Doc Discussions with Dr. Jason Edwards
THIS is the podcast you have been looking for! "Doc Discussions" are just what the title says they are: physicians from a wide range of specialties, talking about relevant, up-to-date medical topics, not to mention tips on habits to help you live your best life. Your host, Jason Edwards, MD, is a board-certified radiation oncologist with a PhD in cellular and integrative physiology at St. Luke's Hospital in St. Louis, Missouri. Dr. Edwards explores not only diseases but also suggests techniques to optimize mental and physical health for a long and good life. Real people. Real advice. Real good. This is Doc Discussions, with Dr. Jason Edwards!
Doc Discussions with Dr. Jason Edwards
How Positivity Can Transform Patient Care
What makes a healthcare experience truly life-changing? This week, we explore the impactful dynamics of hope and optimism in patient care with Dr. Jim Esther, an experienced rheumatologist. Delving deeply into the concept that positivity isn't just a nice-to-have, we illuminate how optimism can fundamentally reshape patient interactions and outcomes. As we share personal anecdotes and professional insights, we highlight strategies that healthcare providers can adopt to foster a supportive and uplifting environment for their patients.
We reflect on personal experiences that shaped our understanding of the healthcare journey, emphasizing how empathy is built through shared vulnerabilities. Each interaction offers unique insights, proving that hope is integral to navigating the complexities of health and healing. The episode goes beyond theory to reveal practical techniques aimed at transforming routine medical visits into meaningful exchanges.
While hope and optimism are essential, we navigate the crucial balance between fostering a positive outlook and maintaining honesty with patients about their conditions. This balanced approach ensures trust while encouraging the mindset needed for resilience during difficult times.
Join us as we challenge the conventional narratives surrounding patient care, examine the contagious effects of stress, and inspire a culture where positivity prevails. This discussion provides valuable takeaways for both healthcare practitioners and patients alike, reinforcing the belief that a little optimism can make a significant difference in how we approach life’s challenges. Tune in today and discover how to harness the power of hope in your life or professional practice!
Hello, this is Jason Edwards and this is Doc Discussions. I'm here with my good friend and colleague, dr Jim. Esther Jim is a rheumatologist and internal medicine physician. Is that accurate? That is perfect. Yeah, now, jim, where are you from? Are you from here in St Louis? I am from St Louis, is that right?
Speaker 2:I did not get very far. My brother and sister both ended up in North Carolina, but I was a family member who stayed in town.
Speaker 1:Yeah, very good, very good. Yeah, st Luke's is a good place, good place to live. It's a wonderful place to live. When I think about you, I think about somebody who's an optimist and through our interactions. Specifically, I remember one big meeting we were in where everybody seemed to be throwing tomatoes at me and you said hey, you know what? I have a little bit of hope. Things are going to turn around.
Speaker 2:Things are going to be okay, yeah.
Speaker 1:And there's actually some pretty good data. They've done a few longitudinal studies where they looked at people who tried to practice hope and optimism and found that they had better health outcomes, measurable differences in their life and certainly in their quality of life. But I think that hope and optimism is it's probably something that we're born with to some degree, but it's something that can be cultivated too.
Speaker 2:I think that optimism is a choice. I do not think that optimism is a warm fuzzy feeling. I think that you have to make a conscious decision to bring something positive to your interactions. And so, like, when you go into an exam room, when you hit the door, you don't hit the door negative, you hit the door positive. You're there to be of service to another human being and you want them to feel comfortable. So the key is to make them feel comfortable so that the interaction goes better.
Speaker 1:I agree, I agree, I agree, and usually people are, especially if it's the first time meeting you. You know they're nervous and they're not. It's an away game. You know they're in your court and some people have a great aptitude at putting somebody at ease by a smile, a handshake, just their overall demeanor, and I think that makes a big difference.
Speaker 2:I think so too. I think nobody gets up in the morning and says, gee, I can't wait to go to the doctor. No, I mean, they go for preventive care, they go for a problem. You're there to provide a service, to be kind and helpful, and so you want to make them feel comfortable, and then everything just goes better.
Speaker 1:Yeah, are there any specific techniques that you've used or found useful as far as cultivating hope and optimism?
Speaker 2:I always, from the beginning, I thought how do I make being a doctor more pleasant for the people who were coming into my office? And so I always made a point of saying that the next interaction was the most important interaction of the day, and I've done that for 35 years.
