By Ewa Matuszewski
First, let me acknowledge how grateful I am to have such loyal followers of this column. I always appreciate the feedback – even when a reader disagrees with me and provides new insights for consideration. Yet, never have I had such a positive response to any column as I did to last month’s reflection on the need to make palliative care as well-known and respected as hospice care. It’s as if there were 1,000 leaders in Michigan’s healthcare community who wanted to delve deeper into the conversation. Hence the key reason to stay on the topic for this month’s column – but other reasons as well.
Two things happened since I submitted the August column that impacted me professionally and, on a profound level, personally. The latter being the unexpected death of my brother Ted who lived out of state. Ours was a complicated relationship but in recent months, we’d again grown closer, sharing meaningful discussions and reminiscences of our early family life. As the children of parents who spent time in a German POW camp (father) and a displaced persons camp (father and mother), we brought a different perspective to our east side Detroit neighborhood and experienced life as immigrants that was both hard and triumphant.
Ted attended Wayne State University for his undergraduate education and then went to Poland, our homeland, for his medical training. A family physician for decades in Nevada, he was known to have generously provided free care to patients who faced economic hardship, no doubt painfully recalling our own early youth of financial challenges. Widowed earlier this year, his physical and emotional health began failing, culminating in his untimely death. I can’t help but wonder if he had been offered palliative care services, would the outcome be different? Would we be continuing on our path of full reconciliation as he regained his whole person health with the assistance of a coordinated care team? Of course, there is no answer, yet there is hope for others as we continue to bring compassionate palliative care into the vernacular.
In my previous column, I focused on palliative care for those managing three or four chronic conditions, such as diabetes, hypertension, or chronic obstructive lung disease or heart failure. Today, I add depression and anxiety to that list. Regardless of the chronic conditions impacting a particular individual, their care is best managed with the assistance of a care team member who is trained in palliative care and able to steer those with chronic conditions – or their family members – to a higher level of care.
The second event impacting my views on palliative care since the August column is the immersive learning sessions my organization has led on the subject, thanks to BCBSM funding. As we prepare nurses, dietitians, social workers, and other care team members on the tenets of palliative care, we’ve honed-in on having that difficult conversation about “what’s next” and really concentrating on the emotional needs of the person receiving care – giving them 100% of our attention, without any distractions. One of my favorite resources on this topic is surgeon, author, and public health thought leader Atul Gawande, author of Being Mortal, the Checklist Manifesto, and other noted science books who also developed a five-step Serious Illness Conversation Guide in conjunction with Ariadne Labs.
I close with this – indeed a difficult conversation for me at this juncture – healthcare professionals tend to keep significant personal issues and experiences to themselves, especially when it comes to their mental health. When life gets overwhelming with new responsibilities and added or ongoing stressors, please reach out to a friend, family member or colleague to talk it through. Don’t be afraid to be vulnerable with that human connection. The truth is, we can all benefit from honest conversations about mental health conditions and suicide. While there’s no simple solution, one conversation can change a life.