Craig Garner 2013-05-22T21:30:32-04:00 Craig Garner http://www.huffingtonpost.com/author/index.php?author=craig-garner Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Craig Garner Good old fashioned elbow grease. PBS's 'This Emotional Life': Reducing Stress This Winter tag:www.huffingtonpost.com,2011:/theblog//3.812479 2011-02-02T15:13:23-05:00 2011-05-25T18:25:24-04:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
The flu -- suddenly it's everywhere. We read about it in the paper and see it on the news. We listen in fear to reports on how it invades our hospitals and schools, contaminating drinking fountains, public bathrooms and restaurants. Each winter this invisible little bug returns with seemingly greater authority to disrupt our daily lives and spread paranoia throughout the community.

The fear and anxiety that accompanies seasonal influenza can also infect hospitals, chipping away at the mission for which they stand by causing patients to question a health care facility's very ability to treat the infirm in times like these. As hospitals in Britain are forced to cancel operations and leave beds empty in preparation for anticipated flu cases, one can only hope that this patient surge in the United States does not escalate to needless panic over possible pandemic.

With today's antibiotic-resistant germs and mutating strains, our grandparents' "sniffles" have been replaced in the eyes of the general public by potentially fatal pandemics, bringing with them a mixture of fact and myth that baffles many of us still wondering how best to protect ourselves and our families during these winter months. Like it or not, influenza is here -- including the H1N1 strain of the common cold better known as "Swine Flu" -- but everyone must remain calm. To survive another flu season, information and common sense must prevail. Indeed, the very origin of the word "pandemic" from the Greek "pan" (meaning "all") and "demos" (meaning "people" or "population") would imply that the best way to avoid one is simply to prevent it from spreading.

In the grand scheme there is as yet no reason to let the fear of flu wreak havoc on the emotional well-being of you and your loved ones. The simple fact is that whether fighting a super-bug or a runny nose, the approach is the same: Prevention is a key element in reducing the chances of finding yourself bedridden throughout the winter. Flu season marks a distinct period where we are all duty bound to take extra precautions to keep from getting waylaid by this year's scourge and spreading it to our families, friends, coworkers and neighbors. By arming yourself with the facts about the flu and taking a few simple steps, you can reduce emotional stress and maintain peace of mind while keeping your family in peak physical condition this winter.

Wash Your Hands, Please

It sounds so simple, and yet it works. Repeating their age-old mantra, public health officials continue to remind us that routine hand-washing is still one of the most powerful defenses against the spread of influenza in its many forms. According to the Food and Drug Administration, proper hand-washing can prevent up to half of all food borne illnesses. Children who wash their hands at least four times per day experience 24 percent fewer days with colds and flu, and 51 percent fewer days sick from stomach ailments.

No matter how potent the germ, it cannot take hold if it is removed before infection can occur. And yet, most of us wash our hands in a cursory manner at best, which limits effectiveness. To properly protect yourself, use warm water, wet your hands and cover them with soap. Rub your hands vigorously together for at least 30 seconds, making sure to scrub all skin surfaces thoroughly. When you are finished, be sure to rinse the soap completely from your hands. Should no soap and water be available, hand sanitizers can be an effective substitute until you can reach a well-stocked sink.

Be it in the hospital or at home, it is doubly important to follow this procedure before visiting elderly loved ones, those with compromised immune systems due to illness, pregnant women, or babies. Children should likewise be taught the necessity of regular hand hygiene, both as a means to keep themselves healthy and as a lesson in consideration for others. However, be mindful not to frighten them or make them overly conscious of disease. Using a musical timer or singing a 30-second song can turn the time at the sink into a fun and constructive, non-threatening exercise.

Don't Fear The Needle

Even in this modern age, many of us are wary of vaccines and what they may or may not contain, and year after year many of us rely upon our excuses until it is too late. But the quick and easy act of getting a shot is an effective way to provide peace of mind and greatly improve your chances of standing tall instead of staying in bed with the chills.

Beginning in 2010, the CDC now proposes "universal annual vaccination," recommending that everyone over the age of six months receive a flu shot. While the CDC recommends that everyone get an influenza vaccine each flu season, particular emphasis is placed on the following groups to get vaccinated, either because they are at high risk of having serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications:

  • Pregnant women


  • Children younger than five, but especially children younger than two years old


  • People 50 years of age and older


  • People of any age with certain chronic medical conditions


  • People who live in nursing homes and other long-term care facilities


  • People who live with or care for those at high risk for complications from flu


  • Health care workers


  • Household contacts of persons at high risk for complications from the flu


  • Household contacts and out of home caregivers of children less than six months of age (these children are too young to be vaccinated)


  • However, there are some people who should refrain from getting a flu vaccine without first consulting a physician. These include:


  • People who have a severe allergy to chicken eggs


  • People who have had a severe reaction to an influenza vaccination


  • People who developed Guillain-Barré syndrome (GBS) within six weeks of getting an influenza vaccine


  • Children less than six months of age (influenza vaccine is not approved for this age group)


  • People who have a moderate-to-severe illness with a fever (these patients should wait until they recover to get vaccinated)


This flu season, focus on prevention and its many possible steps to reduce anxiety while improving your mental health. By fighting the fear of influenza first, hopefully you can avoid the traditional somatic symptoms altogether. As today's germs seek new ways to outmaneuver advances in modern medicine and today's newscasts spread fear through statistics without context, it is important to maintain perspective around the word "pandemic." Statistically speaking, the flu claims very few lives each year, especially for those who are in otherwise good health. With a daily routine of preventive measures and a simple shot, the vast majority of Americans should have little to fear from the upcoming flu season.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': Excising the Fear From Surgery tag:www.huffingtonpost.com,2010:/theblog//3.784543 2010-11-30T12:15:38-05:00 2011-05-25T18:15:22-04:00 Craig Garner http://www.huffingtonpost.com/craig-garner/ "He who is not everyday conquering some fear has not learned the secret of life." -- Ralph Waldo Emerson

The words "fear" and "surgery" are inextricably connected. Not only that, but hospital stays in general are full of unfamiliar experiences that can easily jeopardize even the strongest sense of emotional well-being. To be a patient in the modern age means to give up control and place yourself in the hands of another, whose job it is to lead you through the maze of treatment options and back to recovery.

Still, nothing so typifies this fear and uncertainty as when the doctor utters that one word: surgery. At the same time, however, the Harvard School of Public Health reported in July 2010 that more than two billion people worldwide do not have access to adequate surgical treatment. Perhaps through a better understanding of surgery in the modern age, this, often misunderstood part of a hospital stay, can look and feel more somatic and less traumatic.

Should you or someone you love face the option of surgery, it is important to remind yourself of the many technical advances made by modern medicine in recent decades. For example, 50 years ago doctors faced huge obstacles when operating on a beating heart, since stopping the heart for more than a few minutes often results in brain damage. Today, technology not only makes heart and other formerly unthinkable types of surgery possible, many of yesterday's riskiest procedures are now considered standard. Our skill level has risen considerably.

