Constant kindness can accomplish much. As the sun makes ice melt, kindness causes misunderstanding, mistrust, and hostility to evaporate. — Albert Schweitzer

Truth is often found in places we might not think to look. But some simple poems we teach to children can offer what we need to hear. This phrase is from “Little Things”:

Little deeds of kindness,
Little words of love,
Help to make earth happy
Like the heaven above — Julia Abigail Fletcher Carney

Kindness is often viewed as acts of charity derived from our sense of goodness or obligation toward others. But compassion and charity have benefits we haven’t heard about, and they re significant. Yes, altruism, but we receive a benefit from it.

Researchers know that anything we do can be quantified and modified with the right design, even kindness, and they’ve provided evidence of its effectiveness in our health.

Social relationships, such as charity and kindness, provide the recipient and the giver benefit. We know “that social relationship…moderates or buffers the deleterious influence of stressors.” Where is the benefit of modifying stressors?

Stress buffering (aka support) through “social relationships affect health through behavioral, psychosocial, and physiological pathways.” What pathways might kindness or social support affect?

Several recent review articles provide consistent and compelling evidence linking a low quantity or quality of social ties with a host of conditions, including development and progression of cardiovascular disease, recurrent myocardial infarction, atherosclerosis, autonomic dysregulation, high blood pressure, cancer and delayed cancer recovery, and slower wound healing.

Lack of human contact predicted mortality. The medical profession was stunned to learn that infants would die without social interaction. Seemingly this new evidence provided that what was expected for human health wasn’t sufficient. They found nurturing and physical touch to be vital to an infant’s mortality.

Those who wish to read the work of Rene Spitz on this topic and hospitalism, can find it here.

Video footage of Dr. Spitz’ research is here. A number of videos are available on that site. Ethics are of prime importance and should be questioned by anyone who watchs these videos. They bear a similar lack of ethical consideration as those of Little Albert.

Kindness Knows No Color

Today, there was a New York Times obituary for Dr. Renee C. Fox, someone I’d never known or read about. She had created the field of bioethics in her writings and one of her books, Experiment Perilous: Physicians and Patients Facing the Unknown.

I was intrigued, and a few lines of her obituary caught my attention. I knew it had to be passed on in a Medium article. The subject was kindness and how someone had provided something no hospital can prescribe, kindness.

Diagnosed with polio as a college student, Dr. Fox was admitted to Sydenham Hospital in Harlem, which usually treated Black patients. It was here that she got the one treatment that mattered most.

In her memoir, Professor Fox paid tribute to a Black nurse who got her through the first night. “I do not know her name,” she wrote. “But I do know that I survived that night because she put her head beside mine on the pillow where I lay, and breathed every breath with me.”

My Own Experience with Kindness

Working in an office as a young girl at my first job, I became very ill, and my supervisor decided that I should go home. I had to take the subway by myself since there was no one to accompany me. The train ride would take at least 45 minutes to an hour.

While on the train, I became so ill that I could barely sit up in the seat, and I had to get off at a stop where I needed to change trains. I didn’t know if I’d make it.

I was barely able to walk off the train. Although many people were walking around the station platform and on the train, no one stopped.

But one woman saw my distress. A Black older woman came up to me to ask if I was feeling sick. “Yes, I feel like I’m going to faint.” She helped me sit down on a bench, put her arm around me, and said, “Can you call your mother?” I told her I had her phone number, which she took to make the call for me.

A few minutes later she returned and told me, “Don’t worry, baby, your mother’s coming and I’ll wait with you until she gets here.”

As we waited for my mother to come, I suspect it must have been at least 45 minutes, the woman put her arm around me and continued to tell me that it would be okay and that she wouldn’t leave until my mother arrived.

Once my mother appeared on the platform to take me home, the woman greeted her, indicated she hoped I’d be okay, and left without another word. I never knew her name, I can’t remember what she looked like, but I will always remember what she did.

The woman had probably been subjected to incredible racism by white people in her life, but she helped a white stranger in distress and asked nothing for it. It was the right thing to do, and she showed incredible kindness. I will never forget her.

One Day a Year

Each year on February 17th, National Random Acts of Kindness Day grows in popularity. It is celebrated by individuals, groups and organizations nationwide to encourage acts of kindness.

The movement of Random Acts of Kindness inspires people every day. As a favorite celebration for many, people everywhere are enjoying doing these acts of kindness. Not only do the acts of kindness bring joy to the receiver, but they spread positive reactions to the giver, too!

