Theresa Brown, HEALING: When a Nurse Becomes a Patient
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[1:49]Theresa Brown is the author of healing when a nurse becomes a patient.
[1:53]She is the author of the New York Times bestseller The Shift and has been a contributor to the New York Times.
[1:58]Her writing appears on CNN.com and in the American Journal of Nursing, the Journal of the American Medical Association and the Pittsburgh Post Gazette.
[2:06]She has been a guest on MSNBC Live and NPR's Fresh Air. Her first book was Critical Care.
[2:12]And during what she calls her past life, she received a PhD in English from the University of Chicago.
[2:16]She lectures nationally and internationally on issues related to nursing, health care, and the end of life.
[2:22]Welcome, Theresa. Thank you so much for coming on Moms. Don't have time to read books.
[2:26]To talk about healing when a nurse becomes a patient.
[2:30]You are welcome. Thanks for having me and I love the title. I remember those days.
[2:35]Oh, I thought you met your title. I was like, yeah, it's really good.
[2:38]No, no, Moms. You like my title. Thank you. Yes, yes.
[2:43]I also like your title. So there we go. Would you mind telling listeners what your book is about?
[2:48]I would not mind it all. So five years ago now, I was diagnosed with breast cancer,
[2:56]very small tumors, slow growing, but nonetheless terrifying. And my background is I'm an oncology nurse.
[3:05]Well, my real background is I have a PhD in English. I taught English in college, had kids,
[3:11]had a life change, went back to school, became a nurse, worked in oncology and in hospice.
[3:16]So I knew how bad cancer can be in a very visceral, detailed way, but I think even if you don't
[3:25]have that diagnosis of cancer is always terrifying. So I was terrified and went through treatment
[3:33]and was surprised to experience all these ways that the healthcare system is just completely
[3:43]lacking and compassion toward people. I mean, clinically, it got great care, but there were so many
[3:52]glitches and things that happened that were scary and hurtful and made me feel abandoned. And what
[3:59]that did was made me start thinking about my work as a nurse. And I knew there were glitches.
[4:06]I mean, you'd have to be living under a rock, not to know there are problems in our healthcare system.
[4:11]But I thought, well, I and the people I work with, we care so much. We make up for anything
[4:19]that goes wrong, right? We make the difference. And the care we give is great and we say people's
[4:24]lives. And as a patient, I just saw, no, it's not like that. There's a huge gap between what
[4:34]patients need in terms of having their humanity recognized and what they get. And so the book
[4:41]alternates between me learning, I have cancer, getting treatment for cancer, managing that and
[4:49]looking back on my time as a nurse. This is a good tip for moms who don't have time to read
[4:55]my son who's 26 now, I'm about to remember in ages, read the book. And he said, you know, that back
[5:02]and forth, I said that was annoying. And then I realized it was your mindset. So that's another tip.
[5:11]Yes, that's actually, I appreciate his honesty, he said in a very loving way. And that's a tip for
[5:18]this alternating I was doing in my own mind between, oh my god, now I realize, wow, we can't make up
[5:27]for that. You know, we can't make up for the person who came in to get chemo and it was really,
[5:33]really, really delayed or just all the things that are going on with people. And so this is a very
[5:39]long answer I realized, but basically what it comes down to is having cancer is terrifying.
[5:46]You know, some of that is because we're not really told as I was not. This is very treatable,
[5:55]it's small. We can handle it. We know how to take care of this. And some of it is reality that
[6:01]people every year die of cancer. It's one of the leading causes of death in the US.