To reduce the fright that goes along with going under the knife, it often helps to see a procedure in black and white, especially in terms of success rates. Each year cardiothoracic (cardio=heart, thorax=chest) surgeons perform more than 500,000 coronary artery bypass grafting procedures (CABG), making this the most common type of heart surgery. Indeed, many political figures and celebrities have entrusted doctors and hospitals to heal their heart, including photographer Ansel Adams, author Isaac Asimov, basketball coach Red Auerbach, former first lady Barbara Bush, talk show host Johnny Carson, former president Bill Clinton, businessman Ben Cohen (of Ben & Jerry's), actor Patty Duke, former US Secretary of State Henry Kissinger, singer Peggy Lee, talk show host Dave Letterman, journalist Bill Moyers, talk show host Regis Philbin, Dame Elizabeth Taylor, actor Burt Reynolds and actor/comedian Robin Williams.

Just a few doors down from the heart, classic (open) appendectomies have been performed by the thousands over the last two centuries -- and the number gets higher when you add the laparoscopic procedures done since 1987. One Texas hospital even reports that it has performed 500 craniotomies (skull/brain surgeries) per year over the last three years.

Don't Forget Anesthesia

If you're still not convinced that surgery can be simple, don't forget about the advances in anesthesia. Derived from a Greek word meaning "without feeling," anesthesia refers to the state of being temporarily without sensation or awareness. Anesthesia enables you to undergo these surgical procedures without experiencing pain or distress. Anesthesia, however, does have risks depending on what a particular surgical procedure may necessitate.

Whether a surgical team uses general anesthesia (medication that renders you unconscious and prevents you from feeling pain during your procedure), conscious sedation (medication that also prevents you from feeling pain, but it enables you to stay drowsy and awake), regional anesthesia (medication that blocks pain in a specific area), or even local anesthesia (medication that causes you to lose sensation in a small area for a minor procedure), fear of the anesthesiologist probably pales in comparison to the fear of a surgical procedure without one.

Surgery Really Can Be Simple

When most people think of surgery, they envision something Frankensteinian, or even a wacky doctor's game. Today, however, surgeons can perform extensive procedures with almost no cutting by using measures that are less invasive than ever before. This is why a prospective surgical patient should understand what is referred to as the "invasiveness" of any procedure. For the most part, surgeries break down into three categories: non-invasive, minimally invasive, and invasive (or open).

Non-invasive procedures do not break the skin, penetrate a body cavity or remove biological tissue. In other words, there are no incisions. Most of the tests done during an annual physical fall into this category: taking your pulse, monitoring blood pressure and listening to the heart and lungs. Non-invasive procedures usually don't scare patients.

Minimally invasive procedures usually involve tiny incisions and minimal body intrusion. The procedure could be relatively simple (getting a shot, for instance) or more involved (like endoscopy -- used to take images or small amounts of tissue, aka a biopsy, by inserting a small scope into the body via an existing anatomical opening). These surgeries can take longer to perform but often involve shorter hospital stays, and many can even be done on an outpatient basis.

Invasive (or open) procedures involve making an incision (usually a significant one -- in other words, bigger than a tiny cut) in the patient's body. This is what people often think of when they imagine surgery. It's also what we most often see on TV, and what has been done throughout history, until the late 1980s.

Though the prospect of undergoing any type of operation can certainly be frightening, and each does come with its own set of risks, surgery today is not what it once was. Many of the most complex modern surgical procedures can be done using minimally invasive or tried and true classic open techniques. By taking the time to inform yourself as to the type of surgery and procedure involved, you will be better able to envision each element of the process, thereby removing the sense of dread that comes with the word and reducing the experience to a series of simple steps.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': Eye on the Elderly: Helping Seniors in the Hospital Setting tag:www.huffingtonpost.com,2010:/theblog//3.784546 2010-11-30T05:53:00-05:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/ "All diseases run into one, old age."
--Ralph Waldo Emerson

Finding oneself in the hospital can be trying at any age. But for the elderly such an experience comes with a host of separate issues, both mental and physical, that need to be addressed in conjunction with prompt and professional care for their ailment. As our nation's baby boomers begin to retire and medical advances increase life span, the average patient age continues to rise, a trend that appears to have no end in sight. In our efforts to assist an aging friend, relative or loved one, it is important to keep in mind that patience and perspective rule the day.

In this fast-paced modern age, when a young or middle-aged person gets sidelined through illness or accident, his or her thoughts often refer to the quotidian: school or work responsibilities, upcoming social events and family obligations. While the elderly entertain these thoughts as well, in many instances their priorities and focus will differ considerably. What may seem trivial to a 25-year-old may be of great importance to a patient of 85, be it paying the phone bill, watering the plants or feeding the cat. As a result, one of the most helpful things we can do when visiting sick, elderly patients is to ask them what they feel needs to be done. Through the simple act of listening, the caregiver or friend offers the understanding that the patient is not alone, and the needs of their life outside the hospital are being met. This frees them to focus their attention on the illness at hand and offsets the feelings of loneliness and helplessness that come with any hospital stay.

Rumination and Recuperation

When one is in the hospital, there are often great waiting periods between doctor visits, tests and procedures. Unfortunately, this gives the elderly time to reflect on a plethora of age-related issues relating to mortality and failing health. In addition to the many physical changes that remind us that the body is gradually losing strength, such as incontinence, limited mobility, slowing metabolism, and a decrease in the abilities of all five senses, older patients are often forced to face a number of psychological developments. Concerns over these issues can sometimes snowball out of control if not met at every turn with patience and understanding, be it from a family member, caregiver, or friend.



Planning for the Inevitable

As a result of their increased focus on mortality, many elderly patients who find themselves in the hospital become fixated on getting their affairs in order as soon as possible. In addition to topics pertaining to wills, bequeathments and funeral arrangements, many seniors feel the need to discuss what is to be done in the event that their health takes a turn for the worse while in the hospital.

An "advance health care directive," also known as a living will or advance directive, provides a legal mechanism for individuals to specify what actions should be taken to address their health in the event that they are no longer able to make such decisions due to illness or incapacity. These instructions are often of great assistance, as they prevent the need for doctors or family members to "guess" what the patient would like to have done. By appointing a person or persons in this capacity, individuals can let their physician, family and/or friends know their healthcare preferences, including the types of special treatment they may want at the end of life, as well as the extent of their desire for diagnostic testing, surgical intervention, resuscitation and/or organ donation.

