Lunch Talk at Vanderbilt

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On Monday, March 10th, Dr. Ralph Wood will be having a lunch talk from noon to 1 PM at Vanderbilt Medical School titled the “Literature of C.S. Lewis and Considerations for Formation of Moral Character of Physicians.”   This event, sponsored by SSCD, CMA and MCF, is open to the public and will be a lecture in which the literature of C.S. Lewis is used as a lens through which to explore character formation in the world of the medical community.

For more information about Dr. Ralph Wood and the event, please visit the event’s website to learn more.

Impacting Lives – Helping Others

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Residency can be a daily grind of paperwork, conferences, and constant pages, running from patient to patient, to the point where a feeling of disillusionment can come over you at times as medicine just doesn’t seem all the grand things you thought it would be. Siloam is a place that reminds me of the excitement I had when entering medicine with the simple hope of impacting lives and helping others.

During my time at Siloam I was able to sit and just listen, which is so enjoyable as I am usually stretched thin for time. And I learned so much by just listening. One patient told me that her dizziness was cured by drinking water that had been boiled with garlic, which she said was a common remedy people have used in her family for years.

Another described to me the overwhelming feeling of confusion when going to a drug store and seeing 30 different name brands of ibuprofen in a foreign language and not knowing which is better or which one he should get; he wanted a prescription for ibuprofen so he could bring it to the pharmacist and have her pick it out for him.  These views into what it is like to wade through the healthcare world from a different background were interesting and enlightening.

It was also a good experience to work in a setting where I had fewer resources immediately available and so had to think broader and utilize a good thorough history and physical to guide decision making. I am so used to ordering a litany of labs and imaging without thinking of the cost, but when the patient before you will have to pay for any testing you order, it makes you think harder about what is really necessary and be more judicious.  We should do this all the time but we certainly do not.

I appreciated being part of a place where kindness and compassion infuse the daily work and the patients feel like they have someone who cares about them. At every step the patients are greeted with smiles and concern and open ears and hearts and I think this impacts their health and well-being in as much a way as the practice of medicine does. It is a beautiful reminder of the initial intent we all have when we choose to go into a field of service, but that can get lost in the years of training under layers of jadedness.  It’s nice to know the ideal still exists.

Guest blog written by Dr. Stacey Tillman.
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Dr. Stacey Tillman-
a Vanderbilt internal medicine resident
who recently completed four weeks of training at Siloam.

 
 

Dessert & Conversation with Mary Poplin

Note from the Director–

“The Siloam Institute exists to bridge the gap between academic medicine, the faith community, and the medically underserved.  As trainees at Siloam over the years are well aware, the worldviews of the clinician and patient alike have significant, practical implications for the work of healing.

In addition to training future health professionals to engage at this level (as recounted in stories on this blog), we periodically sponsor lectures or events that foster deeper dialogue around these issues.  With that in mind, we are delighted to co-sponsor an upcoming evening event on Oct. 23rd at Vanderbilt Medical School featuring Mary Poplin, professor at Claremont College and author of Finding Calcutta and Is Reality Secular? 

Whatever your own faith background, we hope you will consider joining us for dessert and provocative discussion about how to integrate personal conviction and professional practice.”

Oct-23 Lecture Flyer

Stress at Home?

This question asked by Dr. Nathan Bullington, a third year Internal Medicine resident completing a primary care rotation at Siloam, opened the door to new insights.

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Dr. Nathan Bullington, Vanderbilt Resident PGY-3

Dr. Bullington writes…

Ms. “H” had labile blood pressures.  A foreign-born, uninsured female in her late 30s with a diagnosis of hypertension was not uncommon.  However, her blood pressure fluctuations throughout the day were not making sense. 

She would sometimes have low readings before her medicine and high readings afterwards.  Sometimes she would have high readings before then drop her systolic blood pressure by 100 points after the medication. 

I stopped our conversation to ask how her home life had been going. 

“Do you have new stress at home?” I asked.  Immediately her eyes welled with tears and she began crying uncontrollably.  She was having immense difficulty with her son’s behavior along with strong feelings of guilt. 

Thankfully, she was open to meeting with Siloam’s behavioral health consultant and praying with the staff pastor before leaving.  This eliminated the need for any new medicines or medicine changes.

It is not unusual for our residents, students, and staff practitioners to ask one more question – perhaps a rephrased one – that opens the door to deeper pain within our patient’s life that is negatively affecting their physical health.  With this new insight, they are better able to direct a plan of care that addresses the patient as a whole person

Whole-Person Health Care Event: Cases and Discussion at VUSM in February

Have you been intrigued by the issues presented on our blog this year?  Still trying to figure out what “whole- person health care” really looks like?  Would you welcome an opportunity to hear and discuss actual cases in person?

