by Nick Jacobs

Tony asked me what I would miss as a hospital CEO? Let me begin by saying that I left teaching at age 31, and thirty years later I still very much miss the interaction with the students. Just yesterday, I received another E-mail from a 50ish year old IT executive telling me that my teaching had been one of the greatest influences on his life. That was the third similar E-mail that I had received in the last five months from that work of 30 years ago.

From teaching I miss helping the students find themselves, teaching them to fly, and saving those borderline kids who were hanging by a thread. My life as a teacher was completely built around being a care-giver and a mentor.

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by Nick Jacobs

Penn and Teller, magician-comedians, have a cable TV show that basically explores all aspects of life in America with the intention of exposing those areas that are not valid. I'm not sure why the noble bull has suffered this indignity of their show's title, but, when it comes to making fun of the nontraditional, these magic men hold nothing back. They look at topics like integrative medicine, snake charming, and sensitivity training through their sarcastic, unprofessionally trained eyes and do all that they can to rebuke the topics being explored.

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by Nick Jacobs

Denise Grady wrote a great Op Ed for the New York Times today about her sister's fight with cancer. In this opinion column she discusses empathy toward vulnerability. Interestingly, she quotes Dr. James A. Tulsky, director of the Center for Palliative Care at Duke University Medical Center whose study published in the Journal of Clinical Oncology found that doctors and patients weren't communicating all that well about emotions. She quoted the study as having revealed that male doctors were less than 50% as empathetic as female doctors in their responses to patients.

Ms. Grady made a point of indicating that it was not necessarily critical for the physicians to engage in long dialogue with the patients where they became psychological counselors. In fact, according to Tulsky, "Brief, empathetic responses will suffice."

A few days ago, I ended a post by quoting Maya Angelou who said, "I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel."

So much of our life is spent looking for emotional support in some way, shape or form. The management schools teach us that "It's not all about the money." The attorneys tell us that "If we are kind and explain ourselves to the patients, our chances of being sued drop exponentially."

This morning we dealt with an employee complaint. It wasn't about time, money, or benefits. The complaint was that the employee was not treated with compassion, respect or dignity. It was about how one of her peers made her feel.

There are very difficult emotional challenges that come with being a chemotherapy or, for that matter, any type of cancer patient. After all, this disease can very clearly make us deal with our own mortality in a very direct, uncaring, matter of fact way. It is or it isn't. We are or we aren't; and one of the examples that we use is that "It may be your 543 rd Leukemia or melanoma or lymphoma, but it is the patient's first."

We are not indicating that our world must be one of mamby pamby, warm fuzzies that never deal with the truth. We are indicating that the people with whom we deal are human beings. I heard a comedian say last night that he had just gone through a tough divorce and lost weight. He then said, "I think I lost about 30 pounds. That's how much a soul weighs, right?"

So, as we move about in our world every day, remember Denise Grady, remember her sister, and remember that warmth, concern, compassion, and empathy are NOT bad things. The day that we found out that my father's cancer had metastasized, the doc told him not to worry. He told him that everything was okay. Then he turned to my mother and winked. That day will forever be burned in my memory. His was the wink of death.

Just remember that, "Wherever there is a human being, there is an opportunity for kindness."

by Tony Chen

All this talk about health care policy, healthcare blogging, and hospitalk, sometimes it's easy to forget that we are talking about real people, real sons, daughters, fathers, mothers, wives, husbands, and loved ones.

Yes, we have to run tight ships financially to ensure the long-term sustainability and advancement of our hospitals. Yes, we need to learn the business of healthcare. Yes, we have to think aggregate in numbers. But let's always remember that we are serving individual people, many who are in the most scaring, vulnerable moments in their lives.

I ran across this story at Blog, MD about Derek Madsen, a 10-year patient who had a rare childhood cancer. Please take a moment today and go through these 20 gripping Pulitzer prize photos of his journey.

Also, we've collected a few other patient stories here.

by Nick Jacobs

Why 2034? It’s actually the date that my actuarial has indicated that my individual involvement in this discussion should no longer have any viability. In other words it’s the projected date of my passing, but, believe me, there will be tens of thousands of we boomers contributing to this discussion until then.

A few years ago, during a scientific mission to Boston for a conference at MIT, it was my privilege to participate in a conference directed toward the challenge of keeping our senior citizens viable, active and out of long term care for as long as possible. We met with several health care professionals, engineers, and scientists who had taken on the challenge of miniaturizing every known type of monitoring system for the human body.

They had begun the effort to successfully decrease the size of these devices to the diameter of a nickel, the relative thickness of a potato chip and a cost of about twenty five cents each. We saw demonstrations of some of these miniaturized devices in actual use. They were adapting systems for monitoring the heart, blood pressure, brain function and respiratory system. With all of the flexibility that wireless communication can deliver, the unencumbered participants would be literally, wired for sound, as they moved freely through the special apartment that had been constructed for this research.

Each and every movement could be monitored all day, every day. The signals generated from the participants various organs were sent directly to a computer that was housed at a physician’s office where any missed beat could be reported through an alarm system that immediately notified the physician in charge.

Think of it. Pappy gets up from his chair, feels a little dizzy, sits back down, and the videophone rings with a healthcare professional checking to see if all is well.

Because of the 1984 feeling that some of we 1960’s free spirits might feel from this “Big Brother” type monitoring, it was suggested that the grandparent might also like to have her sibling monitored as well, thus giving the affect that they are indeed checking on each other.

Think of it. This system could very well keep us out of some offensive, under staffed, insufficiently reimbursed nursing home for at least an additional year or two.

In closing, however, I did receive an e-mail the other day with this suggestion. If you like to cruise, it would be more fun to live on the Pacific Princess for the rest of your life than in the Sunset Valley Nursing Center. The cost is similar, and when you trip and break your hip, they will upgrade you to a suite and deliver meals to your room.