Watching an elderly loved one struggle with the effects of aging while in the hospital is no easy task. To truly provide the support these patients need in times of crisis, gaining insight into their perspective is of utmost importance. Listening to their ideas and concerns, offering assistance if possible, and understanding their end-of-care wishes are excellent ways to assure patients that they are not alone and that their needs will ultimately be met.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': 6 Steps to Understanding Your Hospital Bill tag:www.huffingtonpost.com,2010:/theblog//3.756061 2010-10-14T08:10:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/ "Everything unknown is magnified."
--Publius Cornelius Tacitus, senator and historian of the Roman Empire

Hospital stays can be incredibly stressful. From that open blue gown you and your new roommate must wear to understanding your diagnosis and accompanying treatment, most patients feel overwhelmed and disoriented. When you finally get to go home, weeks may pass, the discharge and rehabilitation process hopefully become manageable, and life returns to normal. But just as soon as the anxiety from that hospital stay begins to subside, one day there it sits, waiting in your mailbox, that enigma of lines, abbreviations and numbers: your hospital bill.

Perhaps even more than the actual hospital stay, the hospital bill can be difficult to understand. The bill will likely contain an abundance of codes and abbreviations, and it may look more like a cryptographic algorithm than a bill. Depending on the length of a hospital stay, for some the hospital bill can create a psychosomatic reaction strong enough to land you right back in the emergency department, the place where this whole thing probably started. Before irreversible frustration and despair set in, however, here are some tips to help you understand the sum total of your hospital stay.

Step One: Understand How the Hospital Makes Your Bill

The first step is to understand how the health care industry tallies costs. Every time you visit the hospital, a bill is drawn up to include fees for any procedure, any medication, and just about any service rendered. The bill may include information such as:

  • The date on which any good (e.g., medication) or service (e.g., doctor's exam) was rendered

  • The department from which it came

  • A brief description, including the quantity of goods and services rendered, and

  • The amount billed



If nothing else, think of your hospital bill as a very specific and detailed recitation of your hospital stay.

Step Two: Try and Find the Bill's "Instructions"

If you have health insurance, chances are that someone will eventually send you a document that explains your bill, more commonly referred to as an "Explanation of Benefits" or "EOB." Your EOB is a summary of:

  • Costs that the insurance company cover

  • How much the insurance company will pay

  • How much the insurance company will not to pay

  • Why these determinations are made, and

  • How much is your responsibility



You can expect to receive your bill from the hospital before you receive your EOB. Many patients, however, wait to receive their EOB before they pay their bill, mostly because the EOB can be a better indicator of what is actually owed.

Step Three: Understand the Reason for the Hospital Stay

Now that you know how to read your bill and EOB, you may wonder how these costs are determined. Hospitals usually work with outside firms to determine the average price of each good and service offered. They then set their own prices based on these values. To fully understand this process, it is first necessary to understand your condition and subsequent treatment as it is divided throughout several different hospital departments.

In the case of pneumonia, for example, treatment draws from nearly all factions of a hospital, including the pharmacy, laboratory, radiology and respiratory departments. Also, due to the complexity of treatment required to address the different symptoms, a typical pneumonia stay at any hospital often necessitates help from a variety of doctors, such as an internal medicine doctor, an infectious disease specialist, and even a pulmonologist. As a result, the combined hospital charges of pneumonia include not just the hospital bill, but also a bill from the laboratory, the radiologist and the multidisciplinary team who worked so hard to rid your body of its bronchial havoc.

Step Four: Understand Your Treatment

While it is important to understand why you ended up in the hospital, the focus of the bill is really what it took to get you home. Here's how a bill might be tallied for pneumonia:

First, to diagnose your condition, your doctor probably requested an X-ray or CT scan to confirm the presence of pneumonia in your lungs. You may have also been asked to take a blood test or provide sputum (a substance that is expelled from the respiratory tract, such as mucus or phlegm, mixed with saliva) for a culture.

If an X-ray or CT Scan was involved, you probably visited the radiology department, and you should expect to be billed for the services of the radiology technician who takes the films, the use of the X-ray or CT scanner, any labs or films, and the expertise of the radiologist, a special kind of doctor whose job is to read these results.

If you had a blood test or sputum culture, you probably met the hospital's phlebotomist, who took your blood. The analysis of any blood sample takes place in a clinical laboratory, complete with a special machine and a special doctor who oversees the lab and reads your results.

If your medical condition necessitated a bona fide hospital stay, at a minimum you can expect a bill for a room.

Inside the hospital, the pharmacy was probably involved in your treatment. The responsibility for providing the proper medication, monitoring a patient's progress and ensuring that there are no negative drug interactions falls on the shoulders of the hospital pharmacist.

Step Five: Read Your Bill

Understanding the way your bill is tallied is still only half the battle. Unfamiliar medications, codes, hospital abbreviations, and procedures can make it nearly impossible to question a given amount or line item. Like any other kind of bill, hospital bills are also subject to computer and human error. A single incorrect procedure code, entered either by the hospital or the insurance company, could mean a difference of hundreds of dollars. This can be difficult to find, let alone correct.

When in doubt, remember that you always have the right to inspect the important hospital documents that you need to identify a billing discrepancy. This can include an itemized, more detailed copy of your bill and a complete copy of your medical chart. By comparing documents such as these to the bill that arrived in the mail, a sharp eye may discover errors.

Step Six: Remember to Breathe

When you're sick and in the hospital, you probably want nothing more than to feel better and go home. When you're home and feeling better, an expensive and confusing hospital bill can really make you feel sick. As confusing as your hospital bill may initially appear, always remember that it is nothing more than an objective accounting of all the events and ingredients that made up your hospital stay.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': Mental Health and the Family Tree tag:www.huffingtonpost.com,2010:/theblog//3.721132 2010-09-20T07:00:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
-- Leo Nikolayevich Tolstoy

Thanks to the recent closing of many mental health facilities as a result of today's tough economic times, the subject of mental illness has been getting a lot of attention lately. The National Institute of Mental Health estimates that 26.2 percent of Americans aged 18 and older -- that's one in four adults -- suffer from a diagnosable mental disorder in a given year. Though no one likes to think of the possibility, the chances that a family will at some time face the specter of mental illness within its ranks are all too real.

While concern for those directly plagued by psychiatric issues is certainly a priority, surprisingly little information is geared toward the effect such an illness has on the loved ones and friends of the sick patient. Unlike cancer or heart disease, whose conditions can be qualified, psychiatric disorders continue to stand as an enigma to much of the modern world. This often leaves those closest to the patient wondering both how to feel and what to do when dealing with the ramifications that are sure to present themselves.

Though advances in diagnosis and treatment have done much in recent years to dispel the stigma attached to mental illness, it can often be difficult for a loved one to come to grips with the reasons behind the illness and the feelings of guilt and confusion that often ensue. It is important to remember that mental illness is just that, an illness of the brain, one that often affects the thinking, judgment, moods, and behavior of the patient. Because of this shift in acceptable thought processes, many people find it difficult to understand the reasons behind the disease itself, as they attempt to categorize the patient's actions, thoughts and emotions in their own healthy terms. When they cannot come to grips with the nuances of the disease, many of those close to mentally ill patients blame themselves rather than the disease for their lack of understanding, while placing the burden for their loved one's condition on their own shoulders in a continued effort to make sense of what has happened. Such behavior often manifests itself in the following ways:

• Guilt. Many family members of the mentally ill believe that they should have been able to control the actions of their loved one. They blame themselves for letting the situation get so out of hand.