[6:07]And our healthcare system just is not there to deal with that terror, anxiety, worry,
[6:14]it's much more like an assembly line and we're people, not widgets or TVs or cars. And so we
[6:21]need better. So I wrote the book in a hope for better. Well, what you did so well is,
[6:30]even though that was a fabulous summary in the book, you show us with so many examples,
[6:34]all the flaws and weaknesses and and just little moments where compassion on the part of a nurse
[6:39]or a healthcare worker of some type would have made like the biggest difference in the world to
[6:44]you, particularly when you, when you talked about your whole diagnosis and you take us through
[6:48]all the steps of that. And there was this one particular nurse, well, the one nurse who left early
[6:53]and then the other nurse who was just like, well, probably we probably can't get to it,
[6:57]give you your results until Monday. And you're like, how can I just spend a weekend waiting? And you're
[7:02]like, so you're telling me that the results will be there, but they're going to be on your desk
[7:06]and you won't have time to call. And she's like, well, I leave it three. You're like, what? And
[7:11]then she never called you. And she never called you. Right. Right. Yes. Yes. Insane. How do you
[7:20]like make sense of that? I mean, it's, it's what, how do you make of that, especially because you're
[7:25]such a compassionate nurse yourself? Like, what do you, what can we do? I mean, I know at some points,
[7:30]you said it's not the fault of the individual people. It's the structure of the system and
[7:33]everything. But how do you take out the compassion of someone or the empathy, even just to say,
[7:39]like, gosh, I wouldn't want to wait all weekend long either. Right. And right. And you get right
[7:44]down to it. It is individual failure. I mean, it, it is on that nurse to just say, well, I leave
[7:52]that for, I mean, that's not an answer. The book, if the book stops with you, then you need to
[8:01]do something different. You can't just say, well, I leave, that's it. You're going to be hanging.
[8:06]So, so yeah, I try to be careful to say it's the system, but also that was part of what was so
[8:13]painful for me in my own treatment is realizing, oh, I had moments like this. Not like that. I mean,
[8:22]I was never like that. I find that particularly bad. But, you know, I certainly had moments like that.
[8:28]Yeah. So I'm going to give what may seem like a little bit of an indirect answer. But
[8:33]when I talk in the book about radiation oncology, which people don't usually think of as being
[8:38]warm and fuzzy. Right. It's a sort of like most creepy aspect of your treatment. But where I
[8:44]I went for radiation oncology, it was so great. And it wasn't like they had a patient
[8:53]compassion initiative or, you know, banners up saying, you're important. It just was obvious
[9:01]in every thing that they did. So they had a cord machine, which I know COVID has made that
[9:08]complicated. This is before the pandemic. Just a simple thing like that. They had a cord
[9:13]machine that was well stocked and they pointed it out to me. You were supposed to come in and check
[9:20]in by putting your index finger on this thing that sometimes works, sometimes didn't and use the
[9:24]computer and a couple times I forgot and the secretary just said, oh, I'll just check you in here.
[9:30]It's fine instead of saying use the computer, which has happened to me more than once. And then
[9:37]I didn't like having to wait in the waiting room with the television on. I don't know why. Let's
[9:42]make a deal before radiation just made me incredibly anxious. I don't know why. So I said,
[9:49]get me turn the TV off. And they said, we will talk about it. And they said, you know, no,
[9:54]we can't because some people like it, but you could sit in the hallway. So this was five days a week
[9:59]for a week.
[10:00]Like staff not in the hallway, a tech came out and got me,
[10:03]never said, oh, you know,
[10:05]you're really making me work extra here.
[10:07]Or I mean, people would not believe the things
[10:10]that get said to you, like I'm not exaggerating.
[10:13]Like that particular thing didn't get said to me,
[10:15]but I know that kind of thing has been said to other patients.
[10:18]They were just so wonderful and lovely.
[10:21]And one of the texts, they were all in their 20s
[10:26]and anyone who knocks millennials,
[10:28]I feel like just haven't spent time with people.
[10:31]I just want to put that out there.
[10:32]These were amazing.
[10:34]And one of them said, you know,
[10:36]we know you don't want to be here.
[10:38]So we have to be extra nice.
[10:41]It's really that simple.
[10:44]And obviously somebody in that office
[10:49]had really focused on that, right?
[10:51]It was important to them to make patients comfortable.
[10:55]And I think that is a lot of what it takes.
[10:58]And I use that example to say, you know,
[11:01]this was not anything elaborate.
