This book explores the psychosocial impact of serious illness - its effect on a person's identity and relationships - and the doctor's role in counseling patients. Even the most seasoned physician often feels inadequate when it comes to discussing the personal impact of disability and serious illness with patients. It takes time, attention, and skill. Most physicians who are good at this learn what to say from observations of physicians they respect and the conversations they share with patients over many years of practice. Like everything else in medicine, there is a continuous learning curve. This book offers a beginning. It includes first-hand experiences and reflections on serious illness by physicians and patients, concrete advice on how to initiate discussions of difficult psychosocial issues, topics for organising discussion, suggested readings, and guides for patient interviews.'Much is written about patient-centered care and the patient experience.What sets this book apart is, first, Lenore Buckley's ability to tell stories about her own medical experience. These teaching tales give young physicians a sense of the task that their profession requires of them, while keeping that task within human proportions. Second and complementing that is her excellent compilation of quotations and stories from the memoirs of patients and physicians, especially physicians as patients. 'I hope this empathic, useful collection of materials for teaching and reflection finds its way into medical school curricula, and I hope it is one of those books that physicians return to during years of practice, especially when they sense that the treatment expert is crowding the witness out of the room. Patients need both doctors. Lenore Buckley shows how doctors are able to expect nothing less of themselves' - Arthur W Frank in the Foreword.
Professor of Medicine and Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
Section 1: The experience of illness. The impact of illness on identity, self esteem, roles and relationships. Personal appearance. Roles at home. Roles at work. Relationships. Emotional responses to serious illness. Vulnerability, uncertainty, lack of control. Fear and anxiety. Anger and mourning. Depression. Coping and renewal. The role of a spiritual life. Creating a new life. Redeveloping relationships with family and friends. Determination and hope. Aftermath: life after illness. New perspectives. Residual effects. Section 2: The physician's role. Empathy and compassion. Talking with patients about illness. Illness and the family. Advocacy. Section 3: Reflections of physicians on illness, medical training, and clinical care.