Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-21T17:33:49.353Z Has data issue: false hasContentIssue false

7 - Between the Big Events

Dealing with the Things That Surface in the Quiet

Published online by Cambridge University Press:  05 April 2024

Robert M. Arnold
Affiliation:
The University of Pittsburgh School of Medicine, Pittsburgh
Anthony L. Back
Affiliation:
University of Washington Medical Center
Elise C. Carey
Affiliation:
Mayo Clinic, Minnesota
James A. Tulsky
Affiliation:
Dana-Farber Cancer Institute, Boston
Gordon J. Wood
Affiliation:
Northwestern Memorial Hospital, Chicago
Holly B. Yang
Affiliation:
Scripps Health, San Diego, California
Get access

Summary

The times in between significant medical events allow for different conversations with patients about living with uncertainty, the effects of their disease and its treatment, the fear of the next crisis, or figuring out who they are now and what they might hope for their future. Sometimes worry about becoming more ill or dying shows up in conversations in disguise, like being fixated on a particular test that a clinician might consider medically less important or even unnecessary. Sometimes completing cancer therapy brings a mix of emotion, relief that it is done and worry that it may not really be. Other times patients who have recovered from an exacerbation, like in heart failure, realize how much they have changed due to the disease and its treatment, and while glad they survived are simultaneously unhappy about how their life has changed. The roadmap for clinicians in these more calm but uncertain times is to ask your patient’s perspective, respond to their emotion (often exploring to create a deeper understanding), and offer your clinical experience of other patients which might apply to help clarify the issues at hand, provide different perspective, and offer support.

Type
Chapter
Information
Navigating Communication with Seriously Ill Patients
Balancing Honesty with Empathy and Hope
, pp. 101 - 115
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further Reading

Charon, R., Narrative Medicine: Honoring the Stories of Illness. Oxford University Press, New York, 2008.Google Scholar
Frank, A., At the Will of the Body. Mariner Books, Boston, 2002.Google Scholar
Hewitt, M., Greenfield, S., and Stovall, E., eds., From Cancer Patient to Cancer Survivor: Lost in Transition. The National Academies Press, Washington, D.C., 2005.Google Scholar
Jacobson, J., et al., Helping patients with serious illness live well through the promotion of adaptive coping: A report from the Improving Outpatient Palliative Care (IPAL-OP) initiative. J Palliat Med, 2014, 17(4): 463–8.Google Scholar
Kantsiper, M., et al., Transitioning to breast cancer survivorship: Perspectives of patients, cancer specialists, and primary care providers. J Gen Intern Med, 2009, 24(Suppl 2): 459–66.CrossRefGoogle ScholarPubMed
Kleinman, A., The Illness Narratives: Suffering, Healing and the Human Condition. Basic Books, New York, 1989.Google Scholar
Rowland, J. H. and Bellizzi, K. M., Cancer survivors and survivorship research: A reflection on today’s successes and tomorrow’s challenges. Hematol Oncol Clin North Am, 2008, 22(2): 181200.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×