And that made me think about Stephen King’s Dark Tower books.
If you have read the Dark Tower series you are familiar with the concept of Ka. It is described as a controlling force in our lives. Call it destiny or fate, or even call it God moments. It is the energy that brings us together on the path of our life. My husband Fred loved this concept so much that his screen saver on his computer endlessly scrolls, ”All things serve the Beam.” And within in the concept of Ka, exists the idea of Ka-tet. A Ka-tet it a group of individuals brought together by Ka. They walk same path of the beam towards the Dark Tower. They are one from many. In Stephen King’s Dark Tower books his Ka-tet consisted of Roland- the Gunslinger, Jake Chambers, Eddie Dean and Susannah Dean. They are on quest together. They are Ka-tet.
On May 27, 2009 I found my Ka-tet and the quest was called 73 cents. Towering on the table was my husband’s medical record. This was a very important book, for on the table lay the story of Fred. Here began our journey. How could we change the world and create patient centered care. How could we access the data silos that seemed do distant and inaccessible to patients and their caregivers?
For the past year we have all worked on this goal using our many talents and abilities. I have had the pleasure of speaking on panels with Ted several times. We are great together. The energy of the other makes both of us better. When the patient and the doctor work together as a team great things can happen. Last night I had the opportunity to co-present with Ted at Health 2.0 Stat in Bethesda. We spoke about the importance of the patient and goal of patient access. And reminded those attending that when we speak of patients we must not forget “the face of our father.” I came to speak about the ways art can effect change within medicine. I also came to talk about how books can save lives. And if failing that goal, how books can help a life have meaning.
Do you know this face? Do you know this name? He is not the patient in room 6218. He is not “unfortunate ym 39yrs old..” He is Frederick Allen Holliday II, Phd. He was a loving husband, a devoted father, a professor of film studies, and a great friend. He was hospitalized for 79 days with a diagnosis of kidney cancer.
I had the honor of being Fred’s wife for almost 16 years. He fell in love with me at first sight… twice. He first saw me painting a flat at OSU in the fall of 1992. He saw me from behind and my long hair was trailing down my back. He thought I was beautiful. I did not see him, and cut my hair short the next day. He met me again about a week later and we talked Stephen King. We both loved horror stories. My favorite was The Stand, and he loved the Dark Tower books. We were meant to be.
Do you know this face? Do you know this name? She is not “the wife in room unhappy with progress.” She is not “little miss A-type personality.” That is what Fred’s oncologist called me as I spent days trying to get access to the medical record. He told Fred, “that if little miss A-type personality wants information she should come to his office hours.” I did. He never stopped answering the phone, talking with his nurses and he never closed the door during my one appointment with him. This face is Regina Holliday. I paint myself in the picture. I am loving mother, an artist, and I was the wife to a great man.
I asked for weeks for access to my husband’s medical record. I was allowed to view an imaging report for three minutes by an internist. I am not sure I got much out of my three minutes, and he told me he wasn’t supposed to let me see the information at all. I went down to medical records to ask for a copy and was told it would cost 73 cents per page and I would have to wait 21 days. I have spoken about this event and blogged about it. I have often seen comments saying I must have not tried very hard to get the copy. I have something to say about that.
There is always a B story and an A story. My husband studied narrative and would have told you that. All the while I was trying to get access to Fred’s record I was trying get another very important book. When I realized the advanced nature of Fred’s cancer I began emailing my friend Deborah about Stephen Kings’s new book that would release in November- Under the Dome. She emailed the publisher’s rep, and he emailed the publisher. They got permission from Stephen King to print an advance galley. Fred was told he had tumors and growth on March 27th 2009. On April 7th 2009, I handed Fred a copy of a book that would not be available to the public for six months.
Thank God for that book. Fred read it during every transport for radiation. It helped him in his darkest hour. And thank God for the Dark Tower, for I would scream the words of those books over the train-rushing roar of the MRI machines. I was unable to get a copy of Fred’s record for many weeks to come. Once I had access to the record, I used it to create an easy to understand “facesheet.” That became the design of the Medical Facts mural.