There are many ways to practice random acts of kindness, as I experienced. And the group that helps us reflect and celebrate kindness toward others has plenty of suggestions. Here’s a list the group provided to get you started on a new way of living and, perhaps in the process, improving your health:

Pay for the coffee or meal of the person in front of you in line.

Leave a kind note for someone, no explanation needed.

Share words of encouragement. You never know who might need them.

Put your skills to work for someone in need. For example, offer to create a résumé for someone seeking a new job.

Drop off a load of groceries at the local food pantry.

Mail a “thinking of you” card to someone you’ve not to talk to in a while.

Order a bouquet of flowers to be delivered to anyone in the hospital. That means, call the florist and tell them to pick a hospital or nursing home and deliver flowers to the person the front desk thinks needs it the most. It could be a sick child, an elderly person with no family, or a college student down on their luck.

Send a thank-you note to the local fire department, police departments, or any military personnel.

Just smile.

The Physical and Mental Benefits of Kindness

Being altruistic and practicing acts of kindness, no matter how small or insignificant you think they are, can lengthen your life, some researchers believe.

Biogerontologists are studying the molecular and cellular science of aging with the goal of its eventual deceleration. One plausible hypothesis that should be simultaneously investigated is longevity enhancement through the cultivation of generous emotions and helping behaviors. The research is quite extensive at this point, but they’re extending it even more.

Volunteering for as little as 40 hours a year or less has a positive effect on those who engage in this activity because, it is believed, of a combination of factors including self-identity, social role, and meaningfulness.

Any volunteering appears to have a protective effect on mortality among everyone and is seen as a two-way street for giving and receiving. But the receiving is done on an invisible, individual basis by the volunteer in terms of health, self-satisfaction, and longevity.

A 12-week study researched a twice-weekly recycling program where volunteer in a community-based care center recycled paper products, plastics, and metals and disposing of electronic products and sorting clothes. Participants had significantly improved in terms of their gate speed compared to baseline.

The average range of the persons in the groups was 65 to 75. It was decided that civic engagement is an essential means of maintaining good health in later years, as shown in multiple studies.

Several of the significant factors would appear to be that older individuals need a sense of purpose and involvement in economic life and social value, enabling them to perceive themselves in a healthier manner. Doing volunteer work also has a positive effect on retired individuals and can combat feelings of depression and self-worth.

Another study of volunteers for older adults found “significantly increased physical activity, improved self-rated health, and reduced depression symptoms over 20 years.”

Kindness is its own reward we hear, but research has shown that kindness has rewards for everyone and should be highly encouraged.

The post Kindness Is Incredibly Good for Your Health appeared first on Medika Life.

I almost always say this when I speak to families about the condition of their critically ill loved one. Usually, when I say these words, my patient is very sick, and they are at high risk of dying. I have lost count how many times I have said the above words to families of patients suffering from COVID-19.

Most recently, I said these exact words to a family who was grieving after their mother, suffering from COVID, just got placed on a ventilator. She had been sick for a long time, and now that she required mechanical ventilation, her prognosis was likely very poor.

I did not pull any punches with the family. I gave them “brutal honesty” about how their loved one was doing. I told them that, while I do not want to crush all hope, I also did not want to give them false hope, which was much worse. I could tell they did not like what I had to say, and – to be honest – I didn’t feel right after our interaction. For some reason, I was may more blunt than usual.

The following day, I got feedback that the family really didn’t appreciate they way I spoke to them. They felt that, as a physician, I should have had more compassion for them and their situation. The nurse, in fact, told me I probably should not go in the room with the family present. I felt I had to rectify the situation, repair the damage to our relationship. And so, I went in the room and spoke to them again.

I said that it is essential that we – myself and my patient’s family – have a good relationship because, we are a team, and if we don’t work well together, then my patient – their loved one – will ultimately suffer.

They told me that they didn’t appreciate how I spoke to them, that it made them feel that I had “given up” on their loved one, that I had no hope left or didn’t want to fight for her. This was the worst day of their life, and my interaction left them wondering what kind of physician I was to whom they left their loved one in his care.

I listened to this “brutal honesty” about how I acted, and I apologized. I didn’t mean to come off this callous and uncaring. I totally understood how they were made to feel, and that was never my intention.

I told them that, if I didn’t care, I would not be there the bedside. I thought about leaving medicine, I told them, but I never did because, I really do care. They were very appreciative of what I said, and I felt we were able to establish rapport once again.

I still believe in being honest, sometimes brutally honest, with my patients’ families. I truly believe that giving false hope is the absolute worst thing I can do as an ICU physician. At the same time, there is a balance between honesty and compassion, and my recent interaction taught me that.