Speaker 1:Yeah.
Speaker 2:When I put my hand on the door to walk in, I'm thinking this is important and this is the most important thing I'm going to be doing all day, and I do that all day long, yeah.
Speaker 1:Yeah, you can definitely fall into kind of the habit of saying, okay, this is just another Tuesday at 2 o'clock, but for the patient it's not that oh no, and you find that yourself.
Speaker 2:When you're a patient, you know you go in to see a doctor and even for us, because we're doctors, you're still a little bit on edge, for sure you know You're thinking, hmm, so when the guy makes you feel comfortable or gal, it's a good thing.
Speaker 1:Yeah, I specifically remember I was having chest pain one time and I came into the ER and Craig Reese, our cardiologist, was there and I was worried and he was in control and I was worried and he just he made, he was in control. He wasn't necessarily a touchy-feely, but he was just totally in control of the situation and it put my heart at ease and that made a difference and it made me a better doctor, being a patient being a patient always makes you a better doctor.
Speaker 2:You know the different health experiences that I have been through. You know, paradoxically, it makes you a better doctor when you go back to work. Yeah, and it just gives you more empathy. Even if you're trying to be empathetic to begin with, it makes you even more empathetic.
Speaker 1:Yeah, it's nothing but good. It's kind of the difference between reading a book and actually doing something, and I agree with you that you can gain a lot of value in being a patient.
Speaker 2:Oh yeah.
Speaker 1:And so you know, recently you had a skin cancer on your ear that we treated in my department. You did, you've done, something I've never done. I've never undergone radiation. I mean, I've treated a lot of people with radiation, but how was that? Well, it was creepy.
Speaker 2:to be honest with you, because, like I'm in the business, I mean I've been in the business for a long time now and a while.
Speaker 2:And so, yeah, it was a different experience. I mean, when you're on the receiving end of healthcare, it's a different sort of experience. And so, even though it was a relatively minor radiation for a relatively minor cutaneous basal cell, it was still an experience. And so when they put you on the table and they put you in the restraining mask so that you can't move, obviously you're very precise. You're a great department, wonderful department.
Speaker 2:But, it's a creepy experience, and so you sit there and you kind of meditate and pray and kind of go through it. And now when people say to me what happens in radiation therapy, I said, funny, you should ask that because I can then explain it to them what they're going to be going through. And the people were nothing but delightful. They were wonderful, nice people. But I think that you can tell patients more having gone through some of this yourself.
Speaker 1:I do. Yeah, there's certainly a desensitization with it. Radiation is typically given five days a week for several weeks and I always tell patients the first two or three treatments are kind of rough, but then it becomes just like eating a ham sandwich.
Speaker 2:I mean, it's no problem as far as the anxiety associated with this and the people there are so good and they're so kind and you're so kind, and so the whole experience is really positive and plus, I got a great outcome.
Speaker 1:But no matter who you are, you're going to be nervous because you've never done it before.
Speaker 2:If you're not nervous, you're lying. It's kind of like if you aren't a little bit nervous as they put you on the table, you're fibbing.
Speaker 1:Yeah, you know, when we talk about hope and optimism, there has to you know kind of the light and the darkness of it there has to be an inherent adversity where it makes hope and optimism a necessity.
Speaker 1:And I think you know everybody has times in their life where they have something that happens to them, no matter who you are. You know King Charles was just diagnosed with a cancer and you know even the King of England, you know, has to deal with, you know, think, somebody who has everything. They still have to deal with adversity, which is inherent to life. And I think that's when it's so important to you want to be realistic, you want to be honest about what's going on, but it pays to hope for the best possible outcome. The alternative is, you know you live your life in misery and you know the two metrics that really matter are the length of your life and the quality of your life in misery. And the two metrics that really matter are the length of your life and the quality of your life. And if you want to optimize the quality of your life, then you should have a little hope, because it's hard to have a good day if there's no hope.
Speaker 2:Oh, I think that's exactly right. Again, being positive is a choice. It's not something. You can bring positivity to a situation, even if it's a bad situation. The same time, you always want to be straightforward and candid. You know the one thing you never want to do is to give false hope. On the other hand, you have to let people know that you're with them and that you care and that you're gonna do everything you can to make their situation better yeah, I agree.
