvelous. The CT results came back sooner than expected and his condition was explained in a way we both could understand. We left feeling much better than we did when we came in and I happily filled out the survey when it came a few days later in the mail.

When we talk about patient experience, we cannot forget the people who are with them. They notice everything. They worry more. They have more questions. They listen closely to how their loved one is spoken to or spoken about. We have to remember to include them in the discussion and address their needs, as well.

From The Other Side

Recently, I had to undergo some surgery. Routine, standard stuff but it did require me to be completely knocked out for a few hours with the possibility of an overnight stay. I’d never gone through anything like this before, so I had my share of nerves the morning of the procedure.

My surgeon doesn’t practice at the hospital in which I work; she’s at the smaller hospital near my home, which was actually a good thing. People were telling me that the car ride home was going to be tough; I’d feel every bump, every sudden stop, every pot hole in the road, so it was best that the drive home was 20 minutes instead of 75.

Before we got started, I was watching everyone. The staff at this hospital didn’t know that I worked in Service Excellence and Patient Experience at the big hospital up the road. To them, I was just another person in need of care. To me, I was kind of a mystery shopper. I was keeping track of how people were introducing themselves to me, how well they explained what was going to happen, how accommodating they were to my husband who was with me, everything. They were great. I even remember that there was Beatles music playing, which helped calm me down even more. All you need is love.

I remember my surgeon coming in ahead of time to check in on me and answer any last minute questions. Same with the anesthesiologist; he came by to make sure I was okay before we went into the OR.

The next thing I knew, it was several hours later. The surgery lasted about an hour longer than expected and it took me a while to wake up. The post-op nurse took out the IV in my left hand and told me it was time to get dressed (I don’t actually remember that part, but I do remember my husband trying to help me get my shoes on). What I do remember is feeling very dizzy and light-headed and needing to lie back down.

It was some time later and I was still feeling like the room was spinning. The nurse that was caring for me told my husband that they were filling up in post-op so I needed to start getting ready to go home. I don’t know what he said, but the next thing I knew, there was a new nurse in the room who put in a new IV into my other hand. I heard something about “getting her some fluids” and a short time later, I was feeling a whole lot better. Still sleepy and kind of out of it, but not dizzy anymore.

With that, I was in a wheelchair, then my car, then home. A few days later when I wasn’t sleeping 18+ hours each day, I started to remember more and more details about that day. I remember everyone being really nice and helpful, but my husband will tell you about the nurse who wasn’t picking up on my physical cues and seemed more focused on clearing the bed than making sure I was well enough to go home. He felt a lot better when the new nurse showed up and took action, but the moments leading up to that are the parts of the story he remembers more than any of the other really good things that happened that day.

Patient Experience is a team sport; all it takes is one misstep for the lasting impression to be less than excellent. And it affects more than just the patient, especially when the patient is unconscious for a period of time. Making sure that family members are well-informed and feel comfortable advocating for their loved one is just as important as direct patient care.

When asked, he and I tell a slightly different story about how things went that day, but what our stories have in common is that the staff was kind, responsive, and showed genuine concern for me. And that’s a great patient story.  

When You’re the Patient

Whether it’s organ transplant, physician relations, or patient experience, I’ve spent my entire career working in and around hospitals. It’s been pretty normal for me to go to a hospital five days a week, for eight or nine hours a day. I know there are people who are terrified of hospitals, who believe that’s where people go to die, but I’ve never really had a fear of them.

I’ve observed a few surgeries, been to hundreds of medical centers, visited thousands of physician offices, served on dozens of hospital committees, and worked in the operational and administrative sides of healthcare. I’ve also been the person who goes with the friend or family member when they have an appointment to ask the right questions, write things down, offer support and comfort, all of that. It’s old hat to me. Not a problem, of course I’ll go with you.

None of that prepared me for what it feels like to be the patient.

My routine mammogram turned into a breast MRI, which led to an ultrasound, which led to a biopsy. Given my prolific and always fatal family history of cancer (both grandmothers, a grandfather, my mom, my dad, and my sister) I was petrified. I’d been kind of joking about it for years; it’s coming for me, it’s only a matter of time; but there was nothing funny about going through all these tests just waiting to hear how far along it had gotten or what stage it was in or how long I had…

I had only been living in this area for about a year and hadn’t yet gotten to know all the players at the hospital where I was having all these tests. As part of the patient experience department, I only knew them from their patient satisfaction scores. Now I was going there for tests and I had no idea what to expect.

