I started my most recent podcast thinking it was mostly going to relate to the Covid crisis. The authors of this article “Frontline Workers in the Backrooms of COVID-19: Caring for the Living and the Dead,” Drs. Lotte Mulder and Jeff Myers, put together a compelling piece about how Covid-19 is impacting a large autopsy service in Michigan. In this setting, social work, photography, and grief counseling play a part alongside forensic science.
The show did cover this material, but took a turn I did not suspect. I should have though (sometimes my brain takes some time to shift gears). These same authors have advocated for an increased role of patient-Pathologist interactions. Although this is something that I have done in my career (moreso when I was in community practice and did more on-site evaluations at the bedside), it was not front of mind. But maybe it should be? Like Dr. Myers commented in our show (and I’m paraphrasing) - isn’t this a more personal version of personalized medicine?
Dr. Mulder, a non-Pathologist who has learned quite a bit about this profession commented “What an amazing world it would be if people would really understand the impact [Pathology] has on patient care.” With cuts looming and constant talk of re-organizing the healthcare field - perhaps it is time for Pathologists to become our own advocates. I believe that if patients knew how big of a role we play in their care - and how many decisions are based on the data we generate, they would be clamoring to make sure we have what we need to do our job well.
Dr. Meyers related a moving story about a patient who wished to speak with him regarding her diagnosis. Mostly she wanted to know his immediate reaction to seeing her slides (I am guessing it was a tumor - but I do not know this). After he spoke with her, she closed by saying “That’s all I wanted to know and nobody else could tell me.” We have a unique roll. With patients accessing their Pathology reports directly, we are interacting with patients with our words on paper. Perhaps the shift to more direct communication was always coming.
The hard truth is that many Pathologists are not used to communicating with patients. Dr. Myers voiced his belief that “it’s time for our discipline to be uncomfortable.” Hard to hear in a time when masking and distancing have us all slowly backing away from each other, but in a deeper sense I suppose he means that we must evolve and change as medicine changes. We need to accept that (some) patients will want to hear from us. We need to tell the patients what no one else can tell them.