[11:04]It was not complicated.
[11:05]It was just basic civility, politeness.
[11:08]And seeing me as a human being,
[11:11]that said, I know that when you work in a system
[11:15]where you're constantly being evaluated on your output.
[11:18]And did you fill out this form, right?
[11:20]And hey, you got this detail on this, you know,
[11:23]fifth computer sheet you're supposed to do wrong.
[11:27]That is gonna like beat the compassion out of you, right?
[11:31]And so it really does have to start at the top,
[11:36]but it doesn't have to be complicated,
[11:38]but it has to be a recognition
[11:40]that the people doing the work are also human beings.
[11:44]And that's gonna enable them to treat patients
[11:48]like human beings.
[11:50]And we have gotten so far away from that
[11:54]by allowing to develop this healthcare system
[11:59]that's so focused on money.
[12:01]Are you able to pay?
[12:03]How can we maximize revenue, you know, discrimination?
[12:07]If you look at the rates of cancer death
[12:10]among African Americans are much higher
[12:12]than among white Americans, you know,
[12:14]the people who get denied care
[12:16]just because they don't have the money to afford it,
[12:18]you know, on and on and on and on and on.
[12:19]All the stuff we read about during COVID
[12:21]and that most people are very aware of,
[12:24]but this is how it plays out.
[12:28]It plays out and this kind of casual rulety.
[12:32]I think it's not too harsh a word to use.
[12:36]And then what I try to also show in the book
[12:41]through data and research is that compassion
[12:44]really does help people heal.
[12:47]This is not just about,
[12:48]oh no, and when you feel like a human being,
[12:50]you know, it's much deeper than that.
[12:54]And it really makes a difference in terms of
[12:58]how well you do, whether you're willing to listen
[13:01]to what's being said to you, you know, on and on and on
[13:05]and on and on.
[13:05]I mean, it just has a cascade effect
[13:08]that can either be positive or negative.
[13:11]And we want that to be positive, right?
[13:14]For healing people, yeah.
[13:17]That's supposed to be the goal helping people.
[13:20]It's true.
[13:21]I know it's like, it's like putting all these ingredients
[13:24]that didn't go well together in a pot, right?
[13:26]If all these people was fear, right?
[13:29]Fear and uncertainty and just totally unsettled.
[13:31]And then another group people feeling angry and tired
[13:35]and resentful and, you know, stressed and overworked.
[13:40]It's just a worse combination, right?
[13:42]It's hard to make that into magic.
[13:46]That's a great analogy.
[13:47]I love that analogy, right?
[13:49]Sort of, sort of, right, angrily throwing everything
[13:52]you can find into a pot.
[13:54]Well, this is what the recipe calls for, right?
[13:56]Just take a minute and say, I think maybe a little bit
[13:59]less salt, maybe a little more tomato, you know?
[14:03]Yeah, it's true.
[14:04]Yeah.
[14:05]Or we have to get a different pot.
[14:07]We just have to change the whole ecosystem.
[14:10]I mean, I think there are some things,
[14:12]and I don't know how you feel like, you know,
[14:14]I feel like even scheduling appointments
[14:16]can be stressful, right?
[14:17]And you keep hearing, like, oh, I found this out,
[14:19]and then I couldn't get an appointment.
[14:21]And like, I just read this book about a woman who broke her arm
[14:24]and she could not get in, she had to fix it within three days.
[14:27]And then she couldn't get an appointment.
[14:30]And her whole family just had to keep calling around
[14:32]to different orthopedias.
[14:33]And it's like, and that was from the ER.
[14:36]This is an event called 22 of Alice in Trail Bridge.
[14:38]But this happened a while ago, but,
[14:40]but it's so not unique in that it happens all the time.
[14:43]You hurt people being like, I can't get into this doctor
[14:46]or that doctor or like, anyway, I feel like some things
[14:48]are workarounds, like, zach-dach,
[14:50]and you know, there are, you know,
[14:51]on the more online scheduling, which takes that down,
[14:54]but still even getting x-rays, even like,
[14:57]oh, you need an MRI, but wait,
[14:59]you might have things so terrible.