One question kept coming up in my head at every encounter: do they have any idea how terrified I am?

Every scheduling phone call, every check-in at the desk, every assistant who walked me to an exam room, every tech who performed a test, every physician who offered an inconclusive result. Do they have any idea how terrified I am? Do they know my family history? Do they know that I’m worried about my daughter, too?  Do they know that in my family there is no such thing as a cancer survivor? Do they know how scared I am?

I think a few of them did. They were kind, patient, gentle. But to others, I think I was just another procedure to do. It made me wonder if I’m looking at the people who come in and out of my workplace every day with that same sense of routine. It’s a hospital, it’s my work, it’s no big deal. After this experience, I know that’s not how everyone sees it.

Hospitals are scary for some. We can’t possibly know all the history our visitors bring with them. What we have to know is how to be kind, patient, gentle. Every patient. Every time.

Are We Treating the Disease or the Person?

A few years ago, my family got the worst news we could imagine; mom was diagnosed with breast cancer. Although true to her stoic Norwegian roots, she was appropriately nervous about what lay ahead. Her mom had died from breast cancer just a few years before and she’d seen all that she had gone through. But my mom was determined to win.

She found an oncologist that she really liked, something I knew was important. After nearly 50 years as a Registered Nurse, mom had a great deal of respect for physicians. She didn’t like all of them, but she knew how much training they’d had, how much knowledge they had to keep at the top of their minds, how much pressure they were under all the time. She admired them. And she’d never, ever question them. So when she found this doctor and hit it off with her immediately, I was happy. She had a lot of respect for her and I know it made a difference in her mindset when battling this disease.

Mom did well. She fought for about a year, after which she looked to be free and clear. We all breathed sigh of relief and went on with life.

A year later at one of her follow up visits, we got sucker-punched. The cancer had returned and had metastasized to her liver. This time, her oncologist had a different treatment plan, something much more aggressive. Mom was totally on board. She liked this physician, trusted her, and would have done whatever she said.

In just a few short months we saw a dramatic difference. Mom was weak, her skin was yellow, she couldn’t eat. She wasn’t the same and she looked like she was getting worse every week. I was working at another hospital as the Physician Relations Manager and had gotten to know a couple of the oncologists there. I asked mom if she’d consider going to one of them for a second opinion on her treatment options.

“No. Absolutely not. I like this doctor. I trust her. I’m not going to anyone else.”

I’d been going to mom’s appointments with her and my dad and was the note-taker. I wrote down everything that was said but rarely spoke, myself. That started to change. I told the physician that mom was doing worse; she had a hard time with stairs, was almost too weak to stand, and couldn’t entertain the idea of food. “But her tumors are shrinking,” was her reply.

The next day, mom took a fall at home. Dad called an ambulance and I met them in the Emergency Department. While they were moving her up to an inpatient room, I pulled my dad aside and told him I wanted to involve another physician in mom’s case. He looked stunned. “Why would you do that?”

“Dad,” I said, “I know she says the tumors are shrinking, but that’s all she’s looking at. She’s not looking at mom. Have you ever seen her this sick? I want the tumors to shrink, too, but not if we kill her in the process.”

“Will she be offended if we tell her we want to see a different doctor?” He was worried about hurting this physician’s feelings. He had seen a genuine friendship grow between his wife and her oncologist and was worried she’d be upset if we sought out another opinion. I tried to reassure him that doctors experience this kind of thing all the time and don’t take it personally. I wasn’t as interested in being factual as I was getting another set of eyes on her. Not her tumors, not her white blood count, her.

He took a minute to think about it. He knew mom wouldn’t be happy seeing a different doctor, but agreed that maybe there was another treatment out there that wouldn’t be so hard on her.

I never got the chance to make that call. When I went to work the next morning, I looked up the phone numbers of two of my favorite oncologists but before I could dial, I got a call. Come to the hospital now. Mom took a turn last night. She was gone two days later.

When I reflect on it now, I keep coming back to the same thing: treat the person, not just the disease. I have no doubt that my mom’s oncologist was a competent physician, or that she wanted my mom to recover, or that she did the very best she knew to do. But it has to be more than disease management. We have to notice how these treatments are affecting patients, their lives, their well-being, even their families.

If you’re a physician, ask yourself: do you treat illness or do you treat people?