• Embarrassment. Social stigmas continue to play a role in the treatment of the mentally ill, and many loved ones have trouble in admitting to the nature of the disease as well as the ramifications it may cause within their family and social circle.

• Confusion. When first acknowledging their loved one's illness, many people cannot come to grips with the reasons behind the disease or the effects it has had on their behavioral patterns.

• Anger. It is common for family members of the mentally ill to feel angry at the patient in the belief that he or she is not really sick, but only looking for attention or an excuse to shun responsibilities.

• Resentment. When a family member becomes mentally ill, his or her burdens are often forced onto the shoulders of those closest to him, adding increased pressure to an already demanding situation.

• Fear. When a loved one is diagnosed with mental illness, family members often wonder if they are susceptible to the illness as well.

• Frustration. The nature of this illness makes it difficult for loved ones to provide the help the patient needs to get better, leaving them to feel inadequate and increasing feelings of guilt.

Helping Family Members Cope
Assisting a friend or family member who has been diagnosed with a mental illness can be a time consuming, heartbreaking, and often thankless task. It is the nature of the illness to rebel against help of any sort, and family members and loved ones often bear the brunt of the patient's frustration at being unable to control himself as he has been accustomed. The key to successfully embarking on a path back to wellness is to remain as non-judgmental as possible. By removing the added guilt of facing up to what he or she is doing to the family, the patient will be better able to focus more readily on getting better.

Recent years have brought about exciting new developments in the diagnosis and control of many major mental health issues, though it is important to note that every patient has his own specific rate of recovery. For a friend or family member, the best way to stay effective in assisting a loved one's treatment is to maintain objectivity and a sense of self. Though it will certainly be difficult to watch as a loved one struggles with his illness, nothing is gained if the rest of the family is pulled down with him. The following guidelines may help you to maintain focus and a positive attitude when faced with the daily tribulations that arise from supporting a mentally ill loved one:

• Confide in a friend. Due to the convoluted nature of the disease, it is often helpful for family members to discuss treatments and behavioral issues with an outside party. This helps to maintain an objective perspective on the effects of the disease.

• Maintain realistic expectations. Do not expect the disease to be cured overnight, if at all. Recognize that frustration and setbacks will play a large part in the progression of the patient's recovery, and any negative actions on the part of the patient have no bearing on the ways in which you have provided support. Unlike most physiological diseases, mental illness is often directly connected to mood swings, which do not necessarily indicate that the disease is progressing.

• Accept help whenever it is offered. When taking on the added burden of a mentally ill loved one, it is essential that family members do not become overtaxed themselves. In order to provide adequate support, the needs of the entire family, and not just the patient, must continue to be met.

• Maintain a sense of humor. As with any situation involving a sick loved one, a positive outlook can make even the most difficult times more bearable.

• Take time for yourself. Remember, your sick loved one is only one part of your life, and you can best serve him or her by staying focused yourself. It is important to spend time every day doing something you enjoy such as a hobby or exercise to allow yourself time to recuperate and eliminate stress.

Wrestling with the intricacies of mental health disorders is no easy feat. If you are dealing with a family member who has been diagnosed with a psychiatric condition, it is of utmost importance that you understand and accept the fact that your loved one's condition is an illness, no different than if he or she had an issue with the lungs, heart, or stomach. Guilt and embarrassment should play no factor in helping your loved one to cope with the demands of the illness, nor should blame be added to the already substantial burden of caring for the sick. The sooner you can accept this illness for what it is and begin to manage its consequences, the sooner your loved one will be able to embark on the journey to recovery. By accepting both the disease and the patient, family members are much more likely to successfully navigate the troubled waters found in any crisis of mental health, and the added strength they find will surely benefit the loved one in need.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': Medicine By the Numbers tag:www.huffingtonpost.com,2010:/theblog//3.700682 2010-09-09T07:00:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
When people are first told that a loved one is in the hospital, they want answers. Straight answers. And they want them fast.

But oftentimes in today's medical centers, what patients and family members alike are met with is numbers: Hypotheticals, probabilities and percentages. When combined with complex medical jargon, this can quickly lead to confusion and uncertainty, as those involved must make sense of the stats before they can understand the state of the patient's condition. Without the proper frame of reference, this type of information can quickly exacerbate fears and increase emotional distress. Rather than serve as beacons to shed light on a patient's chances, these figures quickly become barriers to the truth. For many of us, the numbers are to be feared, not followed.

Still, whether we like it or not, playing the percentages is a medical necessity. In the modern age, health care is all about the bottom line. As technology advances and life expectancy increases, today's treatment options become more and more focused on the probabilities of success or failure. From prenatal care to geriatric services, every patient ultimately wants to know one thing: "Where do I stand?" More and more, the answer is delivered as a number, culled from experience, testing, and appropriate clinical research trials. This often leaves the physician to mediate between patient and procedure, as he or she attempts to present new information in such a way that those involved can both understand and take comfort from that most dispassionate of messengers, the statistic.

The numbers themselves are not to be blamed. At the risk of making modern health care sound like a sports bar in Las Vegas, the purpose of statistics in a medical environment is to give the facts about a patient's condition in black and white, which, if not done humanely, can seem lacking in compassion. The key to recognizing the value of such numbers is to use them as guidelines, not ultimatums.

Properly used, statistics perform a dual function: When correctly interpreted and explained, these numbers can act as a security blanket, breaking down frightening uncertainties into hard facts in which patients can wrap themselves during a time of emotional upheaval, while also providing a solid understanding of treatment options and outlooks. From a doctor's perspective, they stand as a buffer, protecting the physician from being forced into the unrealistic role of savior, no matter what the condition. In their way, percentages help to reinforce the idea that nature, and not the doctor, will ultimately make the final call as to a patient's future. Such impartiality goes a long way toward strengthening the doctor-patient relationship, especially when the prognosis is not as good as a patient might have expected.

Numbers can be persuasive to those patients faced with making important yet difficult lifestyle changes or deciding upon end-of-life treatments. For patients diagnosed with serious illnesses and their families, much of today's medical data provides hope. For example, according to the information available at the end of 2009, life expectancy in the United States reached an all-time high in 2007 -- 77.9 years (75.3 years for men and 80.4 years for women). Between 2006 and 2007, rates dropped for nearly half of the leading causes of death in the United States (cancer, heart disease, stroke, hypertension, accidents, diabetes, homicides and pneumonia), reaching a new low of about 0.76 percent of the population (760.3 deaths per 100,000 people). That is approximately one half the rate from 1947. Once fatal illnesses are slowly being reclassified, provided the patient heeds the warnings found among the numbers and takes the appropriate steps to live in a healthier manner.

On the other end of life's spectrum, many newly pregnant couples become surprisingly imaginative upon first hearing their good news and spend much time contemplating the worst. To calm the parents' nerves (and to protect the doctor's interests), it is now standard practice to administer a series of tests to assess the baby's health throughout development. Then end result of most of these tests comes back in numbers. Statistics again.

