Monday, April 19, 2004
So far, I've read...
...three of the articles in this week's issue of the NY Times [Sunday] Magazine focusing on health care. I'm sure before the week is out I'll have read all but one of the articles, the journal on a mother and daughter's journey through cancer "together". I've found the most interesting article to be the one I just finished, The Writing Cure. The link above, by the way, will probably only be good for a week. Once the stories hit the archives you have to pay to access them. Oh. Okay. In order to access the article you have to be registered with NYT. It's free but just so you know, in case you're sensitive about subscribing to online services. Otherwise, your local book store or grocery or cafè may still have copies of the Sunday edition for sale, magazine included.
The article discusses the perceived lack of compassion and empathy in physicians as critical to their ability to heal and explores ways to approach this by training physicians to be more sensitive to narrative. About halfway through the article an oncologist-hematologist, who has become a leader in one school of narrative medical practice, mentions that, and I quote, "the last thing he wants is his patients '...going to alternative practitioners for healing and me for chemotherapy.'" This is exactly the position in which I was put with Mom's former Prescott PCP, the one who dismissed my mother as a patient because of, well, me and my "damned meddling". There was nothing at all remotely healing about this physician's three encounters with my mother but F[ormer]P[rescott]PCP did operate as a valuable resource for some prescription refills and necessary blood tests. As well, by intimidation but still of worth to me, FPPCP initiated a series of tests that ultimately proved to me my own competence as a healer and the value of healing resources of the alternative health treatment community.
While I can see that if the above mentioned PCP had been trained into an autonomic use of narrative FPPCP would have been more useful to Mom as a healer, I think, the main problem was a pronounced personality clash between this person and me which revealed itself slowly. This is not an excuse, merely an observation.
I have noticed that alternative healers always make an interesting use of narrative as they heal. Usually it's off the cuff, to the point and open ended so that the patient can take charge of the end of the story, so to speak. Once, no, twice, I've seen an alternative healer get the story wrong (the same healer, two different stories) but she was still an effective healer for my mother. By being observant of this ahead of time, when I decided to consider treatment for myself through an alternative healer, in order to choose the healer best matched to me I was able to 'scan' the narrative data I'd stored on both healers and determine that one of them would be inappropriate for me.
I'm not sure that the three of us, Mom, FPPCP and me, ever got to the level of narrative. I don't know if it would have helped in treatment in this case. The character blocks between FPPCP and me became obvious fairly quickly. Whether there were any character blocks between Mom and FPPCP was never determined. In this case, unfortunately, the mutual inappropriateness of the relationship between FPPCP and me was much too heated to allow either of us to focus much on my mother, when she was in the office.
As my mother's medical advocate though, and at this stage her necessary medical advocate, in most cases (except within the alternative healing community; hmmmm...) if I don't get along with a healer then the healer is inappropriate for my mother.
The article also mentions something about productive, satisfying 10 to 15 minute appointments conducted by one of the physicians who is also the leader of the currently popular version of the medical narrative movement. When I was looking for explanations for why it appeared that my relationship with Mom's FPPCP was going to be completely unproductive I realized that the "shortness" of the standard medical appointment 'now-a-days' has not been a problem for me. I routinely find it easy to make sure a 10 to 15 minute appointment is productive and all physicians have been appreciative and cooperative in my efforts. I also don't find newness to practicing medicine a problem. In the case of her Mesa PCP I find it refreshing. When he's not stressed by his schedule (and I give him leeway for adjustment) he is more than willing to consider alternative "narratives" for my mother's health problems as well as alternative treatments. He has a tenacious faith in non-alternative medicine but he also has a deep-seated need to be a healer and hasn't yet become disillusioned. Maybe the difference between him and Mom's FPPCP is that he chose the right initial practice and the right initial colleagues.
Anyway, I recommend the series of articles. The article by Hillary Rodham Clinton is, well, elegantly and politically statistical. The article about Primary Care provides back-up material to the other two I've so far read.
We watched Lawrence of Arabia last night. Although she determinedly declined my several offers and bribes to get her to do some light shopping with me she did not sleep overly much, was up and alert a lot and when I gave her a leg rub it energized her and she stayed up an additional hour and a half.
