The brush with death focuses on the patient’s perspective.


The brush with death focuses on the patient’s perspective.

Dr. Rana Awdish had an abdominal pain when he was having dinner with a friend. Soon, she was lying in the back seat of Detroit’s Henry Ford hospital, where he was completing an important fellowship.

On the night of nearly a decade ago, a benign tumor in the liver of Awdish caused a series of medical catastrophes that almost killed her. She almost bled to death. She was seven months pregnant and the baby did not survive. She had a stroke, and in the next few days and weeks, her organs had suffered multiple failures. She needed several surgeries and months of recovery to learn to walk and talk.

Awdish helplessly lying on a gurney in a hospital delivery area, the first night, medical workers require medical staff to her as a person, not a what she called “abdominal pain and fetal loss” interesting case. But their clinical disjointed medical training worked for her. Later, in the intensive care unit, she overheard a surgical resident talking in the morning.

He said, “she’s been trying to kill us. It made her angry, she said, because she was desperate not to die. “I think he’s treating me like an opponent, and if my care team doesn’t believe me, what hope do I have?

She survived and returned to work at Henry Ford hospital, but her views were unalterable. In her latest book, “In Shock,” she describes her experience as a critically ill patient through glass. The test for her eyes to see the miscommunication, no coordination of care, sometimes in a body completely lack of compassion, on the home page says the health care “should be around a person to build: you”.

Health systems have accepted many changes.

Today, she spent her time as an intensive care physician and medical director of Henry Ford’s health care experience. Over the past five years, she and three colleagues have developed a program called “clear dialogue” to strengthen empathy and communication with patients. In the typical last two days, the Henry Ford hospital staff was having a difficult conversation with the actor who was improvising the patient. The program also trains providers of basic patient communication skills and provides real-time physician “shading” to provide feedback.

In her book Dr Rana Awdish writes: “listening to the patient’s generous ears needs to give up control of the narrative.

Provided by Henry Ford Health System.

“Awdish often talks about her work across the country in meetings and medical colleges,” she says, trying to bring students upstream.

In her book, she says, “listening to our patients with a generous ear needs to be willing to give up control of the narrative. “Our problems make it impossible for us to know the answer. By not dominating the flow of information, we allow actual history to emerge.”

Recently Awdish talked to me about her book. The following interview has been edited for length and clarity.

Interview window

What surprised you as a patient?

What surprised me most was how much I needed, as a patient, to be different from what the doctor himself thought needed. As a doctor, I really focused on providing the best possible medical services. I think it means to treat people as quickly as possible, to restore their health, not to stay in emotional space.

As a patient, I realized that someone could treat me, but if I didn’t feel like they really saw me, somehow I didn’t feel healed. That emotional space is really a healing place.

Through the “clear dialogue” plan, you are trying to address the effective communication and compassion you lack as a patient. Does this help or hinder you from bringing this idea to your own hospital?

In my patient experience, what helped me was that, despite what I saw, I saw every failure. Obviously, as a doctor, I am the product of my training. We are all. It removes a lot of stigma. It’s very helpful.

While I believe we are doing this for patients, I am shocked to see how valuable this training is. As doctor and author Atul Gawande put it: “we all need a coach.” Once we get into practice, where do you go for guidance?

After two days of seminars, do these changes really “take their place”?

Through the training department, we should not only train the communication between senior doctors and patients, but also train their colleagues and residents. Because if residents don’t see the communication tools that their mentors value, they don’t pay attention. And everyone is responsible for each other. Everyone’s ears are suitable for the same thing. It starts to create change, meaning that everyone’s expectations have changed.

How is insurance a barrier to change?

This system is not designed to facilitate dialogue, and it is convenient to spend time with patients. It’s not good for something valuable. To maintain productivity, we need frequent patients, and time constraints, because we are so bogged down in electronic medical charts – all of these things keep you away from patients. Doctors should maintain the sanctity of this space in order to cope with competition priorities.

What can patients do to help doctors?

What I want most people to know is that people are good when the system breaks down. The system actually blocks communication and access. Therefore, we should find the best way to communicate with each other and create the sacred space between us.


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