Without debating the ethics and morality of abortion, which is not a doctor's role, many of these tests seek to ascertain the health of the fetus and predict the odds of certain birth defects such as Down syndrome, trisomy 18, or trisomy 13. The number of things for a pregnant couple to worry about can be staggering, yet doctors are often obligated to advise them of the chances in advance. For example, in North America, 1 in 260 females carry the chromosome for Fragile X (also known as "Martin-Bell") syndrome, a genetic disorder that results in an array of physical and mental limitations, ranging from severe to mild in manifestation. Likewise, 1 in 149 Ashkenazi Jewish individuals carry the gene for Nemaline Myopathy, a neuromuscular disorder that causes muscle weakness of varying severity. In its most potent form, Nemaline Myopathy results in death after just a few years. By incorporating these tests with such relevant factors as the age and overall health of the mother and the genetic background of each parent, doctors can provide a statistical model on which to gauge the probability of the baby's being born to normal health. This can provide parents with peace of mind if the chances of defects are low, or the opportunity to prepare themselves or consider their options if the outlook is not favorable.

At least one reason behind the surge in statistical diagnosis is the continued rise in medical malpractice claims. Having been forced into the role of omniscient healer as a result of advances in diagnostic testing, doctors must now use this same technology to cover themselves in the event of a statistical improbability. A recent study by the American Medical Association concluded that "defensive medicine" (defined as medicine relying upon diagnostic and other therapeutic measures to safeguard against malpractice claims first, and the health of the patient second) increase health care costs by as much as $150 billion each year. To be sure, throwing the title of statistician into a doctor's medical bag of magic tricks does not help to further the doctor-patient relationship.

There is no numeric substitute for direct and clear communication between a doctor and patient. That said, making sense of medical statistics can go a long way in helping a patient understand diagnosis, prognosis and treatment. If you or a loved one has been diagnosed with a potentially life-threatening illness, your decisions about treatment can often be linked to "quality of life" concerns. No matter what age, patients want answers to certain questions, often combined with supporting statistics, such as:

•How will this disease affect my life on a day-to-day basis

•Is this disease terminal, or if left untreated, will it become terminal

•How will the treatment affect my life on a day-to-day basis?

•How will the disease, treated and/or untreated, alter my life expectancy compared to my anticipated decline in health as I age?

It is important to remember that statistics are numbers, plain and simple. While numbers may not lie, they have no bedside manner and can be interpreted in a variety of methods and made to suit many arguments. The best way to know where you or your loved one stands is to discuss your situation clearly and openly with your doctor, taking into consideration the big picture as well as the percentages.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': Surviving the Hospital Discharge tag:www.huffingtonpost.com,2010:/theblog//3.696446 2010-08-31T08:00:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
-- Pablo Ruiz Picasso, Spanish painter, draughtsman and sculptor

"Nosocomephobia," defined as an excessive fear of hospitals, is not a word you often hear in healthcare settings. But maybe you should. At any given moment, a typical hospital stay balances disease and diagnosis, joy and despair, pitting physical and mental tribulations against hope. Oddly enough, "Nostophobia," the excessive fear of returning home, can be just as prevalent to patients who find themselves in need of long term medical care outside the safety and security of the hospital environment.

For most people, the most significant moment of any hospital stay is when they are told they can leave, and how carefully they prepare for this anticipated departure is in many ways as important as the treatment they receive while under a doctor's care. Referred to as discharge planning, hospitals understand the importance of developing a careful and appropriate agenda to address what will inevitably occur outside the hospital walls. Whether the patient is headed to his or her own home, the home of a friend or loved one, or to a rehabilitation center or nursing home, knowing what to expect goes a long way toward reducing stress and ensuring the best outcome for everyone involved.

Discharge planners -- who can be hospital administrators, social workers, doctors, or nurse case managers -- often work closely with families to explain a patient's outlook, offer direction on continued care and help identify the most appropriate facility to suit the patient's needs. Depending on the patient's condition, a good discharge plan may be as simple to execute as taking a few days off work to help at home or as complex as researching health care facilities and coordinating assistance among family members. Generally, discharge is a five stage process:

Stage One: The patient's mental and physical conditions are evaluated by the attending physician and nursing staff, with particular focus on whether or not the patient can safely return to his or her original living situation.

Stage Two: The discharge planner explains the doctor's evaluation to the patient and any available caregivers, focusing on future care, including whether to transfer the patient to his or her own home, that of a family member, a nursing home or rehabilitation facility.

Stage Three: The discharge planner will now begin to personalize the patient's plan, discussing any necessary caregiver training, possible third party care, and whether any extra equipment (such as wheelchairs or breathing assistance devices) will be necessary.

Stage Four: The discharge planner may now recommend third party facilities or home care services that are available to suit the patient's needs, taking into consideration geographic, religious, language and/or cultural issues that might affect quality of care.

Stage Five: This final phase is designed to ensure that the appointed caregiver has all the information necessary to carry out the task at hand, including a summary of the hospital stay, a list of medications and important contact information in case of questions or concerns. There may also be a discussion about potential warning signs in the event that a patient's condition should worsen.

When you or a loved one are recommended to a third party medical facility for long or short-term care, there are many factors to review. Because your time to make a decision may be limited, it is a good idea to consider the following when making your selection:

  • Why was this type of facility chosen?

  • What specific medical needs does this facility address?

  • Is this facility capable of meeting all the patient's needs, or will additional assistance be necessary?

  • How close and convenient is this facility for the primary caregivers and family?

  • Is it clean, quiet and comfortable?

  • Does this facility address any cultural or language related issues the patient might have?



When the Burden of Care Falls on a Loved One
Often, patients find themselves in a situation where their needs are not severe enough to require a third party service, but they cannot fully care for themselves in a home setting. In such instances, a patient's family or friends may be called upon to assist during the rehabilitation process.

When a loved one returns home to recuperate, his or her needs are often diverse, and the job of the caregiver can be complicated. The following are the essential elements of primary care during recovery:

Health and Hygiene: The caregiver may assume such tasks as bathing and dressing the patient, as well as assisting the patient with going to the bathroom, grooming and eating.

Household Chores: While convalescing, the patient will most likely need help with cooking his or her food, cleaning the living quarters, and washing articles of clothing as well as shopping for supplies and medications.

Medical Services: The primary caregiver will likely need to provide a certain amount of medical assistance, helping the patient with everything from wound care and bandaging to administering medications, including the possibility of giving injections.

Companionship: The emotional aspect of rehabilitation are often directly linked to a patient's physical progress, and positive daily conversations help to reassure the patient that he or she is not facing these challenges alone.

If you find yourself in the position of family caregiver, know what to expect as you take on these new responsibilities. Providing post-hospitalization support for anyone can be a time consuming, high pressure task. Those who find themselves undertaking such a role should be mindful not to ignore their own needs and obligations in their effort to assist a loved one.

