September 2012 Archives


   It's September, and the garden is bursting with zucchini, summer squash, peppers, eggplants, carrots, oregano, rosemary, thyme and basil, all crying out to be made into delicious Italian food. What's a poor gourmet to do?  Well, what I really enjoy is the amazing 'Spaghetti Indiano' sauce we create at the ashram, or the delicious pesto made from our basil. So instead of subjecting myself to a pasta carb load, I've been making raw zucchini fettuccine. First peel the zucchini. Discard the peel and then keep going with the peeler, creating fettucine-like strips. Put the strips in a bowl and sprinkle liberally with salt. Toss to mix in the salt, cover and leave for at least an hour. Rinse thoroughly in a colander to wash off the salt, pat dry with paper towels, toss in olive oil and there's your pasta. You could warm it gently but I usually have it a room temperature with hot spaghetti sauce. This is also a great way to use overgrown zucchini.
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Hallo dear readers and sorry for my long absence from the internet! In the next few entries I'll be taking the opportunity to catch up on all the ideas and developments I wasn't able to share with you over the summer. So today I want to let you know about the impact of receiving excellent, stellar healthcare during my trip to the UK.

As many of you know, I recently traveled to London to receive a diagnostic hemithyroidectomy (medical lingo for removal of half the thyroid to see if the nodule was benign or malignant). My internet searches of thyroid surgeons 
had led me to Mr Fausto Palazzo, the UK's top thyroid surgeon, and I counted myself extremely fortunate that he was willing to see me. ( It may seem confusing, but surgeons in the UK are traditionally called Mr, rather than doctor.) I soon found that my experience of receiving such outstanding care had repercussions for me not only as a patient but also as a doctor. By experiencing what it was like to be a patient at a crucial and vulnerable moment, I received fresh insights on what is important in clinical practice.

I observed that there were four features that combined to create an excellent clinical encounter. The first, of course is expertise, the reason I chose Mr Palazzo in the first place. Excellence is not possible without expertise and expertise requires a continual engagement in study and practice. If athletes train and work so hard for the Olympics and Paralympics, how much more so do those of us involved in healthcare need to hone our skills continually. We hold in our hands people's lives and well-being. 

However, there are three other aspects that combined to create a full experience of excellence. All of us have probably at one time or another had the misfortune to see a doctor expert in his field who was still incapable of delivering patient satisfaction because of the lack of these other features. The first of these features is teamwork. I saw that Mr Palazzo had a trusted team of people around him, all of whom contributed in various ways to patient satisfaction. The sense of being held by a team created safety and relaxation essential for healing to occur.

The second, absolutely vital aspect was the warmth and empathy I received from Mr Palazzo himself as well as from the anaesthetist, staff nurses and hospital orderlies. Often I have heard from my own patients about negative experiences they had with highly trained and respected doctors. The number one complaint my patients have  expressed regarding these specialists is lack of warmth and empathy and a dismissive, arrogant or judgmental attitude. Expertise is clearly not a stand-alone criterion for excellence.

Finally, there was a tremendous sense of joy, enthusiasm and positive energy that radiated from Mr Palazzo and everyone around him. It was extremely helpful to feel such an atmosphere of joy and positivity while going into surgery.

 By having the opportunity to observe myself in the midst of this experience, I saw that the non-quantifiable factors--teamwork, empathy and enthusiasm, were much more than warm and fuzzy feel-good optional extras.  Rather, I realized that these aspects of the clinical encounter caused my heart and brain to release oxytocin. And oxytocin lowers cortisol, reduces stress, improves immunity and supports faster wound healing--all essentials for a good recovery from surgery. No wonder my wound was healing  so  nicely!

The experience as a patient has impacted my own practice by showing me that the things I think are important in healthcare truly are important. In striving every day to learn more and become more expert, in building a strong team with staff and students, in devoting my life to loving-kindness and compassion and in finding immense joy in my work, I'm supporting my my patients' health in ways that have only now become clear to me.  

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    This page is an archive of entries from September 2012 listed from newest to oldest.

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