[15:01]Now you're insurance, just, I mean, I don't know.
[15:03]I am just venting, I guess, at this point, but it's so long.
[15:05]No, that's exactly right.
[15:09]And I recently was actually during the pandemic,
[15:13]partially torn my rotator cuff into places,
[15:15]which is really helpful in capacitance.
[15:18]Mostly healed now, which is great,
[15:21]but yeah, it's a small thing, but it's a big deal.
[15:26]It sounds like you know, and maybe people listening now too.
[15:29]But yeah, the whole wait for an authorization
[15:32]and what I would do is just call and make the appointment,
[15:36]and assume it would come through.
[15:39]But yeah, people who don't know to do that,
[15:42]yeah, it's like either this painful shoulder injury,
[15:44]you don't know what's wrong.
[15:45]I mean, I was at home, I was writing the book.
[15:47]What if I had to work?
[15:49]What if I had to do work that involved me
[15:51]using my shoulder, which, let's be honest,
[15:53]the most jobs are gonna involve that, you know?
[15:57]Yeah.
[15:57]What am I supposed to do while I'm waiting for my diagnosis?
[16:02]And that just kills me because we have this culture
[16:06]that's very much like, well, if you're not working,
[16:08]you're lingering, and yet you can't,
[16:11]in a timely manner, get the healthcare that you need
[16:15]that would say, no, I really shouldn't be working
[16:17]because my shoulders really hurt.
[16:20]And yeah.
[16:22]Yeah, it's not like people who are trying to get MRIs
[16:24]are like big scammers.
[16:26]Right, right, right.
[16:28]You know, there are other ways to make an extra few bucks
[16:30]or to steal.
[16:31]Like the people who they're not like, ooh,
[16:34]I'm gonna try to get an unauthorized MRI
[16:36]of my left kneecap today.
[16:38]You know what?
[16:38]So just like give the people the authorization.
[16:41]Why is it even required?
[16:43]And maybe this is, there's a need for a new insurance model.
[16:47]I mean, obviously there is, but, you know,
[16:48]I mean, I know people are way smarter working on solutions.
[16:52]But yeah, I don't know, but that's such a,
[16:55]that's such a great and amazing point, right?
[16:57]No one's like, you know what?
[16:59]I'm gonna rip off my healthcare system.
[17:01]I'm gonna get a colonoscopy.
[17:02]Right?
[17:03]Yeah, exactly.
[17:06]Especially because you're not even,
[17:07]yeah, it's ridiculous.
[17:09]Yeah.
[17:09]What are they protecting so hard against?
[17:11]All they're doing, like the cost benefit,
[17:13]you're stressing out 99% of the people unnecessarily.
[17:17]And then they come in even more stressed
[17:19]and then they deal with the tech who's there,
[17:21]who's like overwhelmed.
[17:22]I mean, it's just like this like ball of inefficiency
[17:26]and emotional chaos.
[17:28]Right.
[17:29]And then people who just get incredibly angry
[17:32]because they had to wait.
[17:34]Yeah.
[17:35]Which I understand, but also I think,
[17:38]that's become like a thing that people feel like
[17:40]they can get upset about instead of saying,
[17:43]why is this whole system so terrible?
[17:46]Yeah.
[17:47]Why can't it be more respectful of me as a human being?
[17:50]My time just, yeah, I hear you.
[17:53]Such a great point, right?
[17:54]Nobody, right?
[17:55]Nobody's like, yeah, I just wanna sit in an MRI machine.
[17:59]I really love those loud clicks and bangs.
[18:01]Yeah.
[18:02]Oh, yeah.
[18:03]Let me in, this is fun.
[18:04]Yeah, right.
[18:05]Yeah.
[18:07]I'm just gonna pretend my shoulder hurts.
[18:09]I mean, they're right, like there's a syndrome
[18:12]called Munchows and Warped People.