Speaker 1:I think you know probably every doctor has seen some example where false hope is given and it always ends up horrible. And you know you lose trust too and you cannot have that in the doctor-patient relationship.
Speaker 2:No, that's exactly right. I mean you can deliver difficult news in a way that's difficult news, in a way that's I wouldn't say positive, but you say you deliver it in the most matter of fact way possible and say this is the plan that we have going forward.
Speaker 1:Yeah, and you try to do it with some compassion and show that you care, show that you're a human being and then, yeah, you're right, Giving somebody the next steps is typically helpful. In my experience, when somebody is dealing with kind of a new adversity, it typically takes them about two or three weeks to kind of come to grips with what they're dealing with. And I've kind of found the same thing in my own life, even knowing that that's what I see in other patients' life, Even knowing that it still doesn't change the two or three week time span before I become desensitized to my new normal and what I see in other patients' life, Even knowing that it still doesn't change the two or three-week time span before I become desensitized to. You know my new normal and what I'm dealing with. But people adapt. I mean they adapt to prison, they adapt to horrible situations. People can adapt to almost anything, I think.
Speaker 2:I think so I think that the big thing is to be kind and candid.
Speaker 1:Yeah, yeah, and straightforward and honest.
Speaker 2:You know you just want to be real straightforward with people. But also, like I know, you do the same thing when you hit the door and you walk in the room. You walk in. You know friendly.
Speaker 1:Yeah, you know, I learned this at a young age when I was like in my early twenties me and my buddies we would. We would go out to the bar to try to meet some nice girls and I learned, when you walk in the door, have a smile on your face, it's going to help your odds, and so it's a little bit different venue, but people like people who are hopeful and warm and have a smile on your face, that goes a long way.
Speaker 2:Yeah. I think, so, and when you run into somebody who's having a bad day, you know you run into negativity. Sometimes, the most important thing is never return negativity with negativity yeah. You return negativity with neutrality, yeah, and you don't engage, otherwise you get an escalation. You don't want that. You want things to beality, yeah, and and you don't engage, otherwise you get an escalation. You don't want that.
Speaker 1:You want things to be cool, yeah, and we've all been kind of um, uh, have our egos exhausted from, um, whether it was physical labor or psychological stress. Where we're you're kind of and and when you play poker, they call it on tilt. When you're when your mind's you know not quite right, and we all deserve a little bit of slack and a little bit of grace when we're we're not doing so well, and so I think that's that's the right way to do it.
Speaker 2:I think that's true. Stress and fatigue are the are the enemies, and you just have to be careful about that. Yeah.
Speaker 1:Yeah, and we're all prone to it and, and it's, it's you try to minimize. As I checked, we're all human, yeah, yeah, yeah, and we deserve to treat each other with a little bit of grace.
Speaker 2:A little bit of grace is a very good phrase, yeah.
Speaker 1:In my experience and tell me if yours is any different. Bringing up to somebody their own negativity, that's kind of treacherous waters. You're unlikely to be successful in that endeavor. But what's your take on?
Speaker 2:it. Yeah, you know, one of the lines I mean is what you give, you keep, what you keep, you lose. And when you die, you take with you only what you gave away. And so I think that the worst, I call it engaging Like have you read Sun Tzu the Art of War? Okay, no.
Speaker 2:But Sun Tzu says deflect. And so when I run into a negative person, I don't think engage, I'm not going to fight with this person, I'm going to deflect. And so I'm just not going to do it. And you have some people. They just can't wait to get angry and you can tell it's like something that they really want to do, and you don't give it to them, you deflect, you say, well, I wish you the best and get back to me, and you just won't deflect. And then they say something even more insulting and you say, well, thanks for sharing. Well, then they realize that you're not going to engage with them on an angry level. If they want to engage with you on an intellectual level, that's swell, but I call it don't engage. If somebody wants to have a fight, they're going to have to find somebody else. Yeah, yeah.
Speaker 1:People walk. There are, we all know, people who walk around in battle mode. They walk around half cocked and it's like, in general, kind of stay away from those people. It's it seems like almost an addiction with some people and that they, like you said, they almost long for that state and are looking for a fight and I suppose there are some kind of few circumstances where that kind of attitude is helpful.
