47 Comments

This is a devastating piece.

From burnout to having-a-bad-day there is NO excuse for such maltreatment.

The Patient is the person with the disease.

And the alt-Med types here attacking her for what she didn’t know doesn’t help any.

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This is quite moving and powerful. I don’t think many of us working in healthcare appreciate how patients feel and are treated. Not until we too become patients. Then our perspective changes. I was a patient and it made me acutely aware of the way the system operates, it’s deep flaws and how it treat people within it. It changed my perspective and behavior as a clinician. Unfortunately the system continues to become more hardened by corporate interests.

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I was a 50 yr old practicing Physician who went in for a prophylactic colectomy after bilateral bouts of diverticulitis of moderate severity. I had a post op anastomotic leak and developed peritonitis, sepsis, septicemia, septic shock and had a near death course. I dreaded even the smell of my room. I dreaded the seeming filth and the touching and care of that Ostomy. I was successfully treated but remained in the hospital for almost a month. I was home and then several weeks later returned with bouts of fever, abdominal pain, anorexia , severe weight loss . Finally I was readmitted and found to have a Portal Vein Thrombosis, Superior Mesenteric Thrombosis , and Splenic Vein Thrombosis potentially at risk of death once again. Another 3-4 weeks in the Hospital and discussions of potential therapies including TPN, TPA RX, Transplant, and anticoagulation . Finally after several weeks of anticoagulation I was able to take sweet and sour gummy’s and a gradual ability to slowly increase the diet . I was discharged 25 pounds lighter but alive because of the fabulous physicians that cared for me but I will never fully recover from being that “ Patient on the other side of the Table “ during that time . The Doctor as a Patient is in an entirely scary world for the first time.

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Wow! I can't imagine all that you went through,Dr Casey. I've long felt that our health care "system" often overlooks the PTSD-type anxiety and response that being near-death in the hospital can evoke and that patients need support as they recover. I'd encourage you to read Dr Rana Awdish's book "In Shock: My Journey From Death to Recovery and the Redemptive Power of Hope". Very moving and might be some of the same things you've experienced and felt. Wishing you the best in continued recovery!

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A scary story. Thank you Dr. C.

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I almost didn’t want to comment; but I’m just returning to my room after a walk to the nurses station and back having had surgery number 59 literally this morning for a sig colectomy (not a typo! Fifty nine!). I’m extremely grateful that I’ve had excellent experiences for the most part with providers, even as a recovering opiate addict at 24+ years sober (no MAT to make for difficult pain management, thankfully). What I appreciate most about this article is that she no longer identifies herself as “patient” which I think is one of the most important points she made. What a beautiful article and I praise her for her vulnerability here. Many patients don’t get a chance to become human and her triumph is lightening my load.

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Jim Ryser - Wishing you a speedy and straight-forward recovery!

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Wow. Thank you Jim. Take care my friend.

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Thank u! Up and walking a lot!

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Stunningly clear. I am so appreciative - but sad and also angry- that actual human beings must write about how it is we in health care manage to reduce so many, in so many ways, to a position other than actual human beings.

While I readily see the flaws in the doctors and the hospitals and the system in which I am working, I am struck by the frank inadequacy of response from so many outside of health care.

I always held out hope that the families and friends, uncorrupted by US health care, would uphold the humanity that we who work in health care often strip away. But your piece forces me to ask if there is some deeper problem here, with how human beings fathom (or “Grok”) each other in the moments of suffering.

“Enough about you, let’s turn it back to me shall we?”

I want to think of that as an intentional joke but it sounds a lot less like a joke after absorbing your words.

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I have an honest question. any advice on what caretakers / loved ones can do to make their loved ones feel less patient-y? ( assuming they already have a baseline level of kindness and regard )

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Honestly? Care. REALLY care. And I have always said when one no longer cares, move to a different career. The difficulty of truly caring is that it will cost you.

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Nicely written and a good reminder to those in medicine. Over the past decade, I've had the misfortune of being on the receiving end of health care and trust me " It is better to give than receive." Our system is horribly broken. Short staffing, IT, quotas, and burn out among providers, are just a few of the contributors that have damaged the doctor-patient ( and nurse-patient) relationship. Empathy is no longer a part of the equation. As a physician, my eperience was eye opening. I encourage everyone in healthcare to employ the golden rule and "do unto others as you would have them do unto you."

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You are or were two patients in one. The first who is no longer a patient but may need to retain the practical outcomes of being such so as to know what must be done to avoid this path in the future. And second, by retaining an identity of being a patient, you are giving that thought power. Being or identifying with a patient is not your true self.

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Wow. That brought me to tears. Kristin, I'm so glad you are able to live life to its fullest again.

