Sunday, November 18, 2018

Dr. Saul A. Schwartz, Remembering My Dad 20 years after his passing

In an earlier article, I recounted my dad's passion for playing different sports in college: baseball, basketball and field and track.

Today,  I remember his passion for caring for his patients (which led, incidentally,  to his building one of the largest practices in the Bronx.)

His dedication to the sick was reflected in several ways. First he made house calls, going up and down flights of stairs. I should know as I would often accompany him-- carrying his doctor's bag. (at the time, he would charge $5 per house visit.) And he spent time getting to know each of his patients--patiently listening to all their complaints.

Well the word go around very quickly along the Grand Concourse and the East Tremont section of the Bronx about the doctor who makes house visits. Naturally, when the patients recovered, they flocked to his office at the Flat Iron Building located at 1882 Grand Concourse.

Here it was not unusual  for up to 40 patients to be waiting for a consult. I would ask dad why they didn't make appointments. His answer was: I would urge them to schedule appointments, but they simply come and who can stop them. Half would find seats in the waiting room and others would stand.

They did not mind waiting, sometimes up to two hours. Why?

Dad had  a special caring, empathetic, bedside manner that was infectious. He took time to hear their complaints, speak to them in Yiddish, German, or English. He did much to alleviate their worries and anxieties that often led to ulcerative colitis, his  specialty.

Dad, I am so grateful to have experienced the importance of taking the time to listen to each patient's story before making a diagnosis- a luxury rarely heard of in the practice of today's medicine.

You have inspired me to write a series of articles to examine the current crisis.

Wednesday, November 14, 2018

Medical Students turn to poetry discussions to share experiences and to develop empathy

In an earlier article I discussed the enlightened lead of the St. Andrews Medical School in giving every graduate a small portable book of poems, Tools of the Trade to accompany them on their rounds.

 Then in my most recent posting, I explained how reading and reciting poetry helps the reader-including the medical student/professional-- to deal with the complex of emotions that are not easily resolved by simple reading of prose.

The next obvious question is: how can medical educators work with their students to get them to express-- in a group setting--what it is they are experiencing when reading poems dealing with their daily contacts with their ailing patients?

St. Andrews has added a new direction: using the Tools of the Trade: Poems for new doctors  book of poems as a base, it has instituted a program called Poems for Doctors. First there is a blog which publishes these short poems. Then "video readings are made by medical professionals or  trainees who have chosen one poem for particular reasons or associations that they explain. Each reading provides a seed for informal discussion in a Facebook group managed by a group of highly experienced medics." (bold italics mine)

Contrast the St. Andrews informal discussion in a Facebook group with the following poetry centered program at Hadassah- Hebrew University Medical Center to "increase student's capacity for empathy and awareness of patients' narratives." Five 1-hour meetings were "held immediately following a teaching round, of seven to nine students with a facilitator doctor. At each meeting a poem reflecting the patient-caregiver relationship is discussed in order to encourage students to share their experiences." The results favored the students' empathetic identification with the patient (what it is like to be a patient). Read evaluation here.



 St. Andrews and Hadassah present differing models of how to  bring students together to share reactions to poetry. First they are alike in that each has an experienced faculty member who facilitates discussion. The former uses an informal discussion in a Facebook group  while the latter brings the students together in a face-to-face meeting held immediately following a teaching round.

Both schools are to be commended for their encouraging students to share their reactions to
poems.

The Hadassah method of having round table discussions, where students face each other --eye to eye --  is, perhaps, preferable because it done immediately after coming off the wards  when the emotions are still so fresh.

   Yet, on the other hand, the St. Andrews method of informal Facebook discussions may be more preferable mode for shy students who may be more reluctant to share their emotions in a 'live' setting.
They may be inhibited to share reactions in a setting where they have to view their peer's reactions such as facial expressions.

Besides St. Andrews and the Hadassah-Hebrew University Medical Center other medical schools such as Yale and Harvard are also taking the lead in including poetry as a means of fostering empathy.

In my next article, I will explore how medical schools are requiring art classes as well. So stay tuned in.