Episode 32 Dr. Rana Awdish Guest

Episode 32 Dr. Rana Awdish Guest: Rana Awdish, MD Rana Awdish, MD, FCCP is the author of In Shock, a critically acclaimed, bestselling memoir based on her own illness. A critical care physician and faculty member of Wayne State University School of Medicine in Detroit, Michigan, she completed her medical degree at Wayne State in 2002 where she was inducted into the Alpha Omega Alpha national medical honor society, her residency at Mount Sinai Beth Israel in New York, and her fellowship training at Henry Ford Hospital where she serves as the current Director of the Pulmonary Hypertension Program. She also serves as Medical Director of Care Experience for the entire Health System. Dr. Awdish’s mandate as well as her passion is to improve the patient experience across the system and speak on patient advocacy at health care venues nationally. After suffering a sudden critical illness, herself, she has devoted much of her career to improving empathy through connection and communication. She lectures to physicians, health care leaders and medical schools across the country. Her book has been integrated into the curriculum of medical schools and universities across the US and Europe. She was awarded the Speak-Up Hero award in 2014 for her work establishing a workshop-based program called CLEAR (Connect, Listen, Empathize, Align, Respect), which trains faculty and trainees in relationship-based communication skills utilizing improvisational actors. She was named Henry Ford Hospital’s Critical Care Teacher of the Year in 2016. She was named the National Compassionate Caregiver of the Year by The Schwartz Center as well as Physician of the Year by Press Ganey in 2017. She has been interviewed by The Times, The Telegraph, The BBC, NPR, the Today Show online, MedPage, Health Leaders Media, and Beckers Hospital Review. She has written for Harvard Business Review, the Huffington Post, as well as the New England Journal of Medicine. Her NEJM Perspectives article, A View from the Edge, went viral garnering over 120,000 views and is ranked in the 99th percentile for reach. Introduction Dr. Lisa Meeks: Doctors with disabilities exist in small but measurable numbers. How did they navigate their journey? What were the challenges? What are the benefits to patients and to their peers? What can we learn from their experiences? My name is Lisa Meeks, and I am thrilled to bring you the DocsWithDisabilities podcast. Join me as I interview Docs, Nurses, Psychologists, OT’s, PT’s, Pharmacists, Dentists, and the list goes on. I’ll also be interviewing the researchers and policy makers that ensure medicine remains an equal opportunity profession. Narrator: Jake Feeman: Hello everyone, and welcome back to the Docs with Disabilities podcast. In today’s episode, we are honored to be joined by Dr. Rana Awdish. Dr. Awdish is the Medical Director of Care Experience for the Henry Ford Health System and the Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit. She is also the author of a best-selling memoir, “In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope,” which chronicles her life-threatening battle with a sudden chronic illness. In this episode, Dr. Meeks and Dr. Awdish fold a discussion of that book and its themes into a wider conversation about empathy and connection in the medical field, and how increasing empathy among medical professionals can create a safer and more inclusive space for people with disabilities. We hope you enjoy. Dr. Lisa Meeks: So, we've kind of put forward this theory in the work that we've been doing, that individuals that have the lived experience of being on both sides, right on the other side of the bed, so as a patient and a physician, bring a level of empathy to the practice of medicine that might not otherwise be there. And we also kind of project this idea that you don't have to have been a patient necessarily to have a high level of empathy, but that being surrounded by individuals with this lived experience also helps the peers. So, the, the other residents, other students, other attendings in growing their empathy through the interactions that that person might have with the patient. And I'm wondering if you have found this to be true after your experience, that you had increased levels of empathy and how it's impacted not only your practice of medicine, but perhaps your peers or people in your circle? Dr. Rana Awdish: It's interesting, I think that it's very true that anytime you have a lived experience that it expands your scope of awareness of just the human experience in general, there's so much, in medicine that is about presenting a certain façade almost. And we don't often allow ourselves to be vulnerable within even our direct groups, our students, our residents, our fellows, our fellow attendings. And illness is a doorway into that, but really, the illness is a surrogate for vulnerability, right? And, you know, you have, in some sense, no choice but to be vulnerable and accepting of help, when you're acutely ill, you need the people around you to care for you. But what I've found is when you can accept that help and really have an open dialogue, about how we're really holding each other up as persons, you know, that by allowing someone to care for you and fill your needs and by accepting that help, and, and healing together, that, that that's a journey that you're then on that's nurturing for both parties. And illness lets you into that, but I think there are many ways we can be led into that, there are multiple doors, um, and our patients offer us those doors if we're willing to listen. I think often our family members offer us those doors. It's a matter of just being open to story. Dr. Lisa Meeks Yes, I absolutely agree. And you talk about this with the patients that sometimes the patients just want to be heard and appreciated and, and understood, and medicine doesn't always allow us time for that interactions for that, for that connection with the patient. But I think we need to be able to do that in order to effectively treat and understand where that person is coming from and so many examples that you give throughout the book of, you know, moments, not only when you provided care to someone, I, I know in the introduction of the book, there's this beautiful story of a woman that you were treating and the, this idea of hope and what, what she needed in that moment versus what medicine was trained to provide for her. And that's one place where that was evident. And then just, even in your own experience, if people had listened to you sooner, you know, that you knew your body, essentially more than other people. You of course have the experience of being a physician, but I think that that's true for so many people, whether they're whether they have medical training or not, that they really are the experts in their bodies and understanding when something is wrong. And we don't give enough credit to that, especially in emergency situations where we tend to take over, right, and, and quiet the voice almost of the person. Dr. Rana Awdish: Absolutely. And that's such an important point because you mentioned time as being, the limiting factor in that relationship. But I, I really wonder how much of it is about not wanting to cede authority and not wanting to hold the patient's knowledge in equivalent position to our own, their bodily knowledge, their awareness. I, I almost think that we dominate the interview with our medical language and questioning and our framework for extracting the history rather than receiving it, because it's about power. Dr. Lisa Meeks: Absolutely. And the idea that, um, we reduce people, right to labels, characterizations of what we've been taught. So, this even terms, the terminology that we use, somebody who's come in multiple times for some kind of unknown origin of pain, “frequent flyer” where there may be something that is very, very wrong, but we decide to quit listening after a while when we have made the decision about what is happening. Um, but absolutely, I mean that power differential is so big, both with patients and with students, to be honest. Um, and I know that one of the things I wanted to ask you about, wasn't planning to ask you about quite so quickly, but I do think it is incredibly important. And that is kind of the mental health and wellbeing of our learners right now. And, and that power differential is a big part of why I think people reach for perfection and cease to seek help or cease to admit vulnerability in that space. Dr. Rana Awdish: You know, medicine sort of set up this, this goal of equanimity1, that imperturbability, that clinical, just stillness in the face of anything that's happening, that really asks us to suppress emotion. And when that's set out as this ideal, you know, never mind that it's probably a traditionally gendered, hetero-normative, ablest version of that. It's, it's really hard in a culture where, you know, the students are trying to become us and they're trying to acculturate into an environment that is telling them, you know, that's not the goal, feelings and working through them is not what we're here to do.

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