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Good to read that this patient was able to return to relative normalcy after a prolonged medical problem. Of course there are others who are grateful for those who helped them emotionally during such medical experiences. There are rude and inconsiderate people both in and out of medicine. It is probably impossible to keep them out of medical school, but it would be nice if they went into areas of medicine that don't involve direct patient contact such as pathology or research. I always told residents and medical students that their demeanor around sick people was very important. I always tried to sit down next to the bed to talk rather than stand there fidgeting and looking like I had somewhere else to go. Talk to them in the same way you would with a friend. Physical touch is also reassuring to many patients. Holding their hand in yours tells them that you are seeing them as a person rather than just a chart in the rack. Most patients can tell real empathy and understanding from pretention and find it very helpful in their recovery. One problem with "hospitalists" is that they never see the patients in their everyday state the way a doctor does in his office practice. And. of course, the progressive bureaucratization of medicine has exacerbated all of these negative features.

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I'm here to read about science... but sometimes it's a pleasure to "waste time".

Very well written and thought provoking!

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Feb 9·edited Feb 9Liked by Adam Cifu, MD

Thank you for sharing. Last year I had a limited experience as "The Patient". I hope to never have to intersect with the medical system again.

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Feb 9Liked by Adam Cifu, MD

Sadly, I am a RN -40+ years in healthcare-who has thrown in the towel and retired. You are right and I am glad you shared your story. I have watched the American healthcare system degrade from compassion and caring to just an opportunity to make stable money. Not all but many of the nurses and doctors are there today for the money-not actually for care of the patients. Medical Centers short staff and Joint Commission/state inspectors look the other way as heaven forbid a for profit hospital close. The elderly have to mortgage their houses to pay medical bills. You do not hear one of our government officials say lets use AI to track hours charged to Medicare/Medicaid--if they did you will see that some physicians, PAs, and NPs charge more than 24 hours in a day. I started when you wore a nurse's cap, knew every patients name, their family, and their concerns. There was actually time to talk and care/know for your patient. No more. I have volunteered in what the US considers third world countries--one thing I learned-in these counties the doctors/nurses may not have all the newest equipment but there is a community that supports the patient better and they know your name. In the US we scan, routinely check armbands, ask name to verify but we don't have to remember it. Such is medicine in the US. I am glad you have recovered and thank you for sharing your story.

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Feb 9Liked by Adam Cifu, MD

The message is to know and listen to people...know your nurse, your doctor, your NP, the custodian, the lab tech, the resident, the patient. As a retired RN, I now as I watch my husband navigate a system that is not designed to know anyone. It saddens me and makes me angry that relationships do notmatter in medicine anymore, or at least to very few. Yes the system is broken, but we all bear responsibility for it. You are labs, diagnostic testing and medications, not a person with a history, friends, loved ones, grief stricken, addiction, or whatever the case may be. Does the art of medicine still exist? I want to believe it does. I cringed when I hear medical professionals talk to my husband who is fully capable of understanding his health as if he is stupid. Nonetheless, I also have been touched by those that do listen and do hear you. And I am grateful for the people who give of their time, talents and skills to bring healing to others. To know and listen to people is a life long learning process. And it is the only way to health and healing in whatever way that may be.

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Feb 9Liked by Adam Cifu, MD

So very moving! Since early on in my training, I was always taught that the patient is the vulnerable center of the hospital process. Even more so than in the office setting. One human laying naked in a bed wearing only a flimsy hospital gown and not feeling well on top of everything else, is in an extremely vulnerable position. Everyone else walking into the room is fully dressed and healthy and typically standing up, looming over the hospital bed. The thing I enjoy most about medicine is interacting with all types of humans and recognizing all the emotions and reactions "illness" can bring out. Thank you, Ms Inciardi, for the reminder of just how important all of this is.

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Feb 9·edited Feb 9Liked by Adam Cifu, MD

ok, but what's missing from this story? where is the part where she stopped listening to her doctor (as hinted at by Dr. Cifu's intro) and found herself a think-outside-the-box functional medicine coach not mobbed up with the insurance/vaccine/pharmaceutical industrial complex who helped her to heal herself with diet, nutrition and herbs?

where is the epiphany when she discovers that she could have recovered just fine without any mutilating surgery or a single hospital stay, if only she had worked with an alternative practitioner who was not a card carrying member of the medical mafia?

i felt that this was merely the excellent introduction to a much longer story. how did she get well? her writing style is compelling but there was too much of the story left untold.

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Carolyn, it is indeed a double tragedy for Kristin - that she could've healed without being cut open. And that by being cut open, she was doubly wounded.

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My bad. What I meant is that sometimes you need to stop reading my reflections on Fridays and here from a patient. Thanks for the feedback. Adam

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yes, later i actually realized that i might have interpreted what you said according to my own bias- which is to NEVER listen to doctors unless you have a broken limb which is something they are good at, but i let the comment stand.

i have zero doubt that a good functional practitioner could have helped her help herself with no extreme medical or surgical intervention. i can only imagine the drugs she was put on and the procedures she was subjected to. i think all your/her readers are dying to know how she eventually got well.

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