Daniela Lamas: You Can Stop Humming Now
Selected Excerpts
“I had believed survival was all that mattered. Maybe that is the way it must be for doctors at the very beginning. But survival was just the start. There was an entire range of possibilities and outcomes beyond the stark life-or-death dichotomy…. I found myself wondering what my patients might face after they left my care. I wanted to know how they would learn to adapt to new realities and whether they would regret the decisions they had made, or those that had been made for them.” (pg. 7-8)
“We recently started a peer support group for ICU survivors and their families…. I listen to men and women admit that even though their spouses are alive and home and they know they should be happy, they wake to the phantom sounds of hospital alarms or burst into tears without warning. Patients tell me how they still remember being tied down to a bed, pulling out intravenous lines, struggling to communicate.” (pg. 240)
Discussion Questions
Over the course of her training, Dr. Lamas widens her focus from the technologies of ICU medicine to the bigger picture of patients’ lives. How do you think her patients and their families benefit from this shift in perspective?
Dr. Lamas describes some of the struggles patients and their families face after surviving the ICU. How can we better support ICU survivors?
How can we, at the individual level and at the broader health systems level, humanize care in the ICU? What would ideal ICU and post-ICU care look like?
Reflections from #MedHumChat
“Perhaps to others this is intuitive. But during my training I really did not pause to wonder what actually happened to the patients who left the ICU. If they were alive and transferred out, that seemed good enough.” —@danielalamasmd
“Someone close to me once described physicians as 'vendors of time.' While we can quantify time, can we capture it? Describe it? Qualify it? Does it shrink, warp, expand post-ICU? The idea of following these experiences is so important + interesting to me…” —@sumedha_arya
“I wish someone had talked to me about what it would be like after the ICU. I got some PT/OT but I needed a lot more. I also needed someone to explain what I'd been through & that I was likely to suffer emotionally as well (I did).” —@brookevitti
“We (and many other centers) are trying to start post ICU clinics to meet some of this need. But often hard to determine how to measure success of such an intervention.” --@danielalamasmd
“Serious illness changes social identity forever. We aren’t the same even if we fully recover. Our families aren’t either. I’ve written about this in relation to cancer. Illness (our own, a loved one’s) is not the only thing that defines us, but it redefines us.” —@AMLeahy
“How do people feel about starting presentations with "Jane is a 49 year old skier, painter, and English teacher, who..."? And saving time to ask patients/families/friends for a quick show-and-tell with photos? Trying to think of ways to get patients off of paper” —@dkats_premd
About this #MedHumChat
You Can Stop Humming Now was paired with In Shock, a book by Dr. Rana Awdish for a #MedHumChat discussion April 24, 2019 exploring Humanizing the ICU.
We were honored to be joined by special guests Dr. Daniela Lamas, MD, Dr. Rana Awdish, MD, and Brooke Vittimberga. Dr. Awdish is an author, critical care physician, and faculty member of Wayne State University School of Medicine whom you can learn more about here. Brooke Vittimberga uses her personal experience with acute myeloid leukemia and bone marrow transplantation to advocate for improving survivorship and quality of life for young adult cancer patients. Learn more about her here.
The pieces for this chat, along with the discussion questions, were curated by Colleen Farrell.
About the Author
Dr. Daniela Lamas, MD, is a pulmonary and critical care doctor at the Brigham & Women's Hospital and faculty at Harvard Medical School. She has worked as a medical reporter at the Miami Herald and is frequently published in the New York Times. Learn more about her here.