We prioritize cultivating a culture of thriving for our team members. Together, we have crafted and integrated a program we call Thrive by Design, which addresses wellness on multiple levels: systems, team, and personal. We meet weekly for Humble Rounds, which has a rotating schedule of topics: education, arts and thriving, as well as team discussions. And some of us gather regularly as part of the Palliative Creative Operations Team (PCOT), inspired by Pixar’s Brain Trust, to brainstorm, pursue creative ideas, and freely collaborate on projects.
We have found that reflective writing is an important way for us to process the work we do, and we take joy in sharing our stories with others. Here are a few recent examples:
How to Process Emotions as a Team
Exercising for Wellness During the Pandemic
Insights from “Dying in the Neurological ICU”
Have Guitar – Will Travel
What’s the Problem?
Helping Patients Share Disappointing Diagnoses With Loved Ones
Resident Narrative Medicine Electives
A narrative elective grew organically from our work, driven by resident initiative and enthusiasm. Now, several residents each year choose to spend narrative elective time with our team, writing stories and poems based on their personal and professional experiences. Some profound pieces have resulted, including this one: https://www.acpjournals.org/doi/10.7326/M19-2137
“It is rare during the frenzy of residency training that you have the opportunity to truly reflect and process the enormous variety of experiences and emotions that we fly through on a daily basis. This narrative elective provided that opportunity in a wonderfully life-giving way.”
-Hannah Brown, resident physician
Together with the Resident Palliative Interest Group, we hosted a concert by brilliant young singer-songwriter J Lind. After a time of wine and cheese, J shared stories and beautiful songs inspired by his experience as a hospice volunteer. A profound audience discussion followed, touching upon such topics as dealing with mortality as a healthcare provider and the role of the arts in medicine.
David Wu had the opportunity to facilitate a discussion of Tolstoy’s classic story, “The Death of Ivan Ilyich,” with the department chairs of Hopkins Bayview.
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We collaborated with leaders of the Resident Palliative Interest Group to screen a documentary, Extremis, for internal medicine residents. The film, which depicts end of life conversations in an ICU in Oakland, anchored a robust discussion in which participants shared about their own experiences talking to patients and families in the ICU.
Stories of Caring and Serving
Recently, we cared for an older retired plumber who had not seen a doctor for decades. He was hospitalized with acute bleeding and was diagnosed with cancer. Multiple attempts at radiation therapy were unsuccessful due to anxiety and pain; this triggered a palliative care consult. A trainee and I met with the patient and delved into his life story, discovering that his anxiety was rooted in past trauma; we also learned of his love for God and country music. He wanted to keep pursuing cancer treatment, so we formulated a tailored, holistic plan: medicines, spiritual care by our chaplain, cognitive behavioral therapy, and Willie Nelson songs in the radiation suite. We were grateful not only that this highly personalized regimen enabled him to tolerate the next treatment, but that the trainee learned firsthand the palliative power of conversation centered on the patient’s story.