Speaker 1:But you know, that's a lot of, that's a lot of cortisol rushing through your veins. It's not healthy for you and anxiety is contagious. You know, if you go and tell everybody, you know you work with all your worries and fears or anger can be contagious too and it's like you don't want to spread that can be contagious too and it's like you don't want to spread that Um and and um and in a way you know whether as as a spouse or as a parent um, or as a healthcare worker, you know part of our job is to kind of um, calm the system down. You know modulate, you know the highs and the lows, um and um, and so, uh, but that's tough and some people just do have a negative bend to them and I think the only thing you can do is maybe try to lead by example, but it's tough.
Speaker 2:Yeah, but I call it don't engage. Yeah, I just don't. I mean, and if they want to have a fight, I make it clear, they're going to have to find somebody else to have a fight with. And you don't have to be a patsy, that doesn't make you a pushover. Be a patsy, that doesn't make you a pushover. You say, gee, with all due respect, I disagree with you, but if they want to have a fight, they're going to have to find somebody else. Yeah, for sure.
Speaker 1:So we've kind of covered the hope and optimism. Are there any other topics that you would like to talk about or anything that you're thinking of that we haven't covered here?
Speaker 2:Gee, I don't let me think.
Speaker 1:What's going on with your practice right now? Are you accepting patients? Are you full, Well?
Speaker 2:I'm full right now. Recently I had two surgeries, which was a great surprise to me, but I had a back surgery and a hip surgery within a very short period of time, and I know this is going to sound bizarre, but I consider it a positive experience because not only was I really on the delivery side of healthcare, but it just gives you a different perspective on everything. And so, you know, I had orthopedic and back surgery and it was fine. Everything turned out great. But it's a learning experience and you learn to appreciate the people who are your caregivers and you learn also to appreciate being healthy and able to go back to work. Yeah, yeah.
Speaker 1:So one thing I've seen when patients have a big surgery like that is that you know, usually they kind of know it's going to be a battle afterwards, and so for the first couple of weeks they're kind of in the fight, but then around week three or four they're kind of will to keep pushing Peters out a little bit. Did you have any of that, or not so much?
Speaker 2:I really didn't. I mean, I just really was. This may sound bizarre too, but I really like being at work. I really really like being at work, and so my whole goal was to get well as fast as I could so I could get back to work.
Speaker 1:Yeah, when we had the ice storm last week and you know, my car slid off my driveway and so I couldn't get to work and it was not a fun day, I start going stir crazy and I realize, like never even think about retirement, it's a horrible idea. Like, never even think about retirement, it's a horrible idea. But work, you know it does. It's a place where you matter and it's a place where you know you have a place in this world.
Speaker 2:And that's a great thing. I think that every life has a ministry, you know, and I think that this is such a wonderful hospital and such a wonderful place, and I think that's why you just love being here. Everybody I see in this place loves being here.
Speaker 1:And most of us are friends. I mean, it's like a small town, so we know each other. Which?
Speaker 1:is great to have longitudinal relationships with people over time. Yes, it really is my job, my house, I have a roof over my head. Not everybody has that and so I kind of go down that list. And then the other thing that people find helpful is reframing things. And so when you say optimism is a choice, instead of saying you have a 10% chance of the cancer coming back, reframe it as there's a 90% chance the cancer does not come back, and that's kind of a more optimistic viewpoint.
Speaker 1:And then having purpose to life, like what you just talked about, like I need to be a doctor, it's my life's ministry. You know, purpose in life means so much. As far as quality of life, harvard did a nice longitudinal study I think it was like the graduating class of 1949 or something like that that they followed throughout their lives and they found there was a few different findings. But having a purpose to life, having good friends, avoiding significant alcohol intake, all those things led to a much better quality of life, which makes sense. But having a purpose to your being and that alone can get you through tough times oh, I think that's true. Yeah, I think that's true. There was an author who was very, very sick and he had written half of his book and it was so important to him to finish the book that he was in the ICU for a long time. But he had to finish this book and that always stuck with me. That you know, having projects and things to do, can, can, will you through the tough times.
Speaker 2:That's true, yeah that's true.
Speaker 1:Well, jim, it's always great talking to you. I want you to know from a personal standpoint that I look up to you and when I think about you, I think of somebody who who hopes for the best, and and my, my wish is that I can become better at doing that, just like you. So thanks for your positive influence that you spread through not only your patients but through the other health care workers here at St Luke's. I appreciate you.
Speaker 2:Well, you're a wonderful human being, so it's an honor to be here with you. Yeah, thank you, sir, thank you.