Saturday, June 14, 2014

A virtual speech

I didn't "get to" give a speech, but I did have a nice time last night after I got home writing an acceptance speech. I hope you like it. I do. 

Friends, thank you for this wonderful honor. When I was nominated for it, I was honored, of course, but surprised, too. I feel that what I do is take the best care I can of the next person in front of me. That doesn't feel innovative, but I see what you are saying in the letter and I guess would have to agree with your point. To win feels an incredible, astonishing honor. Thank you.
I'd like to thank my teams at Home, Health and Hospice Care: the advanced illness management team, the hospice at home team and The Community Hospice House team. Also, my Dartmouth team, my friends, my bosses, my teachers and my family. All of you, thank you for your daily love, support and affection. I could not even get out of bed in the morning without you, never mind take loving care of the sickest and most vulnerable patients in the system. You make me better every day. Thank you.
It seems that today a theme has emerged: that we have a choice regarding our stance towards the future. We can look at the regulatory changes and view the future with fear or we can view it as an opportunity to really live our missions. What is each of our missions? Fundamentally, to love our communities. As with everything else in life, we are offered the choice between fear and love. Michael Leunig says (and copying from John McPhee, I'll read it twice):
(please note, I have asked for copyright permission to put the poem here, and until it arrives, here is a link to it)
When I consider the choice in my own life between love and fear, it strikes me that every time I chose love, I was choosing to be my better self. I'd like to tell you about some of those times.
As Carla has already noted, today is June 13. June 13 is my youngest brother's birthday. He turned 56 today and I called him on my way in this morning and sang to his answering machine. Keith was 41 and I, 35 when I first met him and my other three brothers and my sister. Our father had already died before I got to meet him. Making the decision at 35 to track down and meet half of my family of origin was a real choice between love and fear. I was afraid that they would say that they had not contacted me all these years on purpose and they really didn't want me in their lives at all. That fear held me back from the time I learned of them at about 22 until when at 34, I finally paid $19.95 to do an internet search and found my Uncle Frank. It has turned out well. Keith lived with us, in fact, for a number of years and we have been a tremendous force for good in each other's lives. Happy birthday and I love you, Keith.
June 13 is also the day I was diagnosed with leukemia. It was exactly two years ago today that my secretary came running down the hall, frantic, "Dr Braun! Dr Braun! I'm looking for a doctor to talk to the pathologist, but it can't be you because he's calling about your labs!" It has been a million dollar experience I wouldn't pay two cents for. I have learned so much from it. I thought I was empathetic before, but I get so many things now that I didn't before I got sick. I am a much better doctor than I was before. The "kill the cancer" mentality is easy to fall into, but it never felt right for me. My leukemia was, well, mine. It was truly flesh of my flesh. I feared the leukemia, because I did not want to leave my children motherless, but the fact that fear was not my main emotion allowed me to be open and to receive what the leukemia had to teach me. I love you, my beautiful tiger, and am sorry I had to kill you in order to live.
Today is also the day I got this award. Those of you who are clinicians know the push/pull between fear and love that we feel with patients daily. In palliative care, where our patients are so fragile, the fear is so much stronger for me than it was in primary care. If I screw up, I could easily kill a patient. If I make a mistake, I could suggest a course that would ruin a number of the precious days of their last month. Then there is the fear that they are going to die on me, even if I do nothing wrong at all because that is what very sick patients do. Every day, with every patient, I have to adjust diuretics, pain meds, anti-epileptics, decide if we are going to treat this infection and if so how, choose nausea meds, make decisions about bowels, really think, really care, knowing that this patient for whom I am wracking my brain in all likelihood will be dead before my next day off. Over and over, I have to overcome my fear for them, my fear for my pain at their death and love them enough to apply my knowledge and experience to their specific situation, to really understand them. My patients all know this in their hearts, but I will say it outloud to you: I love you, my dears. Thank you for trusting me.
I have often said to people that if one were giving a life to someone with the intent of making them a palliative care clinician, one would have given them my life. It is nice to see my leukemia and my family of origin braided in with this award through the date of June 13 and I want to thank you again for honoring me with it. I am touched and humbled by your belief in and love of me.
I will close by saying again, we have a choice for the future: love or fear. Let's be our best selves and choose love. Thank you.

A real award

Yesterday, June 13, 2014, I received a wonderful honor at the annual NH Hospice and Palliative Care Organization meeting. I was the 2014 winner of the Ira Byock and Yvonne Corbeil award for innovation in palliative care. From the email notifying me I was nominated:

The criteria for the Annual Ira Byock and Yvonne Corbeil Award is: to recognize an individual, team or organization in Northern New England who has demonstrated innovation and collaboration to:
Improve quality
Expand access, and/or
Increase efficiency

in delivering the best end-of-life care possible to New Hampshire residents.

I was honestly surprised to have been nominated and even more surprised to have won. Janice was reading off the nominees' names and bios and I was actually really interested in them: I didn't know Dr. Saunders done that or that Shawn LaFrance had all those intersting jobs or o my gosh, that was name and it seems to be in the same sentence with "the winner of this year's award." I went to the front and got some (hopefully) nice pictures taken with Janice and Carla. If they will allow, I'll post them later. Here is a picture of the award:

I will be hanging it in my DHC office. I am very proud and happy, appreciative of those who nominated me and did all the work of writing the letter, the committee who voted for me, the patients who allow me to take care of them, Steve and Barbara who point me in the right direction, my friends and family who support and love me so well. I promise to work hard to deserve this honor this year and going forward!