Although I have seen the movie of how critically ill patients with COVID fare time and time again, my patients’ families have not seen it before. For them, seeing their loved one get worse and need a ventilator is the worst moment of their lives. I need to be more cognizant of this fact and do my best to deal with families in a gentle manner.

That doesn’t mean I sugar coat how my patient is doing. I will never do that. At the same time, I need to make absolutely sure I do not come off as if I could care less about their loved one. I need to make sure that I am not conducting myself as if to say, “Why even bother?” It can be a tough tightwire to tread, but tread over it I must as a critical care physician.

We are all exhausted. We are exhausted from the relentless death, destruction, and despair wrought by this pandemic. We are frustrated at the senseless death, especially now with widely available vaccines. People need to understand that. At the same time, it is as important – if not more important – that we understand that our patients’ families are devastated when they see their loved ones crash with COVID. We need to be careful not to be brutally callous in the attempt to be brutally honest.

The post The Double-Edged Sword of “Brutal Honesty” appeared first on Medika Life.

She left with life-changing news.

Exam, mammogram, and biopsy

Her breast cancer was confirmed, and she disappeared. We made phone calls, left messages, and sent certified letters to no avail. In medical terminology, we call this “lost to follow up.” She ghosted us.

We continued our pursuit. Months later she returned. She did not follow up with the breast surgeon or Oncologist. She didn’t like them. Her family had other opinions.

She was angry.

I could feel it.

This was life or death

I would like to say I encouraged her to seek treatment, but I didn’t. I pushed her to get help. Not a gentle nudge but a shove. It was intervention time. I spoke the cold, hard truth. The goal was to break the dangerous cycle of denial. After relentless encouragement, she promised to go.

The resentful look in her eyes told a different story.

She was not ready.

She just wanted to leave.

Surgery, chemotherapy, and radiation

I saw her a few months later. My intervention worked. She had bilateral mastectomies and removal of the lymph nodes. She was undergoing chemotherapy and radiation. She was still angry.

She resented me.

I knew it.

I reminded myself her care was all about her. This moment was not about me. My job was not to be liked but rather to help her get well. In desperate times, patients focus their frustration on what they can control. Patients need a place to channel their feelings and rage. My job that day was to be the target.

Fear manifests as anger. She was furious and frustrated.

But she was alive.

Three years later we meet again

She came to see me yesterday. With a huge smile on her face, she embraced me in a giant bear hug. She held the hug a little too long. She grabbed both my hands and squeezed them tight. We locked eyes. She said, “thank you.” She appreciated my fight to get her treatment.

Then, with a beaming smile, she told me her cancer was back.

My heart sinks

After three years of remission, her breast cancer came back. The metastatic disease has spread to the chest, lungs, and brain. It is inoperable. She is restarting chemotherapy. She qualified for an experimental protocol with a 2–3% survival rate over three years.

I am rarely speechless. I can not talk. Tears fill my eyes. I try to fight it.

I am the doctor she trusts to take care of her. I am losing it.

What? No? Not possible. That can’t be true. She has a teenage son.

Quickly, I process her reveal. Inoperable metastatic cancer. Experimental protocol. 2% survival rate.

I stop fighting my emotions. I cry. I manage to say, “I am so sorry.”

She looked me in the eye and said “But I am ok”

She explains she came today just to see me. She wants me to know she “is good.” Her spirits are great. This was the best she felt in years. It took a long time for her to get to this place of acceptance.

She has found joy in living.

She shares her story. In the past, she blamed me for finding her cancer. She was frustrated every office ended in bad news. She resented me for forcing her into treatment. She was furious she had cancer.

Now, she is at peace. She is thankful. She appreciates all that I did. She needs me to know she is no longer angry. She has accepted her fate. She has found a happy place. She is loved.

My eyes glisten with tears. Her eyes glimmer with joy.

I am in awe of her strength, her will, and her compassion. We finish our visit with another hug.

It was my turn to hold the hug too long.

Afterthoughts

I think about her often. I try to shake the memory. I can’t. She was closing the open loops. Seeking resolution.

When I think about her, I smile.

My heart fills with admiration and gratitude. I am thankful she blessed my life. I am thankful she came to see me. For 15 years, I had the honor of being her doctor.

She found her happy place.

I will find mine knowing the true reason for her visit was to say “Goodbye.”

The post How a Breast Cancer Patient’s Strength Inspires Her Doctor appeared first on Medika Life.