It's windy and cloudy, today. Despite the current prediction on the weather channel for a clear, sunny day, I don't see it. They are predicting a high in the low 60's. I don't think we're yet pushing 50 up here. I doubt that I'll be able to get her out which, I think, is okay. I've already heard a weak reconnaissance cough so my guess is that she'll be up in about an hour. I'll build out the house now in preparation.
Today is a Monday. Aiyee!
Later.
The article discusses the perceived lack of compassion and empathy in physicians as critical to their ability to heal and explores ways to approach this by training physicians to be more sensitive to narrative. About halfway through the article an oncologist-hematologist, who has become a leader in one school of narrative medical practice, mentions that, and I quote, "the last thing he wants is his patients '...going to alternative practitioners for healing and me for chemotherapy.'" This is exactly the position in which I was put with Mom's former Prescott PCP, the one who dismissed my mother as a patient because of, well, me and my "damned meddling". There was nothing at all remotely healing about this physician's three encounters with my mother but F[ormer]P[rescott]PCP did operate as a valuable resource for some prescription refills and necessary blood tests. As well, by intimidation but still of worth to me, FPPCP initiated a series of tests that ultimately proved to me my own competence as a healer and the value of healing resources of the alternative health treatment community.
While I can see that if the above mentioned PCP had been trained into an autonomic use of narrative FPPCP would have been more useful to Mom as a healer, I think, the main problem was a pronounced personality clash between this person and me which revealed itself slowly. This is not an excuse, merely an observation.
I have noticed that alternative healers always make an interesting use of narrative as they heal. Usually it's off the cuff, to the point and open ended so that the patient can take charge of the end of the story, so to speak. Once, no, twice, I've seen an alternative healer get the story wrong (the same healer, two different stories) but she was still an effective healer for my mother. By being observant of this ahead of time, when I decided to consider treatment for myself through an alternative healer, in order to choose the healer best matched to me I was able to 'scan' the narrative data I'd stored on both healers and determine that one of them would be inappropriate for me.
I'm not sure that the three of us, Mom, FPPCP and me, ever got to the level of narrative. I don't know if it would have helped in treatment in this case. The character blocks between FPPCP and me became obvious fairly quickly. Whether there were any character blocks between Mom and FPPCP was never determined. In this case, unfortunately, the mutual inappropriateness of the relationship between FPPCP and me was much too heated to allow either of us to focus much on my mother, when she was in the office.
As my mother's medical advocate though, and at this stage her necessary medical advocate, in most cases (except within the alternative healing community; hmmmm...) if I don't get along with a healer then the healer is inappropriate for my mother.
The article also mentions something about productive, satisfying 10 to 15 minute appointments conducted by one of the physicians who is also the leader of the currently popular version of the medical narrative movement. When I was looking for explanations for why it appeared that my relationship with Mom's FPPCP was going to be completely unproductive I realized that the "shortness" of the standard medical appointment 'now-a-days' has not been a problem for me. I routinely find it easy to make sure a 10 to 15 minute appointment is productive and all physicians have been appreciative and cooperative in my efforts. I also don't find newness to practicing medicine a problem. In the case of her Mesa PCP I find it refreshing. When he's not stressed by his schedule (and I give him leeway for adjustment) he is more than willing to consider alternative "narratives" for my mother's health problems as well as alternative treatments. He has a tenacious faith in non-alternative medicine but he also has a deep-seated need to be a healer and hasn't yet become disillusioned. Maybe the difference between him and Mom's FPPCP is that he chose the right initial practice and the right initial colleagues.
Anyway, I recommend the series of articles. The article by Hillary Rodham Clinton is, well, elegantly and politically statistical. The article about Primary Care provides back-up material to the other two I've so far read.
We watched Lawrence of Arabia last night. Although she determinedly declined my several offers and bribes to get her to do some light shopping with me she did not sleep overly much, was up and alert a lot and when I gave her a leg rub it energized her and she stayed up an additional hour and a half.
It's windy and cloudy, today. Despite the current prediction on the weather channel for a clear, sunny day, I don't see it. They are predicting a high in the low 60's. I don't think we're yet pushing 50 up here. I doubt that I'll be able to get her out which, I think, is okay. I've already heard a weak reconnaissance cough so my guess is that she'll be up in about an hour. I'll build out the house now in preparation.
Today is a Monday. Aiyee!
Later.
