Summary: 📚🩺💡 This article is a must-read for medical students and future healthcare professionals! It emphasizes the importance of empathy and human connection in healthcare. It reminds us that while medical knowledge is essential, it is equally crucial to build strong relationships with patients to provide holistic care. The article provides practical tips on how to cultivate empathy, active listening, and effective communication skills. It also highlights the positive impact of these qualities on both patient outcomes and personal fulfillment as a healthcare professional. Don't miss out on this insightful and inspiring read!

Takeaways:

1. 🌟 Cultivate empathy: Put yourself in your patient's shoes and try to understand their emotions and perspective.
2. 👂 Practice active listening: Pay full attention to your patients, show genuine interest, and ask open-ended questions to encourage them to share their concerns.
3. 💬 Enhance communication skills: Master the art of relaying information in a clear and understandable manner, avoiding jargon and providing patients with an opportunity to ask questions.
4. 🤝 Build rapport: Build a trusting relationship with your patients by showing empathy, respect, and understanding.
5. 📖 Continuously learn and improve: Stay up-to-date with medical knowledge while also focusing on personal and professional growth to better serve your patients.
6. 🌞 Don't forget self-care: Take care of your own well-being to avoid burnout and be able to provide the best care for your patients.

Michael Anderson: Bridging Indigenous and Western Health Care in Palliative Care

Michael Anderson, a surgical oncology and community palliative care doctor and health researcher, is on a journey to bridge the worlds of Indigenous and Western health care to improve palliative care for Indigenous people.

Tell me about yourself and how you came to work as a palliative care physician.

I grew up in what I now realize is a common story. My dad is Mohawk, and my mother is of English-Canadian descent. I grew up knowing I was Mohawk, but not knowing what it was to be Mohawk because my family had learned to hide it because of residential schools and discrimination. My grandmother’s message was: “This is something you may not want people knowing because it doesn’t work out so well for you.”

I’m a Western-trained doctor and as a surgical oncologist, I saw lots of death in a very Westernized institutional setting, and I grew increasingly discontented with it. There was a real discomfort with how institutional death, especially in the health-care system, is framed. And I got this lovely gift – death was my opportunity to learn about what it is to be Mohawk.

Was there a specific moment that made you start focusing on palliative care?

I don’t know that there was one exact moment, but I remember a series of things. I remember being on call and getting a call from a colleague who had a patient with advanced lymphoma. He said, “Hey, can I get you to see this family?” I said, “Sure, what’s the surgical problem?” He says, “There’s no surgical problem. I’ve had real trouble having a conversation that the dad is dying. You are good at talking to people about death so could you go talk to them?” That was a moment when I realized how crappy a job we do at talking to people about death.

I watched some of my colleagues struggle with these conversations – and do it badly – and have families make terrible choices because the doctors were uncomfortable talking about death. Death is something we know happens but especially in medicine and oncology, death is almost treated as shameful and needs to be hidden and I really couldn’t reconcile that.

What do Indigenous knowledge systems teach about dying and death?

My journey of learning Indigenous culture and about death started with asking elders – Haudenosaunee, Anishnawbe, anyone I could talk to – I asked them, “What’s the word for death in your language?” And what struck me, everyone said the same thing, we don’t have a word for death. I remember one Mohawk elder said, “There is no word for death in Mohawk. The closest translation would be to wrap you in the flowers of Mother Earth.”

So, there were all these beautiful expressions. But death as a concept doesn’t exist in many Indigenous thought processes. It’s a transition. It’s like birth. Birth is your spirit entering this realm and death is your spirit leaving this realm. But the finality of it, that death is the end, doesn’t exist.

The second was, an elder who told me, “At the end of one’s life, your physical realm is often diminishing, you’re growing weaker, but that doesn’t mean you don’t have an opportunity to heal. The end of your life is an auspicious opportunity to heal your spirit.”

So, the Western doctor in me was taught that when people have a life-limiting illness, their big fears are symptoms like pain and shortness of breath. But it’s actually not. My experience and increasingly the literature shows that it’s existential stress, legacy. It’s things to do with your spirit. It’s not things that giving you morphine are going to address.

So, your physical realm may be diminishing but the chance to heal your spirit is really profound at the end. The next piece to the line, “The end of your life is an auspicious opportunity to heal your spirit” that the elder told me was, “And you heal your spirit through ceremony.” You don’t heal your spirit through morphine or a ventilator. You heal your spirit through ceremony.

Death was my opportunity to learn about what it is to be Mohawk.

My takeaway is that at the end of life in the medical sense you’re losing, you’re losing, you’re losing. In the Indigenous sense, you got opportunity, opportunity, opportunity. And it doesn’t matter whether you’ve been disconnected or connected to your culture, the same opportunity exists.

What is the need for culturally safe palliative care for Indigenous patients and care partners?

What I knew at the beginning of my journey is that I had spent a career witnessing racism in health care. I’m light-skinned enough that people don’t think to mind what they are saying around me. So, I saw it. I heard it.

The first time that I remember overtly thinking that everything my grandmother taught us was right was when I was a medical student. I sat there listening to doctors, who I really liked and were great mentors, say horrible things about this Oji-Cree family who had come down from a northern Ontario First Nation with a sick child. They didn’t know this family, they had never met them before, and were saying horrible, stereotypical things. I know that if I could feel it, the family could sure feel it. And I know it said to me, “Indigenous people aren’t treated so well in this system. I really should keep my head down. It is not good as a young doctor for people to know I’m Mohawk.” And as a resident in another city, I witnessed the same thing. And not a whole lot has changed.

So, in the early part of my medical training I stayed silent because I was junior and vulnerable. I am no longer junior, I do not feel vulnerable, and I do not stay silent now.