I've watched your action movies on celluloid for a decade, always marveling at your competence and cool. Your decisions on-screen are bold, instant and infallibly correct. You never seem to age, but only to get more beautiful every year. Your life, on and off screen, appears like a fairytale.
Your latest op-ed in the New York Times (March 24, 2015) showed me a whole new side of you.
I am a critical care physician. Twenty years ago, I began my training to be a "hero doctor." I wanted to be able to rescue people from the jaws of death. I wanted to be like those guys on ER. I wanted to be unstoppable, like you.
But those decades taught me that life isn't a movie. My bold attempts to extend life at all costs did not usually result in cure, but instead prolonged the dying process. And as luck would have it, I was in the right place at the right time -- University Hospital in Newark New Jersey, 2003, when new research was being done to enhance communication for ICU patients and their families. Our involvement contributed to the growing awareness that honest communication, particularly the acknowledgement of death, is key to good health care decision making, particularly at the end of life, but at all points along the way. Instead of rushing in and "doing something," we needed to start breaking bad news, asking questions, and finding out what was right for the patient.
Of course you're not an ICU patient. And my hope is that you will go on to live a long and healthy life. But your acknowledgement that life is unpredictable shields you from the fantasy of immortality, so often perpetuated in contemporary medical culture -- and even more so in Hollywood. You have elected to keep your feet firmly grounded in reality, which is essential to wise engagement with the healthcare system.
As for me, I realized that my approach to providing healthcare was out of focus. I was only seeing the disease, not the patient. I was the lead actor in my own drama. And in the process I was causing a lot of suffering. The hero doctor model, like the Hollywood blockbuster, is simply not based in reality.
Now, in addition to critical care, I also practice Palliative Care medicine, which prioritizes honest, open, patient-centered communication. Don't get me wrong, I haven't stopped loving the ICU. Last week I saved a life, and that felt heroic. But I have redefined heroism, and for me it now includes the courage of being able to talk honestly with a patient about her death, whether in the distant future or the next few days. The process can be painful and laborious, as you have demonstrated. Yet it works. It's real.
And so, reading your words in the New York Times last week gave me great hope. Although medical culture is just beginning to shift, I have come to believe that, for now, this new paradigm in medicine needs to be led by lay people. And you are the quintessential lay leader to start this conversation.
Now you have become a genuine hero to me, one who models this alternative approach, who is unafraid to consider her own mortality and engage in realistic decision making with her doctors. You are leading the way, and i hope that your vulnerability will render us all less fearful.
Thank you, Angelina. You are more courageous than any of the characters you've portrayed.
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