Posts by Brett Hendel-Paterson

The Return of the Death Panel?

Few media flaps have left me as disappointed in us as a country as the vortex we allowed ourselves to be swept into around the “death panel” debate in 2009.   Initially I watched in stunned disbelief, later in anger and frustration as a logical and patient-centered proposal was slandered to the point that it was taken out of the Affordable Care Act, never to resurface until now. There has been recognition for years that we are failing our patients at the end of their lives – a most vulnerable time - delivering care that is not aligned with patients’ values, puts them through needless suffering, and, by the way, is super expensive. Thankfully, the Center for Medicare and Medicaid Service (CMS) is once again considering reimbursing physicians for these voluntary conversations between patients and providers. In our health care system, care can end up incredibly fragmented. The sicker the patient,…

Settling In

I am coming up on my two year anniversary. Not my wedding anniversary (soon to be 15 years – thanks Maia!), but two years since I joined the ranks of the patients. It was two years ago this week that my day was interrupted by a page from my internist saying, “I don’t know how to tell you this, Brett, but you have Chronic Lymphocytic Leukemia.” At 38, I became one of the small percentage of patients who are diagnosed with CLL at a young age. Several folks have asked me how it has changed me or how I work. It’s funny – I don’t really know how to answer that. Sometimes I am grateful for CLL; it has required me to strive to balance my professional life and private life in a way that I never had to before. I have also been very grateful to my group at…

Could you be just a little sicker?

I take a deep breath as I get ready to go see Mrs. H. I can predict after sign-out from the ER doc where this is likely to go. Mrs. H. is an 87 year-old woman who comes to the emergency room with weakness. She stumbled and fell to the floor but could not get up to reach the phone to call for help. She laid there on the floor for an hour until her son stopped by to visit and brought her to the ER. Through diligent testing, she is found to have a urinary tract infection and dehydration. She has a few bruises, but nothing is broken. Her son is with her in the emergency department, and he is relieved that she will be admitted to the hospital (admitted – as far as he is concerned). He has been afraid something like this would happen to her for…

A Battle of Wills

Through our careers, we all accumulate memorable patients. This month’s post is dedicated to the memory of “Henrietta” (not her real name) who died recently and had an impact on my life. I would never claim to know all about her - we only met in the medical realm, after all, but I am grateful that I had a chance to get to know her at least a little bit over the past many months, and I wish we had had a chance to meet outside the hospital. Henrietta was the one running the show over many long hospital stays. Nobody was going to steer her course on good or bad days. Discharge today - I don’t think so. Things aren’t looking good with this cancer - I’m not hearing any negativity today. A new medication for symptoms - no thanks.   I think I should call your family – no,…

Panic and Preparation

Things move fast in an outbreak – whether an outbreak of disease, panic, or both. A lot has happened since my last blog post. I wrote the last post just after Thomas Duncan became the first person to die of Ebola on U.S. soil, and nurse Nina Pham was infected while caring for him. In the past month, we have seen one additional nurse infected with Ebola, and both Amber Vinson and Ms. Pham have been discharged from the hospitals after clearing their infection. Some have cheered and others jeered as nurse Kaci Hickox has clashed with the governor of Maine over an imposed quarantine after she returned from Sierra Leone.  The number of cases has also crossed the 10,000 mark, with many more to come. Discussions continue about many facets of the outbreak: Where were mistakes made? How should we prevent the spread to healthcare workers? How should we…