Ajay Major, MD, MBA, Jeannette Guerrasio, MD, and Megan Griff, MD, left to right, laugh at a quip from Frances Cory during a conversation aimed at fostering compassion in health care. Photo by Debra Melani.
By Debra Melani
(May 2018) In the end, his patient died.
But as Ajay Major, MD, MBA,
then an intern, flipped through the old veteran’s medical record, he
found comfort in the memories the notes inspired.
Major, now a
second-year internal-medicine resident on the University of Colorado
Anschutz Medical Campus, calls up those memories of the witty old man
with terminal cancer who always asked for bourbon (and his devoted wife
who always rolled her eyes in response), as a reminder of the importance
of compassion in health care.
“Medicine is hard,” Major said.
“We see a lot of patients with a lot of difficult medical issues, and I
think burnout stems not just from feeling overworked, but also from
feeling that we’re not truly caring for our patients on a human level.”
co-president of the CU Anschutz School of Medicine Resident Chapter of
the Gold Humanism Honor Society, spread his message during the society’s
annual Solidarity Week in February by encouraging his colleagues to
take part in the week’s centerpiece program, Tell Me More.
Changing the conversation
with a questionnaire and a smile, second-year internal-medicine
resident Megan Griff, MD, entered her patient’s room, finding Betty
Redwine, 77, wrapped in a light blanket and relaxing in a chair. “Is it
OK to talk and find out about your life?” Griff asked, after explaining
the program and introducing Major and attending physician, Jeannette
“OK,” Betty Redwine said, returning her doctor’s
smile. “But it’s nothing exciting,” she said, grinning up from beneath a
black-suede, shower-like cap that she informed her guests was taming
her unruly hair.
Prompted by four Tell Me More questions, Redwine
soon was sharing pieces of her past. Discussions of capillaries and
high blood pressure gave way to remembrances of children’s feats and
life’s treasures, sounding more like tea-time chatter than bedside
diagnoses. When Redwine let a little secret slip, the room filled with
utterances of disbelief.
“What?” Guerrasio said, after Redwine
revealed she worked as a registered nurse for 35 years. “Why didn’t you
tell us?” asked Griff. “My mom is a nurse, too,” Griff said, when the
commotion subsided. “You guys are hard-workers,” she said, patting
Staying centered on the cause
While it might seem small, a dose of compassion can result in an array of benefits, Major said.
allows the patient to feel that the care team really cares about them,
but it also brings some catharsis for providers,” Major said. “Just
finding out a little bit more about our patients’ lives outside of the
hospital can help re-center us in the work that we are doing as
physicians and, I believe, help prevent burnout.”
On the patient
side, studies show compassionate healthcare results in higher patient
satisfaction, a higher pain threshold, reduced anxiety and better
outcomes, according to the Arnold P. Gold Foundation, which is named
after a renowned pediatric neurologist who became an international
leader and advocate for humanism in health care.
diseases for lots of reasons, and everyone’s lives really affect the way
they respond to health problems,” said David Schwartz, MD, chair of the
Department of Medicine. It makes sense that patient-provider
relationships based on trust result in better care, he said. “We need to
know how their lives might be contributing to the development of
disease, and how their lives might contribute to our ability to
effectively treat their disease,” he said.
Remembering: ‘I’m a person’
Megan Griff, MD, chats with University of Colorado Hospital patient
Frances Cory as part of a program aimed at teaching the value of
compassion in medicine..
up from her bed as the Tell Me More trio walked into her room, Frances
Cory, 79, had them laughing before even agreeing to chat. “You want to
talk beyond my medical condition? You mean you don’t care about my
medical condition anymore?” said the mother and grandmother, who later
responded to a question about her biggest strength: “My sense of humor.”
Cory, who shared with her visitors that she had served more than
5,000 volunteer hospital hours during her lifetime, said she thought
the program was important. “It’s nice to know that you take the time to
talk to your patients. I’m a person.”
The Tell Me More program
offers a valuable reminder for medical providers that their patients are
people, and not just medical mysteries to solve, Guerrasio said. “I
actually, as a doctor, find these conversations really helpful. And it’s
what makes me come to work every day.”
Notes about the
patient-doctor chat are jotted down on the Tell Me More questionnaire,
which is then displayed on the wall so that everyone involved in that
patient’s stay, from therapists and nurses to doctors and janitors, can
use it as conversation fodder, Major said.
Seeing nothing as too small
getting to know his end-stage cancer patient and his wife as an intern,
Major learned not just about his patient’s bourbon routine, but that he
was a strong war veteran who had “always been a fighter.” That helped
Major, when the man opted for a late chemo-treatment that was
questionable at his stage and age. While the old veteran fared well
through therapy, he developed an infection afterward that ended his
When his patient was transferred to hospice, Major told
the palliative caregivers about his patient’s taste for bourbon. Looking
through his patient’s medical record after learning of his death, Major
was jolted by one caretaker directive: Bourbon, one ounce at bed time,
“It seems like such a small detail,” said Major, who
published an article in JAMA Oncology about the patient experience. “But
when his fighting wasn’t working anymore, he started thinking about
things he really enjoyed in life. And having his little bit of bourbon
was kind of important to him. So we made sure he could have that to the