Patient Doctor Relationships

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

SEPTEMBER 28, 2017

The title of this entry really should be Patient Provider Relationships, but that does not have the same ring. I have often thought and spoken about the wonderful, treasured,unusual relationships that I--and many other oncology clinicians--share with our patients. Especially for social workers or other therapists, it is rare to have this kind of sharing and openness and shared sense of purpose and commitment. In Social Work school, we were taught to never share personal information. I remember a professor's advice: If a client asks you where you are going on vacation, you should respond: "Why do you want to know?". Even then, I could not imagine giving that answer.

If a patient asks me where I am going on vacation (and this naturally comes up when I have said I will be away for X time as we prepare to make the next appointment), I tell her. I don't go into details, and I surely don't carry on about my pleasure in the plans, but the appropriate human and polite response is to tell the truth.

I know some people for years. Some others, I know for years and years. Still others, I know well for a long time, don't see for maybe a decade, and then they come back into my life because of a new problem. I care about them all, and there have been some women through the years whom I have truly loved. They aren't really friends, of course, and I am ever careful about what I share about my own life. There are boundaries. Since we have seen one another weekly for years, it is natural that they know about the major milestones in my life as well as some more minor events. It is right to celebrate these very special connections.

This is an introduction to a very lovely essay by Lidia Schapira, MD. Her title also reminds me of my mother's lifelong conviction that there is very little in life that tea can't help.

Finding Ways to Celebrate the Joys of Living Over a Cup of Tea 
· Lidia Schapira, MD, FASCO

The subject line of the email was direct: “will go on new med…ibrutinib no longer working…I am FINE and feeling uplifted.” 
After reading this email, I immediately called Trish and asked how she was doing with the news. She recited the results of her recent lab tests and rattled off the name of a new medication. Her treatment would be followed by a brief planned hospitalization for observation. This fact alone surprised and amused her. 
“The team couldn’t believe I had never been hospitalized for leukemia,” Trish announced. After living with leukemia for more than 30 years, this was going to be her first experience with the cancer ward. 
“How are you doing?” I asked again, adding emphasis. 
“I am FINE,” she said, slowly and deliberately. “I feel loved and supported…but…I’m worried about what will come next.” 
Was this the beginning of the end? What if this new treatment didn’t work? What then? We settled into an old, familiar pattern of thinking aloud and discussing various possible outcomes. We didn’t solve the problem, but we both felt better.

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Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
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