[18:13]Yes, yes.
[18:14]Pretend they have health issues,
[18:15]but it's very unusual.
[18:17]And most of us have better things to do with our time.
[18:20]And so.
[18:21]Exactly.
[18:22]Yeah, ridiculous.
[18:24]That's funny.
[18:25]I feel like, yeah, if I were to start my own MRI business.
[18:28]Yeah, right.
[18:30]That would redo it, how would we all do it differently?
[18:32]When did you decide to make your experience into a bug?
[18:36]Oh, that's a really good question
[18:38]that I'm not sure I have a great answer to.
[18:40]I think, well, being a writer,
[18:43]I just sort of had stories in my head,
[18:47]but I think it was probably not,
[18:50]it's probably at least a year or a year and a half.
[18:53]So I was done with treatment and probably about a year.
[19:00]I thought, because I had been thinking about,
[19:03]okay, what's my third book going to be?
[19:05]And then I was diagnosed and then just couldn't figure it out.
[19:10]And the, my agent said,
[19:14]couldn't figure out this book.
[19:15]Sorry, I'm not being clear.
[19:16]And she said, you know, Theresa,
[19:18]you're still grappling with the dragon by which she meant.
[19:23]You're still coming to terms yourself
[19:25]with everything that happened.
[19:27]You're not ready to write about it,
[19:28]which was exactly right.
[19:30]And she said, I don't know if you need a break or what.
[19:33]But then we made the decision to move,
[19:35]sort of, we'd always lived in the same neighborhood
[19:38]in Pittsburgh.
[19:39]In Pittsburgh, if you move,
[19:40]especially because we moved across a river,
[19:42]it's just like, oh my God, you might as well,
[19:44]you know, gone to Tibet, right?
[19:46]But so we moved to a new neighborhood.
[19:49]We crossed the river.
[19:50]And that was what I was focused on, right?
[19:53]The move and getting us there and selling our house
[19:55]and gotten to my new study in the new house
[19:59]and suddenly.
[20:00]the book started to make sense.
[20:03]And then I was able to put it together.
[20:05]But I'd been, I'd sort of written pieces.
[20:09]So the whole book was like that.
[20:12]It was the most unusual writing experience
[20:16]where even though I had an outline,
[20:21]I could only write a very small amount.
[20:24]I could never see into what was gonna come next.
[20:27]Even though I, it was my life, right?
[20:29]I knew what had happened.
[20:31]But I couldn't see exactly how I was gonna write it.
[20:34]It was just like a fog.
[20:36]And it did have definitely some anxiety.
[20:39]Like what if I get to a point where I just don't see
[20:42]into the fog and wore the fog clear
[20:43]and there's nothing there.
[20:45]But that didn't happen.
[20:46]So yeah, yeah.
[20:48]But it was always that back and forth
[20:52]and these very short chapters
[20:56]that I wanted to be gem-like.
[20:59]Not in this sense of this is amazing and beautiful,
[21:02]although that would be nice,
[21:04]but sort of refracting light into different colors
[21:07]and shapes and textures
[21:08]and different intersecting hard surfaces.
[21:12]And that was really my hope for the book.
[21:16]Yeah, I hope the next one will be a little more straightforward.
[21:20]Oh yeah.
[21:21]What's do you already know what it's gonna be?
[21:23]I'm thinking about writing a book about pain,
[21:26]which is a huge topic.
[21:28]And I'm not sure what angle I would take with that.
[21:33]Yeah, uplifting.
[21:34]Yeah, I know.
[21:35]Well, that's the other thing.
[21:36]It's like what I'm about agony and disaster.
[21:39]I need to find a way to know.
[21:42]No, but it's good.
[21:43]No, it's managing pain and being, you know,
[21:46]it's all sort of a piece.
[21:47]I feel like you're trying to increase empathy
[21:49]among everybody for what they're doing.
[21:51]Right, how do we think about our pain?
[21:53]And interestingly, back when I was a PhD student in English,
[21:59]that was some of what I wrote about,
[22:01]how do people tell narratives about trauma?