While the discharge process marks the conclusion of the hospital stay, it is often just the first step on a long road to recovery. The challenges facing newly discharged patients and their caregivers can be a complex mix of mental, physical, emotional, and financial hurdles. By planning for this step at an early stage, both the patient and his or her caregivers will be more prepared to address the hurdles that go hand in hand with convalescence, leaving them free to focus their time and energy on the task of returning the patient to a healthy, productive lifestyle.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> PBS's 'This Emotional Life': The Hospital Menu in the Modern Age tag:www.huffingtonpost.com,2010:/theblog//3.654925 2010-07-25T07:00:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
Medical technology has made dramatic leaps in the past 150 years. From the invention of the X-ray and the introduction of vaccines to the mind-blowing capabilities of high-tech 64 slice CT scanners that allow physicians to view the inner workings of the human form, the ways in which we practice medicine today seem light years ahead of our predecessors. And yet, oddly, one aspect of the hospital stay has remained surprisingly constant -- the menu.

Until recently, that is. Today's hospitals are learning how important a tool the menu can be when it comes to promoting healing, increasing nutritional awareness and improving their patients' emotional well-being. The twenty-first century has brought with it new ideas and sound philosophies relating to the bond between what we eat and how we feel, and nowhere is that link more dramatically felt than when one is forced to dine from a hospital bed. In the past the focus of hospital food was primarily somatic, although the lackluster fare did not always provide the much-needed healthy boost of vitamins and minerals. Today's hospitals have come to recognize not only the value of well prepared, fresh food in bolstering the immune system, but the benefits choice can have on a patient's psychological outlook during trying times. Food, it seems, is powerful medicine not only for the body, but also for the mind.

Since study after study continues to stress the influence proper nutrition has on rates of healing and overall health, many of today's hospitals have begun to address the tired stereotype befitting Jell-O cubes and ice chips, striving instead to serve fare that is both varied and enjoyable. In doing so, both patients and hospitals benefit. By allowing patients to choose their meals, they are given a degree of control over their situations, albeit small, which can go a long way toward reducing the stress of waiting for test results, exams or procedures.

Over time, it has become clear that the old methods of serving patients are no longer a match for the needs of the modern hospital or those it serves. Since the average age of the hospital patient continues to rise as Baby Boomers find themselves entering their sixties and demanding a standard of quality that they have grown to expect, many hospital administrators have opted to outsource food services in an effort to provide patients with quality meals that are prepared without taxing the hospital infrastructure itself.

Today, nearly 20 percent of American hospitals employ food service outsourcing in one form or another, and the trend is on the rise. By doing so, hospitals are able to focus solely on the task of ministering to patients, freeing up staff members who once doubled as waiters and providing patients with food prepared by culinary experts who take pride in conjuring up a variety of nutritious dishes guaranteed to surprise if not delight the most curmudgeonly gourmand. This not only increases efficiency, it results in improved service, better food, greater selection and higher patient satisfaction. To keep up with the modern patient's need to be pampered, many outsourcing companies have even begun to offer room service dining, which is in many ways similar to a hotel experience. When hungry, patients simply place an order with the kitchen, and their request is brought up in a timely fashion after having been vetted by the hospital dietitian. Food is freshly prepared and the menus are extensive.

Whether outsourced or not, many modern hospitals have committed to improving the quality and scope of their menus in an effort to capitalize on the link between healthy eating and psychological well-being. With greater variety comes better nutrition, as patients are not only eating healthier food free of excess sugars, starches and preservatives, they are eating more of it. The concept of food as preventive medicine has resulted in some leading hospitals offering primarily organic and chemical free food, including hormone free milk, antibiotic free chicken and beef and locally grown fruits and vegetables.

This stands as an excellent example of the way in which hospitals are beginning to regard education as a key factor in the continued health of their patients. Most American hospitals employ registered dietitians to ensure that patients eat healthy, well-balanced meals during their stay and receive the necessary education to continue such patterns at home. In this way, hospitals can do their part to proactively treat patients before they become sick as a result of obesity or lack of nutrition.

Understanding the full impact of a proper diet is no easy task for anyone, hospital patient or not. Modern times can often blur the lines between healthy or unhealthy, too thin or too heavy, without even addressing nutrition. Whether the focus is on obesity-associated morbidity or orthorexia nervosa (an antiphrastic oxymoron which is used to describe an unhealthy obsession with eating healthy), a hospital stay can help patients recalibrate their eating habits and promote greater combined mental and physical health in the future.

If you or a loved one find yourself in a hospital for any length of time, consider using your stay to familiarize yourself with the basics of nutritional healing and overall healthy eating. This will help you not only during your visit, but as you return to your regular lifestyle.

Get to Know Your Dietitian. Dietitians create menus that meet healthy eating guidelines set by the American Dietetic Association, as well as satisfying regional tastes (foods that are familiar to a large immigrant community, for example) and addressing specific patient related health needs such as those exhibited by diabetics, breast-feeding moms, wheat-allergy sufferers, etc. Your hospital dietitian will gladly provide advice and information on ways to improve your dining habits and cooking preparation, taking into account any health-related issues.

Shop Around. If you are not in the hospital as a result of an emergency situation, take a few minutes to find out what each of your neighboring hospitals have to offer in the way of dietary education, menu preparation, and room service dining. While medical expertise should always be the primary concern, you might be surprised at the quality of food service now being offered by medical centers in your area.

Use Your Down Time. While no one ever wants to be in a hospital, the periods of waiting between tests or while healing do provide many people with the opportunity to think about their health and reflect on ways to improve their quality of life once they are discharged. Ask questions and use the experts around you. By thinking long-term, you may be surprised to see just how easy it is to adopt healthier patterns once you are back to your normal routine.

By bringing the menu into the twenty-first century, today's hospitals hope to educate their patients in the ways in which proper nutrition can bolster not only the body, but the mind and spirit as well. As always, the evolution of medicine continues to take its cue from Hippocrates, who must have thought holistically when he said, "Let food be thy medicine and medicine be thy food."

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.

]]> PBS's 'This Emotional Life': Rethinking 'Medical Miracles' tag:www.huffingtonpost.com,2010:/theblog//3.629845 2010-07-02T08:00:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
A phenomena within health care, often applied when no rational scientific explanation can be given, preexists medicine itself. Be it via the Internet, urban legends or contemporary television and cinema, we have all marveled at the thought of the teen who lived 118 days without a heart, or the paraplegic man who was once again able to walk after being bitten by a brown recluse spider, or the window washer who fell 47 stories and awoke from his coma on Christmas Day. Sometimes, medical degree or no, the only way to explain the reasoning behind such patient outcomes is to use that often overburdened word -- miracle.

From the outset, medicine and religion have been begrudgingly forced to spar in their attempts to provide relief. As the two have evolved, they have constantly found ways to overlap, each jockeying for position as the times around them changed. One point of mutual interest and competition has always dealt with diagnosis. For example, thanks to advances in modern medical technology, we now know Tourette's Syndrome to be a rare neurological disorder. In its more aggressive stages, Tourette's presents itself with facial tics and expressions, the perception of the eyes rolling upwards, and involuntary, often guttural sounds. Though contemporary physicians are capable of recognizing this disease for what it is, it is interesting to note that Tourette's was once widely understood to be a form of demonic possession, and dealt with accordingly.

