By Sara Wykes
Illustration by Shout
He was just barely out of his teens, full of youthful promise, when he and his parents arrived at Stanford Hospital. He died a year later of leukemia. Something about this kid got to the professionals who cared for him through those months, something that brought them to tears more than once as they watched him deteriorate.
A few months later, more than 120 medical professionals packed into a Stanford Cancer Institute conference room, and one by one they recalled experiences with this patient, and tears flowed again.
“I didn’t want to deal,” said one physician, after telling the group that the day the young man was sent home for the last time he left the unit to avoid seeing him. “And the thing I’ve done to deal with this is zero — until this meeting.”
Since fall 2011, Stanford has become one of 245 hospitals and health-care institutions to adopt Schwartz Rounds, a regularly scheduled time to discuss social and emotional issues that arise in caring for patients. After listening to a panel’s short presentation on a case or topic, caregivers respond with their own perspectives. At Stanford the sessions take place every two months.
“We wanted to provide a place where people could speak their emotions in a safe environment, without censure, as a catharsis,” says Sridhar Seshadri, the hospital’s vice president in charge of the cancer center.
The rounds are the brainchild of the Schwartz Center for Compassionate Healthcare, a nonprofit founded by health-care attorney Kenneth Schwartz shortly before his death in 1995 from lung cancer. The organization’s mission is to advance compassionate health care, and the Schwartz Rounds are its centerpiece.
“In some ways, feelings have taken second place to the illness and the technology,” says Douglas Blayney, MD, the Ann & John Doerr Medical Director of the Cancer Institute. “Patients often have a support network. We in the profession don’t often have an opportunity to share with one another, to know what our colleagues are feeling and how they are coping.”
But a body of research (as well as common sense) reveals that those who give care need care, too, and that lack of it contributes to burnout. Finding that care, or even acknowledging a need for it, has been difficult in medicine, a culture that tends toward bravado. “In Schwartz Rounds, you find counsel in everyone else,” says Julie Latini, patient care manager of the hematology/oncology unit at the hospital. “We get insight on how to cope better.”
“We want to come up with new strategies to care for ourselves better so we can care for our patients better,” says Kavitha Ramchandran, MD, medical director of Stanford’s supportive oncology program. “This is a chance for us to be open and honest with one another, to talk about the human impact on us of caring for patients with devastating illnesses.”