BACK of the BOOK
Heard in the Blogosphere
White Coats and White Lies Comparing Notes
“Physicians – including us – do lie. … We tell these untruths not to de-
ceive … but to offer words that lighten [patients’] hearts in moments
of despair. We do it, we tell ourselves, to spare their feelings. … But
perhaps we sometimes lie for our own sake, and it is our feelings that
need to be spared so we can get through the night without breaking
down in the call room when all signs indicate the outcome will not be
good. … To be sure, deception that limits an individual’s or a parent’s
ability to make informed decisions is reprehensible. Sugar-coating
devastating results, or making light of grave situations as if there will
be meaningful recovery is also wrong. … [But] the foundations of a
doctor-patient relationship can remain strong even with ‘white lies,’ as
long as our actions are grounded in kindness and we are doing our best
for our patients in difficult times.” In a recent Twitter thread, Jahan
Fahimi, MD, PhD, an emergency
physician at University of California
San Francisco, posted an open letter
to cancer specialists:
—Nana Matoba, MD, and Angira Patel, MD, on the value of the “white lies” doctors tell patients in STAT News
Disabusing Disability
Becoming a doctor is challenging enough, but for medical students liv-
ing with a disability, the challenge is even greater. On NPR’s “Weekend
Edition” and WHYY’s “The Pulse,” several doctors and students spoke
about their experiences, the growing movement to increase accessibility
and inclusion of people with disabilities in the medical field, and how
their disabilities may make them better doctors.
“When I scrubbed in on a surgery one time, the surgeon … turned to me and
said, do you want my opinion about whether you should become a doctor? …
And he then opined that I had no right to go into medicine because I lacked
the most important quality in medicine, and that was 24/7 availability.”
—Lisa Iezzoni, MD, MSc, a health-policy researcher at Harvard Medical School living with multiple sclerosis
“I think we have to do a better job of educating those in the field about
what the potential is for those with disabilities, versus what is [con-
sidered] or assumed to be an automatic inability. … We are having this
conversation in a very open way.”
—Geoffrey Young, PhD, senior director for student affairs and programs at the Association of American Medical Colleges
“In admissions, we sort of dictate the face and function of what medi-
cine is going to look like by virtue of who we bring in. It’s critical we bring
in a group of learners and future practitioners who will mirror patient
populations that they’re taking care of.”
Jahan Fahimi, MD, PhD
@JahanFahimi
Dear oncologists and surgeons,
Don’t let your friendly emergency physician be the first person to talk to
your patients about their code status or end-of-life goals.
Sincerely,
Emergency physicians everywhere.
The missive was answered by hundreds of health-care providers, patient advocates,
and patients who expressed solidarity, voiced their dissent, and – ultimately – argued
for better conversation between practitioners and patients.
Nathan A. Pennell, MD, PhD
@n8pennell
Dear emergency room docs and hospitalists,
Please don’t tell my patient with treatable lung cancer and potential to
live many years with minimally toxic treatment that they’re about to die
and should go on hospice before they see me.
Sincerely, Thoracic Oncologists
Gerard Doherty, MD
@gmdoherty
Dear Emergency Physicians,
Please read the notes, but more importantly, please call us whether
we’ve been prescient about the course or not.
We know these people and will be happy to hear from you before plans
have been settled.
Surgeons
—Lina Mehta, MD, associate dean for admissions at Case Western Reserve University School of Medicine
“You have to be the person deciding what medication to give. … You
have to think about what could be the reason why this person stopped
breathing or their heart stopped. The tasks required to run a code aren’t
just physical tasks. … Once people see how many people are out there
practicing with disabilities, I think that will normalize this more.”
—Feranmi Okanlami, MD, MS, a University of Michigan physician who is partially paralyzed
Genevieve Boland, MD, PhD
@gmboland
We are all a team. This is what patients think even when we feel
differently. Let’s work to ease their path through clinical care. Let’s
remember we all have one goal in mind – the patients’ wishes and best
interests. It’s hard. But we are on the same side.
Addy Raja
@addyfilms
Follow ASH and ASH Clinical News on:
@ASH_Hematology, @BloodJournal,
@BloodAdvances, and @ASHClinicalNews
Facebook.com/AmericanSocietyofHematology
Dear all healthcare professionals and members of society/relatives of,
receiving healthcare,
This is a complex scenario that requires an integrated approach. Let’s
continue talk to each other and understand each other’s perspectives.
Yours sincerely,
A human.
@ASH_Hematology
ASHClinicalNews.org
ASH Clinical News
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