Then three days after meeting Ted and all the rest of my new friends, I painted Fred’s Medical Record on a wall in a local Deli for all of our neighbors to see… Next, my new friends in the world of Health 2.0 began blogging about the mural. You can see their posts here, here, and here.
After spending a few weeks in hospice Fred was told he would need to go home. Our one bedroom apartment was too small for five people and a hospital bed so we would have to move. With the help of friends we moved on June 10th. Fred came home on June 11th. All of his Stephen King books were arrayed beside him. On the day he died we were still talking Stephen King. On June 17th he died. I thought of the Dark Tower and what Roland had said:
"I do not aim with my hand; he who aims with his hand has forgotten the face of his father.
I aim with my eye.
I do not shoot with my hand; he who shoots with his hand has forgotten the face of his father.
I shoot with my mind.
I do not kill with my gun; he who kills with his gun has forgotten the face of his father.
I kill with my heart."
— Stephen King (The Gunslinger)
On June 23rd I began painting 73 Cents- my personal Guernica, and no one would forget this face. I would use my eyes, my mind and my heart and vow to make health care better for us all. I painted 73 Cents from June 23rd to September 30th 2009. It is still there today, at 5001 Connecticut Avenue in Washington, DC. It is a monument to Fred and patients everywhere. And just like the internet, it advocates 24 hours a day, and you cannot tell it to shut up.
Soon you will see my newest painting Give Us Our Dammed Data at the Clinovations Gallery Show on 7-29-10. It shows 19 authors, and I wonder if you know their faces. I wonder if you know their names. I wonder… can we use our “Cognitive Surplus” and activate our “Consequential Strangers” to help “The Empowered Patient?”
These are the authors:
1. Sanjaya Kumar, Fatal Care
2. Jari Holland Buck, Hospital Stay Handbook
3. Janet Mitchell, Taking a Stand
4. Michael Millenson, Demanding Medical Excellence
5. Margo Corbett, The Savvy Patient's Toolkit
6. Sandra Gilbert, Wrongful Death
7. Trisha Torrey, You Bet Your Life, The 10 Mistakes Every Patient Makes
8. Dave DeBronkart, Laugh, Sing, Eat Like a Pig
9. Julia A. Hallisy, The Empowered Patient
10. Carolyn Oliver, MD, Cautious Care: A Guide to Patients
11. Elizabeth Cohen, The Empowered Patient
12. Sorrel King, Josie's Story
13. Lisa Lindell, 108 Days
14. John James, A Sea of Broken Hearts
15. Melinda Blau, Consequential Strangers
16. Clay Shirky, Cognitive Surplus
17. Martine Ehrenclou, Critical Conditions
18. Patrick Malone, The Life You Save
19. Evelyn V. McKnight, A Never Event
I have read many horror stories in my life, a lot of them were written by Stephen King. But these are the true horror stories. These people have taken their pain and anguish then condensed it into a book so others do not have to suffer as they did. In each book, you read about that horrible moment, when if only these people could have had real time access to the medical record, someone would not have had to suffer or die. It reminds me so of Stephen King. It happens often in his work. He warns the gentle reader, you could stop reading right now and pretend the story ended well, but often it does not end well. I have communicated with all of these authors via email. They want you to know their story. They want you to see their faces.
Do you wonder if it matters if someone hears the patient’s story? Do you doubt that working together we can create a better medical system?
On Tuesday the 13th 2010, I presented a speech at Health and Human Services about the importance of patient access to the electronic record during the announcement of the definition of Meaningful Use in the final rule. Politely, I echoed e-Patient Dave’s call to action- Give us our data. How did I get to speak? I spoke because a husband and wife who own a deli gave me a wall. A man who owns a gas station gave another wall. I painted and you blogged, tweeted, and posted on Facebook. We are all patients in the end. Together, let’s change the face of health care.
Check out this SlideShare presentation:
Let's change the Face of health care
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