On the flip side, take the curious phenomenon of Lazarus Syndrome. Since 1982, there have been 25 documented cases of a deceased patient coming back to life without any medical intervention whatsoever, due to a spontaneous and unexplained restarting of the heart muscle after death. The name comes from the biblical tale of Lazarus, who was raised from the dead by Jesus after four days. Though medical science has put forth several possible theories for such an occurrence, it remains a widely debated mystery to this day, from both a scientific and religious standpoint.

Whether or not a patient believes in miracles, there can be no dispute that certain advances in medicine are nothing short of miraculous. In 1944, doctors performed heart surgery for the first time. In 1952, Jonas Salk took the first step toward eradicating the dreaded polio virus. Today, scientists can administer vaccines to cure many diseases, some even after infection. These same scientists believe they can also inject a patient with his or her own cells to help repair vital organs, thereby allowing the patient's body to essentially heal itself without any outside, invasive intervention. More and more, the gulf between miracles and modern technologies continues to widen.

At their core, both medicine and religion seek to heal. To support this objective, modern medicine began to focus its attention on shortening the list of any diagnosis that could be classified as a "terminal illness" (an illness from which, despite treatment, death is certain). At the turn of the twentieth century, as patients began to realize that modern medicine was advancing quickly and achieving previously unheard of results, the role of medicine itself started to change. Patients began to expect not only treatment of symptoms, but cures. With this understanding came a new feature formerly the exclusive jurisdiction of religion, the possibility of hope.

To a certain degree, the medical miracles of yesterday have slowly become the miraculous advances of today. Many previously unexplained situations are now seen clearly from a scientific standpoint, a sure sign of progress. But to hospital patients and their loved ones who must face incurable disease, this temporal distinction weighs in as little more than semantics. Looking in from the outside, it appears that most families do not care whether comfort comes from a modern miracle or medical breakthrough, so long as it eases the pain.

No matter how far science advances, however, one should never discount religious faith within the medical arena. In fact, it is just such conviction that has always pointed the way to medical success. Study after study has shown that the act of having faith -- be it in an afterlife, an all knowing creator, or a CT scanner -- can have a dramatic effect on both the condition and quality of life during a loved one's final days, for the patient and family alike. Modern medicine still has a long way to go in its quest to unravel definitively the mysteries of the human body, and when its efforts fail us, faith is the only remaining foundation.

Should you find yourself in the unenviable position of comforting a loved one when time is short, faith may prove to be your most powerful tool. In such times, communication and honesty are of utmost importance. Ask questions of the patient, and respect his or her needs and convictions. Some people insist upon continued care until the end, while others want only to be checked up on. Many want an ear that is willing to listen. Certain patients continually search for clinical trials or secret elixirs to keep their faith alive, while others take comfort in resigning themselves to what is to come. Respect the viewpoint of the patient and do your best not to superimpose your own desires or beliefs on top of theirs. Remember, this is their time, not yours.

As technology continues to discover new ways to push the limits of our understanding of the workings of the human body, faith in the unknown becomes ever more important, standing as a beacon to highlight the next step in a series of challenges. Not only must medicine and religion be allowed to coexist within a hospital, they must be able to complement one another. Most modern hospitals are big places. Surely there is room for both.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]> Charting Changes in the Doctor-Patient Relationship tag:www.huffingtonpost.com,2010:/theblog//3.593860 2010-06-01T12:23:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
Part science and part art, the practice of medicine has changed drastically in the 6,000 years since Hippocrates first uttered his famous oath. This evolution in recent decades, as seen both in its practice by physicians and the expectations thrust upon it by patients, has influenced a shift away from the hands-on study of the body as a primary means of diagnosis to a more clinical approach, due to both the advances of modern medical technology and the wealth of health care related data accessible to all via the Internet.

A Little History

Thousands of years ago, medicine offered little more than diagnosis and prognosis. The doctor's role was not to heal, but to predict. Over time, advances in both the understanding of human anatomy and the power of medical technology combined to revolutionize the medical expert's ability to identify and treat a variety of illnesses. As physicians learned more about the interplay between each of the body's organs, scientific discoveries began to shed new light on the mysteries hidden beneath the skin. The physician's exam, once lauded as the cornerstone of diagnostic science, gave rise to the X-Ray, which led to the CT scan, to be followed by magnetic resonance imaging (MRI). In truth, such technological breakthroughs are the reason so many diseases once considered death sentences are now routine and treatable.

There is no question that these modern scientific marvels have greatly increased the twenty-first century physician's ability to diagnose and treat his or her patients. But there is a cost. Initially intended as practical tools to gather additional data upon which to base a diagnosis, these new tests and procedures have become the central focus for many medical practitioners. The art of the physical examination, once so essential to both the diagnostic process and the emotional well-being of the patient, is becoming obsolete.

What Television and the Movies Can Teach Us About Attitudes Toward Medicine

These improvements in modern technology are in large part responsible for the transition that has taken place in the modern doctor's bedside manner and overall attitude toward the patient. Nowhere is this trend more apparent than in the changing role of television doctors throughout recent decades. In the seventies, for example, Robert Young portrayed the kindly and world-wise general practitioner Marcus Welby, M.D., a man who struggled to treat his patients with compassion in a profession trending steadily toward specialized, impersonal care.

Such struggles were in vain, it seems, as Welby's contemporary counterpart, Gregory House, M.D., uses his diagnostic brilliance as a means to keep himself always at arm's length from his patients. No longer is a doctor thought of as a kindly old man who makes house calls and listens to his patients' troubles and aches, he is now instead a young physician who hardly handles his patients while computing a checklist of ailments from which to order the proper panel of tests.

While the discussion of Drs. Welby and House above may portray two extremes in the doctor-patient relationship, the range of combinations in between has also appeared in television and film alike. In The Exorcist, Chris McNeil is a very concerned mother who desperately wants to identify the medical condition responsible for altering the behavior of her daughter Regan. The treating physician, relying upon early 1970s medical technology, offers his explanation:

"It's a symptom of a type of disturbance in the chemical-electrical activity of the brain. In the case of your daughter in the temporal lobe, up here in the lateral part of the brain. It's rare, but it does cause bizarre hallucinations."

Late in the film, Regan's physician returns to the McNeil Household during one of Regan's more memorable performances. Though scientifically baffled, the physician is determined to hold firm to his instincts:

"Pathological states can induce abnormal strength, accelerated motor performance. For example, a 90-pound woman sees her child pinned under the wheel of a truck, runs out and lifts the wheels half a foot up off the ground. You know the story, same thing here."

