Painting Your Words

On April 24-26, I was honored to attend the Fifth Annual South Carolina Patient Safety Symposium.  I flew in a bit early, so I was excited to find out I had time to walk around the neighborhood around the conference hotel.  I was staying at the Columbia Marriot, so before going on my adventure I asked the concierge if she recommended any local destinations.  She told me if I drove 15-20 minutes I could go to a nice shopping center.  I replied, “I am walking (as my friend Ted Eytan often encourages).”  She looked at me and said, “Well, there is not much around here.”  Then reaching under the counter she said, “You might like this place.”  She handed me a brochure for the Mast General Store.

Then I began my adventure.  The area surrounding the hotel was an aesthetic gem of texture and history.  I past some shops that were shuttered with soap covered windows.  But time and time again, I peered into shops that looked as though they began their life in the 1960’s and had not closed or renovated in the past 50 years.  I walked by the most dapper men’s suit shops and saw jackets that would look so fine on the backs of The Walking Gallery. I counted three wig shops that my friend Tiffany would love. 

I stepped briefly in the Mast general store and it presented like a Cracker Barrel if it opened in Downtown Annapolis, MD.  It was very clean and very well displayed and very touristy.  I did not stay long.  Nearby there were several independent art galleries and a small independent art store.  I was so happy.

Next, I found a wonderful dress shop.  It is called Coral’s. In that shop there was the most helpful staff that showed me glittering dresses of every hue under the sun.  Then they listened to the story of Fred Holliday and learned the reason why I speak for patients. I bought a new dress and then headed out the door to the local beauty shop for a little “maintenance.”

Whist I was in the beauty parlor, I thought of Surgeon General Regina Benjamin as I spoke to the stylist about healthcare and HIT throughout the entire appointment.  When the stylist was helping other clients, I listened to the local radio station play six advertisements/announcements relating to health in South Carolina. 

Then it was time for dinner and it was like old home week!  I saw Christine Bechtel VP of the National Partnership for Women and Families, Jennifer Sweeny also of the National Partnership, Maureen Bisognano President and CEO of IHI, Rick Foster Senior VP of Quality and Safety at the SCHA (South Carolina Hospital Association) and Helen Haskell Founder and President of Mother’s Against Medical Error.

As we sat down for dinner, I noticed a large number of people went to sit at Atul Gawande’s table and Helen’s table, I went over to sit next to Mary Stargel the Administrative Coordinator of SCHA and Cheryl J. Dye a professor at Clemson University.  I was so excited to meet Mary as I have exchanged quite a few emails with her over these past many months.  I learned that not only was Mary handling details of the conference she is also a young mother and enrolled in college course work. Cheryl made a great dinner companion as well and spoke of her work at the Institute for Engaged Aging. It was a delightful evening.  I said thanks to our hosts and headed back to the hotel.

The next day was the first conference day and I painted “Silos.”

In this painting the silos that separate providers, patients and professors are breached.  Hands strain far above the green grass as each person tries to connect with each other.  To the far left is a cowboy.  He is a reference to Atul Gawande’s speech focusing on safe surgeries.  In medicine certain doctors are called “cowboys” when they do not function as team players.  This is alluding to the wild-west where a man is a law unto himself. But Atul recently interviewed a real cowboy and let us know that a working cowboy is more pit crew than lone gun.  He depends on the work of a team to save the cattle in the herd, and even the lowliest member of the team can call out an alarm when things are going wrong.      

The next figure is a nurse holding a child.  Here is the voice most often missing in the conference speaking agenda.  She is trying to balance so much and rarely has someone to speak for her at events like this one.

The next figure is Atul Gawande himself.  His is straining to create a connection between the child and a young mother.  Upon his chest he has a check mark representing the surgery checklist.  During his presentation he showed a great clip from ER showing how very important it is to have a surgery check list. Atul’s goal is to drop surgical death rate below 1%.  He mentioned in the world-wide launch of the surgery checklist the biggest pushback has come from physicians.

