Podcast
Episodes
Andrea Warnick is a registered psychotherapist and educator on the topic in children. Recognizing that grief looks different in children and that it’s important for the healthy development of a child, Andrea puts an amazing amount of empathy and compassion at the forefront of her work with children and their families. The hosts Dori, Irene and Giovanna highlight the lessons of honesty and the use of language in their debrief.
What can be done to encourage and foster empathic interactions in the health care system? Dr. Lawrence Loh is the associate medical officer at Peel Public Health. Dr. Loh shares how advocating for system wide change can help create space for empathy. He describes empathy in public health as learning the stories behind the data to protect, promote and optimize the health of a diverse community.
Kim Martyn shares her patient story of living with cancer. Kim talks about what led her to apply for MAID (Medical Assistance in Dying). She shares how she has included her daughters in her decision and the difficulty of choosing a date for MAID.
This is Part 2 of 2 episodes on Medical Assistance in Dying. Part 1 is a discussion with doctors who provide the treatment.
Doctors Amy Nolen and Debbie Selby share their experience as providers of MAID (Medical Assistance in Dying). In 2016, Canada passed a law that decriminalizes medically assisted deaths despite controversy among the health care community and Canadian population. The doctors discuss the difficulties in navigating the patients requests and legalities. Drs Amy and Debbie describe how MAID deaths can look and feel different for family and friends.
This is Part 1 of 2 episodes on Medical Assistance in Dying. Part 2 will feature an interview from a patient.
When Gill Deacon was diagnosed with cancer for the second time, she was the host of CBC Radio’s Here and Now and had gained a dedicated daily audience. Open heartedly she shares her experience living through cancer both personally and publicly. Gill has named the post-treatment phase of cancer “the reckoning”, recognizing that this period was intense and unfamiliar.
The new rhythm of life is not an easy adjustment for cancer survivors. The hosts debrief about managing patient’s expectations beyond the schedule of cancer treatments. Giovanna, Irene and Dori reflect on the importance of follow-up with patients during this vulnerable period.
Gill Deacon has returned to Here and Now which can be heard weekdays 3-6pm, on CBC Radio 99.1FM. She has written a memoir Naked Imperfection, and a national best-seller, There’s Lead In Your Lipstick.
Emotional or existential distress is not as easily noticed in patients with serious illness. Dr. Jennifer Moore is a palliative medicine consultant, specializing in dignity therapy. Claire Suarez is a physician’s assistant working in in-patient oncology and is trained in meaning centered therapy.
Irene, Dori and Giovanna reference Harvey Chochinov’s work in dignity therapy and how it uses questions to help discover meaning in patients lives. Asking:
“What has meaning for you?”
“What is the most meaningful for you?”
“What had meaning before your illness?”
“How has that changed?”
“How has that impacted you?”
“What keeps you going?”
LInk to Dignity Therapy: http://www.dignityincare.ca/en/toolkit.html
It is discussed how imparting meaning is not helpful for the patient but we can ask questions and actively listen. This exploration needs to be a journey of self-awareness. Patients can feel stuck in a situation, and showing kindness can help their experience. Patients may shy away from talking about meaning, but it can be helpful to explore. It doesn’t need to be an hour-long conversation; it can be many short conversations.
The hosts end the season by talking about how the psychological condition can impact physical condition so treating patient, as a whole is important. Helping treat the priority of conditions directed by the patient can establish a therapeutic relationship of trust. Ask questions that go beyond the physical state.
When faced with bad news, it can be difficult to speak to others leading to interactions that are inauthentic. Euphemisms, platitudes, and missed efforts, can patronize the patient and put distance in the relationship. Mike lives with metastatic colorectal cancer, and receives palliative care from Dr. Irene Ying. When Mike found out that his cancer was incurable, he felt a sense a freedom. No longer having to focus on every up and down of his treatment, and the relief of not searching for alternatives, Mike shifted focus to quality of life. Mike appreciates family and friends who are able to ask sincere questions and be present for his experience. His health care team keeps open communication and give straight forward evidence, which makes Mike feel secure.
Irene, Dori and Giovanna elaborate on how it is important to know a patient’s preferred way of receiving information: varying from subtle to stark honesty. The doctors discuss how the uncertainty of illness can be the most difficult element of treatment; the fear of the unknown. The hosts reflect on history taking methods to make each patient feel taken care of. The doctors talk about how authentic relationships bring a closeness to the people involved. The heart of empathy is connecting with another person in a genuine understanding of what someone is going through.
When caring for a loved one with serious illness, caregivers focus intensely on the patient. Without checking in on the caregiver, the health care team may be overlooking the importance this has. Laurelea was the caregiver for her husband Steve. As Steve was diagnosed with terminal kidney cancer, he had to stop taking antidepressants to start treatment of his disease. Laurelea describes the mental darkness that Steve experienced, and how it was difficult for her to find the support needed. Since the death of her husband, Laurelea continues to advocate for system changes to provide psychosocial support for patients and caregivers.
Dori, Giovanna and Irene describe practical solutions for treating the patient as a whole person and acknowledging the caregiver. The doctors talk about how treatment of disease differs from providing good care; the consideration of psychological, social, emotional and spiritual conditions. The hosts discuss how the vocabulary and imagery of “fighting” can make a patient feel responsible for the outcome of their illness.
Dr Daphna Grossman is a palliative care physician at North York General Hospital in Toronto ON. Describing her journey to palliative care, Daphna speaks about the role of mentorship. Her care is rooted in kindness and compassion to alleviate any possible suffering. Daphna believes the impact on health care providers is two sided: enriching or exhaustive. In order to provide the best possible care, Daphna describes the practices that keep her centred and mitigate stress. Daphna wants to spread the message that palliative care is about helping with suffering along the journey with life-limiting illness - not just end-of-life.
The doctors discuss how to recognize compassion fatigue and burnout. Giovanna, Irene, and Dori, share their personal strategies for emotional self-care. The episode concludes with a round table about the benefits of the mentoring relationship.
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