by Dr. Kenneth H. Cohn

I enjoyed reading Anthony Cirillo's post last week about how his views of healthcare changed once his mother became a patient--so much so that it inspired me to share my own experience.

Like the people whose sudden illness he describes in his post, I was cruising along in life until my third year of surgical residency, when I noticed a lump in my neck. It was later was diagnosed Stage 1A non-Hodgkin lymphoma. I received eight courses of chemotherapy, complicated by a Vincristine-related seizure that caused three compression fractures of my thoracic spine.

[More:]

I regarded my illness as disruptive rather than unproductive due to the knowledge I gained about the "art" of patient care .

Now, I no longer argue with patients and families who display anger because of their helplessness. I apologize, empathize with the way that they feel, and ask them to help me develop a plan that works for them. I understand why Senator Paul Tsongas called his lymphoma a gift, even though it took his life: "Now the matter of belief is central to me and gives me a truer sense of direction. These changes are a precious gift. My illness gave them to me. I treasure them."

I learned from a fellow physician with cancer how to mope, cope, and hope. I started to refer to swimming as "hydrotherapy" because it gave me a feeling of mastery and helped dissipate anger. A fellow surgeon confessed, "One of the really ironic things about the human experience is that many of us have to face pain, injury, or even the possibility of death to learn the real purpose of being and how best to live a rewarding life."

Mr. Cirillo recalled in his post how two healthcare professionals who recovered from serious illness left their organizations because they saw a different way to address systemic challenges in healthcare. He wrote passionately: "And here is what causes an ache in my heart: Health reform is not going to fix any of this. As more people seek care, their experience will get worse."

His prophesy assumes that our non-system of healthcare will remain the same, for example, that people who have easily diagnosable and treatable conditions, such as colds, sprains, and bladder infections will continue to see physicians; that each insurer will use a different form that providers must fill out to receive payment (plus phone calls and other tactics that divert providers from spending quality time with their patients); and that in every city, multiple hospitals will staff Emergency Departments with specialists on call in case a trauma victim is diverted from the primary trauma care facility.

Finally, Mr. Cirillo's prophesy asserts a scarcity mentality, that we have a limited quantity of healthcare professionals to treat an enlarging population. In contrast, my mentor, Lee Kaiser, asserts that most people and organizations see themselves at the center of the universe, which leads to egocentric, self-interested approaches that facilitate exploiting others for competitive advantage, hardly a sustainable approach to the service of others. He maintains that there is no economic, social, or political solution to the current healthcare crisis. Spirituality, based on abundance, collaboration, and sharing provides the only solution because it makes problems disappear.

Like fellow surgeon Dr. Atul Gawande, I believe that healthcare reform embodies an iterative journey, where we test different hypotheses in our learning laboratories, because no one has sufficient knowledge to assert that one way of delivering care will work for all our citizens: "But if we're willing to accept an arduous, messy, and continuous process, we can come to grips with a problem even of this immensity. We've done it before."

What do you think?

>> Do you agree with Harvard Professor Rosabeth Moss Kanter that change is disturbing when done to us, but exciting when we do it ourselves?

>> And with President Lincoln that the best way to predict your future is to create it?

>> When I was invited to China in 2006 to speak at the 1st People's Congress on Health Communication, I learned that in Chinese, the word crisis is symbolized by two characters, wei, representing danger, and ji, representing transition and opportunity. Do you see the opportunity that lies ahead?

Ken Cohn is a practicing general surgeon/MBA who divides his time between providing general surgical coverage and speaking, writing, teaching, and consulting on physician-hospital relations.