A monthly podcast about pediatric palliative care, hosted by two pediatric palliative care docs, Sarah Dabagh, MD, and Daniel Eison, MD, MS. Sharing the insights, opinions, narratives, commentaries, and invectives of #pedpc.
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27:51
How lovely it would be if everyone were as thoughtful and palliative-minded as we are! Palliative care providers are meticulous about language when talking to patients and families, but are we as thoughtful about the words we use to talk about our patients and families?
In Episode 4, Sarah and Dan talk to Gitanjli Arora, MD (@pedsworld), and Rachel Rusch, LCSW, MA (@RuschRachel), from the CHLA Comfort and Palliative Care Team. Inspired by Dr. Arora's essay, "A Lovely Family," in the Journal of Palliative Medicine (@PalliativeMed_j), we discuss how even the most lovely of words can prevent us from digging deeper, disrupt the productive tension where palliation dwells, and perpetuate our biases.
Daniel Eison:
This is Dan.
Sarah Dabagh:
And this is Sarah.
Daniel Eison:
It is so thoughtful of you to have joined
Sarah Dabagh:
A lovely podcast about all things pediatric
Daniel Eison:
The views in this podcast are ours alone, and are
Sarah Dabagh:
So Dan, I think I'd like to start this episode
Daniel Eison:
Go for it.
Sarah Dabagh:
So, when I think of pediatric palliative care steps to the left, and that means the flower's blue, it dance that means something within our discipline when we're
Daniel Eison:
I really like that analogy. I think it fits with patients and families. And you may have seen the essay that one
Sarah Dabagh:
You know, I really thought you're gonna say you
Daniel Eison:
I am even less of an expert on bees.
Gitanjli Arora:
My name is Gitanjli Arora, my friends call
Rachel Rusch:
My name is Rachel Rusch and I am a clinical social
Sarah Dabagh:
Dan and I were very inspired to get you guys your inspiration?
Gitanjli Arora:
So Rachel and I were spending the day together palliativist said, "Tell me more." And so in that we talked looked like every storybook I've ever read of what a lovely And they talked a lot about how they wanted to spend that time.
Rachel Rusch:
I appreciate all that so much Tanya. And I think our human-ness to the room. And sometimes language might fail
Sarah Dabagh:
I almost hear both of you saying that "lovely" is
Gitanjli Arora:
Earlier in the morning, we had been asked to treatment plan. She's difficult. You're not going to get anywhere mom was black. Because I only hear those terms of "difficult," stories about her son and her fears, and her worries, and her advocate that she is for him, and there was so much love in though both interactions touched me, and I think touched Rachel,
Rachel Rusch:
I think it is the space between us and the family remember that question, "Tell me more," about the lovely family
Daniel Eison:
One of the things that's really at the core of care community is having as a community now, a little bit with the way we use words and the way we approach families.
Rachel Rusch:
There's something you said about conversations of health equity. And I think that's something that Tanya has put around them that is influenced by race?" In our
Gitanjli Arora:
Palliative practitioners are perfectly But I can only do that if I'm providing the space to hear someone's life that are weighing into their experience and in are seeing with them being able to communicate with the team,
Sarah Dabagh:
I like to think of, in one phrase, as just warm part of that? I wish I could give credit to the person who language, and just that sort of open space to share experiences.
Gitanjli Arora:
That's being said, I do really worry about between the provider's experience and the patient and I think we also need to create more space around working with"dying" very thoughtfully and very carefully. And yet, when we don't inform the interpreter of the words that we are
Rachel Rusch:
I so appreciate you calling light to that place lifelong, evolving process. I'll speak for myself as a person who training, it will still continue for the duration of my life. And
Gitanjli Arora:
I think sometimes we feel a lot of shame thing to do is to interrogate,"Oh, I saw myself do that. And Harvard. And every year, I continue to associate female myself.
Rachel Rusch:
We are humans who are kind of moving through the
Sarah Dabagh:
There do seem to be phrases that I hear in I think, again, as palliativists, something that order in their chart," takes a few more words, takes a couple e time and systems of medicine t hold up more of that language,"palliative-minded" and"thoughtful." I think those are
Gitanjli Arora:
I think it's another version of revealing our making or someone's approach. Our role is to be in service to suffering looks like, that's not really being of service to them. for you?" And I think that's where the interesting what that family is truly saying. And it also gives us an
Rachel Rusch:
It's a call to be aware of our language and what again, I respect the effort that is, in some ways being made to what you meant," or, "This is what we learned from this
Gitanjli Arora:
You know, sometimes it's, "The other team and families, but definitely with other colleagues. And I oncologist is pushing for a clinical trial for their I'm trying to really understand that conflict and ask a lot of all of that. And then together with full information, we figure
Rachel Rusch:
Tanya, you're making me think of a recent recommendations by some of the primary team and that we, as a that there is a tension here. And yet I appreciate that we can against you and I don't feel you are against me, and yet we can good and positive! And yet you're what you're saying is in the hallway, where we said to each other, "Tell me more." What
Sarah Dabagh:
This is actually a place our team has tried to this thoughtful way?" So we purposely reintroduce language, from someone, so if anyone's listening and can tell me who,
Gitanjli Arora:
it's not ever going to be possible for me to physician's shoes. But our role is to create the space so all of think can really be helpful. That it is "every loving that I'm doing that.
Rachel Rusch:
And how do we engage in dialogue with each
Daniel Eison:
I feel like this concept of productive tension, team and family having different ideas about what's best is yet somehow these two conflicting things existing ourselves on being able to dwell in that space. And I joked about and break the silence, to just be like, "Well, let me collapse
Gitanjli Arora:
In particular, when I used that word, "what a And that was then hard for me. So I wanted to boil it down to a time. We do anyways. We might think we're compartmentalizing,"Okay, now, done! Next!" maybe just recognizing that we do
Sarah Dabagh:
What are our take-home points from this
Daniel Eison:
I think the main thing that I'm taking home from
Sarah Dabagh:
And I think that lesson, be thoughtful with
Daniel Eison:
I absolutely agree. And as we discussed, the brilliant about this piece, "A Lovely Family," is that "lovely"
Sarah Dabagh:
Not that saying"lovely" is like-- not saying
Daniel Eison:
Yeah, it's not that any given word is a good are shaping the way that we see them, which then shapes the way
Sarah Dabagh:
Thanks for listening. Our theme song is please reach out via the email on our website. This has been