[22:05]And this great book came out called The Body in Pain
[22:09]by woman named Elaine Skari, who was at Harvard.
[22:12]I think she still is, but it's a great book,
[22:15]but also, yeah, a hard book,
[22:16]because she went to the Amnesty International Archives.
[22:19]And I'm not gonna be doing that.
[22:21]So I'm gonna try to find something
[22:24]a little bit less mired in the worst possible pain
[22:29]you can imagine, a little more ordinary,
[22:33]which can still be terrible, but you know,
[22:36]what we go through, right?
[22:37]It is all of a piece, yeah.
[22:39]Well, now my mind is kind of spinning on
[22:40]like how to make this experience better
[22:43]because everybody has to deal with the healthcare system.
[22:45]And I feel like even like this conversation has made me
[22:48]shift like how I feel about even walking into it.
[22:51]Right, if I know I'm going into a fraught situation,
[22:54]I'll have different, as opposed to thinking,
[22:56]everything's gonna run smoothly.
[22:58]Right, like maybe we should all bring a little card
[23:02]or two with us for every doctor's appointment
[23:04]or things that we feel stressed about.
[23:06]And the card is something like,
[23:08]I know you're having a rough day,
[23:09]and you have a ton of patience,
[23:11]and you don't have to pay attention to me,
[23:13]but I'm, you know, you're making my day
[23:15]by even thinking about my life, so thank you.
[23:18]I bet I would change the whole dynamic
[23:20]in the whole rest of their day.
[23:21]Wow, that is a great idea, right?
[23:25]It's so cheap.
[23:26]I mean, you could just handwrite it on a scrap of paper
[23:29]and put it in, I don't know.
[23:31]I think it would, I think I'm gonna dry it next time.
[23:34]If everybody were to do that or approach it
[23:36]with that attitude, anyway.
[23:38]Yeah, and the one thing I really encourage people to do,
[23:42]and I keep intending to write something about this,
[23:44]but is something goes wrong
[23:48]and makes you feel bad or, you know,
[23:51]you feel like you weren't attended to complain,
[23:54]but complain appropriately, you know.
[23:57]Here's what happened.
[23:59]Here's how it made me feel.
[24:00]I do think places want that feedback,
[24:05]but you wanna make sure-
[24:07]Not to get people in trouble.
[24:08]Right, right.
[24:09]And I mean, for example, right in a college
[24:13]at this appointment, they had me in a room
[24:15]where they were getting my vitals,
[24:16]and nurse just, it didn't knock on the door,
[24:19]came into the room and just stood there
[24:20]and didn't say anything,
[24:21]and stared at the computer screen.
[24:22]And I got, oh my gosh, that, like,
[24:25]and, you know, I talked about it and they listened,
[24:27]and it seems like that's just basic manners,
[24:30]but sort of having an opportunity to have management
[24:33]remind people,
[24:35]yeah, these are human beings.
[24:37]They are vulnerable.
[24:38]Amazing.
[24:39]Yeah.
[24:40]Well, Teresa, thank you so much.
[24:41]I feel like this has changed my life,
[24:43]our little brief conversation.
[24:44]Oh, I love your book, please.
[24:46]We'll do so, too, so healing by Teresa Brown.
[24:49]Thank you so much.
[24:50]Thank you.
[24:50]You're welcome.
[24:51]Okay, bye.
[24:53]Thanks for listening to this episode
[24:55]of Moms Don't Have Time to Read Books.
[24:57]Don't forget to follow me on Instagram,
[24:59]at Zebioans, and at Moms Don't Have Time to Read Books.
[25:02]Also sign up for my newsletter at zebioans.com
[25:05]and sign up for my virtual book club
[25:06]and meet lots of authors on Zoom every other week.
[25:09]Thanks so much to Steve and Ryan at Textures Sound
[25:12]for the Sound Editing.
[25:13]And thank you to Morning Moon Productions
[25:15]for providing this fantastic intro and outro music.