Between the nurse and Dr. Gawande is the community.  During the second keynote Eric Coleman, MD said that the majority of healthcare occurs in the community, not in the clinical environment.  If we want great changes in health we must begin at a community level. 

Holding Atul’s other hand is a pregnant woman wearing a shirt that says “39weeks.”  This image referred to a fun video that started our conference day.  In the video staff and children showed the importance of triple aim concepts like hand washing, the surgery check list and postponing elective cesareans.  They tied each film vignette together with an Olympic theme.

Holding hand’s with our pregnant mother is a patient.  The patient is holding out a balanced level.  This is a direct reference to Eric Coleman’s remark that we must meet patients at their level.  This was closely followed by a demand that should be a rallying cry for the e-patient movement.  “We must retire the word non-compliant.”  It is an excuse to give up on a patient, and whenever this word is used it reflects badly on the provider who uses it.

To the patient’s left is Cheryl. J. Dye holding a fishing pole and a FedEx box. The FedEx box is a reference to Eric Coleman’s remark about the word patient at it is used at medical conferences, “Could we just replace the word patient with the word FedEx package and have the same conversation?  I think yes.”  Cheryl holds a fishing pole to reference the old adage that we should not just give the starving man a fish to eat, but instead we must teach him how to fish.  This adage applies to caregivers and patients alike, 42 million caregivers provide 80% of the care for chronically ill.  We must be given the tools and support to do our jobs and be part of the care team.

To Cheryl’s left is Ethel from Maureen Bisognano’s speech.  Ethel was a patient in a care facility who was wasting away after the death of her husband.  She was given more and more pain medications and medicine, but nothing stopped her failure to thrive.  Each day Ethel would make one request of her nurse.  She wanted a dog.  One day her nurse was near an animal rescue on her way to work.  She found a dog for Ethel. Ethel made a miraculous recovery in a matter of weeks.  She now plays the violin for the other residents instead of wanting to die. 

That is the story behind “Silos.”  Next it was time to move my easel to the Awards banquet luncheon. Helen Haskell would hand out Patient Safety Awards in the name of her son Lewis Blackman.  The South Carolina Philharmonic serenaded us with an amazing triumphant eulogy as we ate and I painted “The Fame of Hope.” 

In this painting, I place Lewis within a flame.  He is slightly older than the day he died from a medical error.  His face is brightly lit and turns from the viewer to the woman he holds in his arms.  A young African American woman with babe at breast looks with a worried glance into the eyes of the young man before her.  She and her child represent all the lives saved by the safety initiatives that have been enacted in the name of Lewis.

I painted this while crying for a Lewis I never met, as a friend from his childhood sang:

“I've heard it said

That people come into our lives for a reason

Bringing something we must learn

And we are led

To those who help us most to grow

If we let them

And we help them in return

Well, I don't know if I believe that's true

But I know I'm who I am today

Because I knew you...

Like a comet pulled from orbit

As it passes a sun

Like a stream that meets a boulder

Halfway through the wood
Who can say if I've benn changed for the better?
But because I knew you
I have been changed for good." 

“For Good” from the musical “Wicked.

We must all have hope of a change for good.  That flame of hope burns brightly and is fueled by those who died untimely deaths.

On April 26, I painted the final painting “Awards of Transparency.”

Here the background is filled with an endless expanse of circles.  They are Olympic circles, they are microbes, and they are the dots that represent each one of us.  Before these circles, a figure stands.  She is a medical provider clothed only in the awards of excellence.  She has embraced fully open and transparent care.  She accepts the patient and caregiver as team members and using every tool at her disposal to fight against infection and medical error.

This painting is a challenge.  Could you walk down the street wearing only the awards of excellence in patient safety?  If you did so would you be “clothed?”

I thank the team that brought me out to speak and paint in South Carolina.  I leave inspired by the life of Lewis and the courageous campaign of his mother.  I will do the best connect Silos, because though my arms may be short, my heart is large. I will do my utmost to always remember the awards of transparency are not silver and gold medals, but instead represented by lives lived.