With no knowledge of the reasons for her daughter's illness, Regan's mother, like most people, was unable to engage in any meaningful debate about the accuracy of her daughter's diagnosis. Armed with years of medical education and training, the ordinary doctor circa 1973 could strong arm just about anyone with his opinion. All this has changed, however, with the advent of websites such as WebMD, MedicineNet and WrongDiagnosis.com.

The rise of the Internet has made advances in medical science more accessible to patients, granting them new depth and scope, medically speaking. With such a wealth of knowledge literally at their fingertips, patients now want information immediately when it relates to the science of medicine, often researching both disease and cure on their own. For better or worse, doctors have to some degree lost the unquestioned sanctity that has historically accompanied their "mysterious" profession.

Rebuilding the Doctor-Patient Relationship

Though the benefits of modern technology are not to be overlooked, the changes they have instilled make it increasingly important for both medical practitioners and their patients to maintain an objective approach to one another. A well-rounded doctor would do well to incorporate newfound scientific resources with renewed emphasis on the physical exam and patient history, in an effort to once again personalize the medical experience. A wise patient must keep in mind that the Internet, while a practical educational tool, is no substitute for a medical degree and in-field experience.

Perhaps most important to improving the doctor-patient relationship is the need for communication. To get the most out of your doctor's visit, it is essential that you express yourself while at the same time understanding the often complex issues and instructions your physician presents to you. Following is a set of guidelines to assist patients in their effort to communicate quickly and effectively, so that doctors have the information necessary to do their job and patients feel their needs have been addressed:

  • Be thorough. Your role is to provide the details on how you are feeling. The doctor will decide what is relevant.


  • Be honest. Your doctor has seen it all, and he or she is not there to judge you, but to heal you. Telling the truth about lifestyle choices, symptoms and concerns marks the fastest route on the road to recovery.


  • Ask questions. If something your doctor says about your condition or treatment is unclear, ask him or her to repeat it or put it in simpler terms.


  • Bring lists. The better prepared you are for your visit, the more relaxed you will be when questioned, and the more you will benefit from your doctor's instruction.



With all the benefits provided by modern medical technology, it is clear that the clinical emphasis on diagnostic medicine is here to stay. As the relationship between physicians and their patients continues to shift, it is important for both sides to remember that the practice of health care is a partnership as well as a profession. By effectively opening up a dialogue in which information and concerns can be shared, the doctor is better able to assess the situation, while the patient is made to take a more active role in the course of treatment, leading to a more relaxed, balanced and satisfying experience for all involved. ]]> The Visitor / Reducing Stress in a Hospital Stay tag:www.huffingtonpost.com,2010:/theblog//3.576360 2010-05-14T11:18:00-04:00 2011-11-17T09:02:45-05:00 Craig Garner http://www.huffingtonpost.com/craig-garner/
The hospital stay is often a time of great stress for patients and their families alike. Recently, President Obama issued a directive for the creation of rules ensuring that hospitals protect the rights of patients to designate visitors, stating in part: "There are few moments in our lives that call for greater compassion and companionship than when a loved one is admitted to the hospital." While the President's comments have been widely debated, his underlying sentiment emphasizes the importance of reducing stress in a hospital setting for all those involved.

Let's face it, no one wants to be in a hospital. Whether visiting a loved one or being visited yourself, the hospital stay poses a unique set of problems in that the presence of illness tends to tilt the scales of any relationship. Lying in a hospital bed surrounded by tubes and monitors, the patient is in a vulnerable state both mentally and physically. Separated from his or her natural environment, the patient is not only in unfamiliar territory but in the process of coming to grips with the fact that he or she is ill. Such a one-two punch often forces patients into crisis mode, leaving them feeling frightened and confused. In such a situation, the mere sight of a loved one is often enough to greatly reduce stress levels by assuring them that they are not alone in the situation.

But this burden must go somewhere, and it usually makes its way to the shoulders of the loved ones who come to visit. Family members, too, must navigate the shifting roles brought on by illness, as the physical and emotional toll of caring for a sick loved one can have a dramatic effect on everyday life. Such seemingly simple tasks as eating healthy, getting enough sleep, and addressing work responsibilities and personal commitments often fall by the wayside as time is sacrificed for the good of the patient. To make matters worse, stress is often increased by having to wrestle with concerns about the patient's care, complex medical information, financial anxiety, questions of insurance and the possibility of long term issues after the patient's discharge.

As difficult as it may be for people to watch a family member battle illness, for some groups the emotional distress brought about by grief or concern is further compounded by the struggle they must undertake to simply gain admittance to see their loved one. Though the President's recent directive is a step in the right direction, the rights of gays, lesbians and unmarried partners both to visit and make decisions with respect to their loved ones' care have historically fallen short, forcing them to watch from the sidelines as the patient battles his or her disease without the support of the partner. In addition, the elderly, who are often balancing the aforementioned stressors with additional feelings of grief and impending loss, must allow for issues deriving from potentially weakened immune systems, limited mobility and lapses in cognition, factors which can impede their ability to offer support. Children, too, can have trouble when trying to see those closest to them, as many hospitals have strict regulations prohibiting visitation by those under seventeen.

In the event that you are allowed to visit your loved one, good communication skills and a positive outlook are essential when providing comfort. The stress level of a patient can be either reduced or increased by the visitor, so it is important to remember that ultimately the needs of the patient come first. Following are guidelines to assist the family member so that his or her visit serves to calm the patient, rather than add to an already stressful situation.

● Ask permission to visit. While many patients enjoy company, some do not like for others to see them infirm or tired, or simply do not feel up to having guests. If you suspect you are intruding, politely ask if another day would suit them better. The key is to let the patient know that you are thinking about them.

● Gauge the effect of your visit. A family illness can sometimes force interaction between estranged members. However, this is no time to address old wounds. What matters now is to offer support in a time of need.

● Stay positive. Though your loved one's hospital stay may be taking its toll on you, it is important to keep the patient's thoughts on the task of getting better. Complaining about the situation or introducing feelings of guilt or resentment will only increase the overall stress level.

● Keep your visit short. No matter how much your loved one may enjoy your company, he or she needs plenty of rest. The fact that you have taken the time to see them is what matters, not the length of your visit. The simple act of seeing a friendly face can work wonders.

● Don't visit when you are ill. Though you'd like to show your support, visiting a loved one while sick is never a good idea. Patients in hospitals often have compromised immune systems which can cause additional complications during treatment. Instead, feel free to call or write until you are feeling better and are no longer contagious.

● Participate in the treatment. Should your loved one approve, it may be a good idea to get involved in the process by familiarizing yourself with the patient's condition, symptoms, and outlook. You may also want to introduce yourself to all related medical staff. This is a great way to remind your loved one that he or she is not alone, and that someone who cares is looking out for their best interest.

● Take care of yourself. While your primary focus may be on your loved one, it is important to note that you cannot be of help to him or her if you get sick yourself. Spend a few minutes every day doing something you enjoy, and try to eat well and get as much sleep as possible. The stronger you remain during this experience, the more you will be able to provide your loved one with the support he or she needs during this trying time.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.]]>