The Physician as Patient
Enrolling in a mindfulness course like Michael Baime’s Healing the Heart and Mind [see main story] is one way for healthcare professionals to rediscover compassion and empathy for their patients. Three years ago, Marcelle J. Shapiro M’80, a recent participant in the class, experienced another. “I had the ultimate do-over,” she says.
Shapiro shared her story in a speech during the White Coat Ceremony—at which students recite the Hippocratic Oath, symbolic of joining the medical profession—for the Perelman School of Medicine Class of 2015.
In 1987, she began her career as an interventional radiologist in an academic setting, teaching, training residents and fellows, and doing research. In 2002, she joined a practice at Jeanes Hospital, a Temple University affiliate in Northeast Philadelphia. The bulk of her time was devoted to patients in the Fox Chase Cancer Center-Temple bone-marrow transplant unit at Jeanes. “I developed a wonderful and fulfilling work relationship with my transplant colleagues,” she told the students.
In February 2010 she started feeling jittery and anxious, developing tachycardia (a racing heart) and even strep throat. It had been a particularly hectic and stressful year for her professionally, and she attributed her symptoms to pressure at work—until one day she became short of breath after only a little activity and “just didn’t feel right.” Her doctor referred her to the ER for an evaluation.
When the nurse who drew Shapiro’s blood returned to repeat the tests, she became concerned. She asked what the findings were and when the nurse read them to her, she knew instantly: “Oh my God, I have acute leukemia.” The nurse wanted to make sure the labs were correct, but Shapiro knew they were, given her symptoms.
“From that moment on, my entire world changed,” she said. It wasn’t long before she found herself on an interventional-radiology table being fitted for a catheter like the ones she had fitted her patients with. She received one round of chemotherapy through that catheter, after which her condition deteriorated rapidly. She was transferred to Fox Chase and placed in a drug-induced coma, on a ventilator and dialysis, for seven weeks.
Shapiro awoke (with no memory of what had happened) in complete remission, but to ensure her long-term survival she needed a bone-marrow transplant. “Images of so many of the critically ill transplant patients in whose care I participated were now swirling in my head,” she said. To complicate matters, her clinical colleagues would now be her personal doctors. It was an anxious time for Shapiro and her family, who are also physicians.
On June 30, 2010, Shapiro entered the hospital for a stem-cell transplant from her brother, a perfect match. She was discharged five weeks later. “It was a very difficult hospitalization,” she said. “So much was out of my control, but whatever part of the process I could control, I did. I was thankful that my doctors and nurses allowed me that privilege.” Shapiro dressed daily and walked the halls when she could, remained vigilant in caring for her severe mouth ulcers, and kept herself well hydrated.
The discipline required great focus and tenacity, and Shapiro was well aware of her relatively fortunate position as an educated consumer. “Many patients don’t even know where to begin or what to ask. It is imperative to listen to what your patient is saying and what he or she is not saying,” she told the medical students. “The words silent and listen share the same letters for a reason: to truly listen to a patient, one must take time, be approachable, and be silent.”
Today Shapiro is a teaching preceptor in the Doctoring I and II class at Penn. (Doctoring is a medical-professionalism course that spans from the first through the third year of medical school.) She took Baime’s mindfulness class to help her validate what she had learned through the transplantation process and to formalize her mindfulness practice. “The only way I got through the transplant was to live in the moment, one moment at a time,” she says. She has also started to incorporate mindfulness techniques with her students.
“Mindfulness has also helped me so much with my own family,” she says. “I want them to take the course so that they can be fully present with me at this remarkable time in my journey.” — K.L.F.
SEPT|OCT 2013 Contents