On Mondays in the month of February, The Siloam Institute will be partnering with two medical student organizations at Vanderbilt University in a series of case presentations and discussions about the realities of Whole-Person Health Care.  Below is a description provided by the student leaders of Medical Christian Fellowship:footwashing

Striving to see and care for one’s patients as the complicated human beings they are is a difficult thing in the hectic, busy environment of health care. The following series will explore the joys and challenges of practicing medicine in a way that acknowledges and addresses patients and their health problems from a holistic perspective, seeing patients as physical, emotional, and spiritual beings.

Doctors from the Nashville area will share their experiences and lessons learned and engage in discussion on this topic in the format of case presentations. The final session will consist of a primarily discussion-style forum in which participants will discuss the presented cases along with the issues and challenges they raised regarding Whole- Person Health Care, in order to glean further insight into the practical expression of caring for patients as complete human beings in the context of everyday medical practice.

The Siloam Institute of Faith, Health and Culture will be co-sponsoring this series along with the student organizations Medical Christian Fellowship (MCF) and the Society of Saints Cosmos and Damian (SSCD).

These presentations will be held for four consecutive Monday’s at 12 pm, noon in Light Hall (room 202) on the Vanderbilt Medical Campus (Nashville, TN, USA) and will last for one hour. Lunch will be provided.

February 4th–Dr. Morgan Wills, Siloam Family Health Center

February 11th–Dr. Anderson Spickard, III, Vanderbilt School of Medicine

February 25th–Dr. Morgan McDonald, Vanderbilt School of Medicine

Please direct any questions you may have to Ian McGuinness at ian.m.mcguinness@vanderbilt.edu

Beyond the prescription pad: how Siloam taught me the importance of whole person care

Vanderbilt University fourth-year medical student, Scott Hagan, writes of his primary care rotation at Siloam…

“Can I talk to the pastor today?”

This was the first question of one of the first patients I encountered at Siloam. He came to clinic to be evaluated for new symptoms of chest pain, and was very concerned about his health.

Vanderbilt University Medical School student, Scott Hagan, and Dr. Wills during his Primary Care Preceptorship rotation.

In the traditional model of medical care, there is a standard approach to the patient with chest pain. Rule out life threatening etiologies first, and then treat other, less dangerous causes appropriately. Similarly to prior clinical environments in which I have trained, this biomedical approach to care was provided in an efficient manner for our patient (he happened to have heartburn, which improved with the right medication).

However, unlike the standard medical clinic, Siloam regards medical treatment as only one component of a larger system of healing. Our patient was not only seeking medical therapy, but, in an upsetting situation, was asking for our help in his spiritual life. A long-term patient at Siloam, he felt comfortable asking for pastoral care at this visit because the staff has created an environment dedicated to whole person care. Pastor Doug Mann promptly entered the exam room and prayed with the patient, and his spirits were lifted. At this visit, I am certain that we were not merely healing the patient’s chest pain.

Time and time again in my month at Siloam, I found this approach to whole person care put to practice. For the patient with uncontrolled diabetes who needed some new ideas on reducing carbohydrates in his diet, we arranged an appointment with our dietician. A patient struggling with depression admitted that social isolation was significantly contributing to his feelings of sadness. He expressed a desire to become more active in his church, and Pastor Doug helped him to brainstorm ideas to connect with church members throughout the week. The patient who wished to quit smoking met with Rebecca Swift, the Behavioral Health Consultant, not only to form a plan to quit, but also to incorporate behavioral changes to improve his chances of quitting.

The common thread through all of these encounters is that the physician is no longer the only provider improving the health of the patient. Whether it be the pastor, social worker, physical therapist, or pharmacist, a team of providers is now committed to addressing the health needs of the patient. Physical health is no longer the monopolizing goal of the clinic visit. Spiritual, social, and emotional health become priorities.

The staff and volunteers at Siloam have created an innovative environment in which whole person care is taken very seriously. I have emerged from this experience emboldened to bring this model of care into my career as a physician.

Whole-person care starts with trust among team members

Primary Care Preceptorship

Stephanie Couch, VMS-IV, works with a patient while on her clinical rotation at Siloam Family Health Center.

Stephanie Couch is a fourth year medical student from Vanderbilt who recently spent a month doing a clinical rotation at Siloam.  She writes…

Although I have learned several things during my time at Siloam, the most profound is the need for providers to care for each other in order to provide whole-person care to their patients. The working environment at Siloam is unlike anywhere I have worked so far in medical school. Not only because the staff treat me differently, but the way they treat each other is unique. The nurses, techs, volunteers, and providers are all equals as people and each of them asks the others about things going on in their lives. I have seen a little of this in other clinics, but never to the extent that it occurs at Siloam. These interactions build trust between everyone in the clinic, which is necessary for successful whole-person care.

Without trusting that the next person can continue caring for the patient well, the various aspects for approaching care would not be used significantly. I don’t know if whole-person patient care spilled over into whole-person office care or the other way around, but I suspect caring for each other in this manner allows providers to care for the patients’ whole persons. This experience has demonstrated for me the kinds of interactions I want to have with staff in my practice in order to build the trust needed for whole-person care.