Posts about all things related to medical humanities
A few weeks ago, I sat with an elderly man with locally advanced bladder cancer and his daughter. She was worried; he no longer seemed like himself. He slept most of the day. He had no appetite, not even for her cooking, which he had once loved. She described how he used to fill the kitchen with stories from his morning walk—the neighbor’s new dog, … Continue reading Shattered and Adaptable: Two Books, One Truth About Being Human
Photo by Kelly Sikkema on Unsplash The HIV Transformation In the mid-1990s, as a young resident new to the U.S., I was still learning about HIV/AIDS when a patient arrived in our Connecticut ER one night – a young man, close to my age, muscular and healthy-looking but desperately short of breath. I remember him vividly. His chest glistening with sweat, he heaved with each … Continue reading The Parallel Frontier: While We Cure Cancer, Can We Deliver Those Cures?
Fifteen years ago, Dr. Abraham Verghese introduced us to the concept of the “iPatient” – digital representations in electronic medical records that were commanding more physician attention than the actual humans in hospital beds. Today, we face something far more profound: the “AI Patient,” where artificial intelligence not only stores data but diagnoses conditions, generates treatment plans, and writes clinical notes. What’s striking is how … Continue reading From iPatient to aiPatient: Balancing Algorithms with Empathy
So here’s the thing about pain: it’s complicated. Last weekend I was on call when my phone rang. It was an elderly woman in her 80s with advanced cancer that had been stable. Her chart said “pain well-controlled on optimized opioid regimen” – one of those clinical phrases we use that sometimes means everything and sometimes means nothing at all. She started talking about bone … Continue reading I Only Want What’s in Your Mind and Heart”: The Origins and Science of Total Pain in Oncology
While many healthcare institutions nationwide face challenges in enhancing goals-of-care discussions with seriously ill patients, an unexpectedly simple study from the VA demonstrated that a different approach could change how we think about these conversations. In 2013, at the Palo Alto VA Medical Center, Dr. Manali Patel proposed what seemed like an unlikely solution: What if individuals without medical training could assist veterans with advanced … Continue reading When Less is More: A Simple Solution to Complex Healthcare
Im not afraid of dying, she said, smiling at me. I feel like Im on a runway, about to take off. Her words, spoken with such clarity by a woman facing two advanced cancers, have stayed with me. As a palliative care physician, I wish more patients felt empowered to face their mortality with such openness. But the truth is, we, as a society and … Continue reading What If This Is the Best I’ll Ever Feel?
When Efficiency Trumped Narrative Here’s an odd thing about modern medicine: We have perfected the art of medical storytelling for over 4,000 years but have spent the last few decades systematically destroying it. Doctors have always been storytellers first, from ancient Egyptian scrolls to medieval Islamic physicians carefully documenting case histories. Until we decided efficiency mattered more than narrative. Today, we stand at another pivotal … Continue reading AI and the Future of the Patient Narrative: The Rise of (a)iRecord
Between Gravity and Grace: Discovering the Role of Levity in Patient Care “She had always been interested in standup comedy, and it occurred to her that what’s funny is true. That’s why people respond because the unspeakable is getting said.” I came across these words in Ariel Levy’s 2017 New Yorker profile of Elizabeth Strout, and they stopped me in my tracks. For years, I had struggled … Continue reading Finding Space for Humor in Serious Illness Care
A few weeks ago, an elderly patient with advanced metastatic cancer came to see me in my palliative care clinic. She did not speak English. She came in with her daughter, who translated as the patient did not wish to use an interpreter. She told me about her worsening pain. We had a good visit; I got to know the patient and her daughter a … Continue reading Not just Bones and Muscles
A few years back, Abraham Verghese wrote “Physician as Storyteller” where he told a story of a patient of his who underwent a discectomy complicated by a rare infection at the side of the surgery. Verghese wrote a case report detailing the clinical situation which he later shared with the patient who was elated to be “a rare case.” Until he read the report: “Abraham, … Continue reading Restoring the Clinical Note
Marcin Chwistek, MD 