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Grief & Loss

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SARA LOMAX-REESE: Hello, this is Sara Lomax-Reese, it is 12:00 on Tuesday or a little after 12:00 on Tuesday and that means Health Quest Live and I have to be honest, I have a very heavy heart today and the next hour will be tough and I appreciate Barbara Grant sitting in with me.  By now you may have heard our dear colleague and friend, Fatimah Ali transitioned.  We were with her yesterday at the station and the day before at the Scotsboro Boys and the months and days before that.  She made our mid day morning sizzle during the Real Deal with Fatimah Ali. Fatimah offered smart, some times funny, sometimes biting, take no prisoner's perspective.  She was honest and honorable and we will certainly miss her deeply.

BARBARA GRANT: I know this is going to be really hard and we all right now ask your indulgence because we are reeling a little bit.  Our prayers and our thoughts are foremost with Fatimah's family and particularly with her daughters who are under the weight of this great tragedy right now.  So we are going to try to get through it; we really are trying to get through it and I guess you can't help but, as you have moments like this, to think about sort of your sharpest memories of folk and I immediately flashed back to almost when I first met Fatimah, she was an intern at DAS and we don't normally mention other stations but today we are going out of order in a lot of ways.  She was always sharp and committed and opinionated.  She was just unapologetic about her stand on many, many things and even though sometimes Fatimah could really be headstrong but she was always really thoughtful and that is one of the things that graced us as she spent time with us here at WURD that she was a thinker.  

LOMAX-REESE: She was a thinker and a professional and a journalist.  She was very committed to being a journalist and I want to invite and acknowledge our guest.  We are starting a new segment that will happen twice monthly with Dr. Donee Patterson, also known as Dr. Donee.  She is with Einstein Hospital and we are really excited and we really appreciate the fact that she has been very flexible in kind of being present for what we are experiencing here at the station today and we wanted to talk with her about the physical shock and some of the physical manifestations of this experience of loss and grief and I wanted to see you if you could speak to that.  Welcome, thanks for being here.

DONEE PATTERSON, MD: Thanks for having me.  I appreciate you letting me continue to be here today.  I know that the station is going through a really hard time.  It is a major, major loss for the City and for the Nation.  We are kind of changing our topics here today but we thought that we would talk about the emotion of grief and depressant and how long grief should last and there is a lot of debate on how long grief should last.  We will talk about that later, but basically grief is an emotional reaction to a significant loss and it can be anything.  That is definitely the feeling that we all have today, the deep emotional sense of a great loss and it can go on for days, months, years.  It is commonly held that there are different stages of grief.  We all go through different stages and each stage doesn't last a particular time; you can't say two weeks for this stage or three months for this stage.  There is definitely about seven different stages of grief.  The first one is shock.  I think that is what we are all going through now.  It is shock and denial and you kind of almost hoping, I don't know about you, but you are kind of hoping that when you said you had an emergency e-mail, I was kind of hoping you would pull it up and it would not be true, and actually maybe she was in the hospital and she was ok.  You have this kind of denial.  We all have that and I want people to know that's real and that it is not imaginary or made up or there is nothing wrong with you, that that sense of denial and shock is real.  Can you talk about the shock?  It's real.

LOMAX-REESE: Yeah, go head Barbara.

GRANT: I was just going to ask you what is shock almost because I think that we all right now just have a sense that we are sort of walking through a fog a little bit and we don't quite know what to do or what is appropriate and physically, I just had this sick feeling all day, like my stomach just feels sick and I don't know what to do with it.

LOMAX-REESE: I'm not sure why…how do you take care of yourself in moments like this, because I think it's not just emotionally but physically, what are some of the things that we can provide to that family?  To Fatimah's family in terms of support?

PATTERSON: There are a lot of questions there.  Barbara had asked what is shock?  That is a great question because it is all the emotions we are all feeling.  It is that denial, it's that surprise; it's the feeling that you actually feel sick and Sarah was mentioning that you just feel fatigued.  I talked to someone else earlier before I came here, she just said I just want to go back home and just get in the bed and kind of believe that this is not true.  All those emotions are real and then Sara you were asking me, so what can we do about these feelings?  Well, we have to allow our bodies to feel it; to just deny it or pretend that it didn't happen is not real; is not actually healthy for your body.  We have to let the family grieve; we have to give them their space but also it's kind of a balance; we give them their space but we also let them know that we are there for them in any way and you continue to be there because that is what they are going to need now.  They lost a major, major figure in their life and they are going to need support from the family and the community because I think what's going to help them is to know how much she was loved.

LOMAX-REESE: We could talk about this the whole time, but I also want to honor what you just said and don't create a public space, a public forum at this point, it's really too raw and too new.  What we originally had talked about talking about was how to get the most out of a doctor's visit and how we need to each take ownership and take responsibility for managing our own wellness and health and well being.  Why don't you talk a little bit about that since that is what you originally planned for?

PATTERSON:  I think it is appropriate here to talk about how to make the most of your doctor's visit and I'm not alluding that I know anything about Fatimah Ali's medical condition; I'm not saying that at all, but what I am saying, for the rest of us we need to make the most of our doctor visits so that we can be absolutely as healthy as we possibly can be.  It may seem common sense to some people but there are somethings that I hope we talk about today that we can hash out that every single person listening today will come out and say you know what, I hadn't thought about that; I 'm going to do that and make my doctor visit more efficient next time.

GRANT: And productive, that's the word that I thought you were going to use because I've seen these…there are a couple of commercials running on TV a bout how people question things in their lives and we will make lists of questions to ask certain kinds of people, or if you are buying a house you will have a whole list of things you go through to make sure that the house is in tip top shape and stuff like that.  But when we go to the doctor, we don't have a list.  We don't have a series of questions or things we want to check off to make sure that everything is tuned up.  I know I have left the doctor's office a lot of times thinking oh man, I forgot to ask him about that.

PATTERSON: Exactly, that's perfect.  So the very first thing I need people to know is that you need to be prepared for your doctor visit.  Like you said, we all have gone grocery shopping without our  grocery list but it is so much better if we have that list and so that is what I need people to understand.  Doctors, if you think about it, they have a schedule and when you schedule your appointment your part of that schedule so they don't necessarily have an hour to sit down and spend with you so you want to make the most of that 15-20 minutes, it doesn't seem like a lot but you can get a lot accomplished, you know you are on radio, you can get a lot accomplished in 15 minutes but the key is you have to be prepared.  So I really want people to think about their doctor visit as a before, during and after. Who is going to teach us this kind of stuff because your doctor doesn't have time to teach you think and your parents may not really think about it this way.

GRANT: And there is no handbook.

PATTERSON: No, no handbook so I want people to think about it today, think about your visit as before,    So before, be prepared.  If you are changing doctors, you send your records ahead of time, way ahead of time and then you call and follow up and make sure that your records are there because those records are vital, that's your history.  Then make sure that you have your questions written down, literally take time to sit down and think about OK, what are the questions that I have.  Not two seconds before the visit, that counts too but if you sit down the night before and actually think, OK what do I want to talk to my doctor about and write it down.  Get a .99 cent book from the dollar store and that will be your medical book and you write down all your questions.  It is so helpful, but I just want to stop there and say if you have 35 questions, you have to be realistic that your doctor is not going to be able to answer all those 35 questions and many times people come to me and they do have their list and the thing that are important to them aren't necessarily the things that are important to me.  OK, let me reword that.  The things that are most important to them, may not be the most important things to me.  For example, if someone ays their nails are discolored or they are having elbow pain, those things are very important to me, but also if they say they have chest pain, that's going to move to number one on my list.  So yes, I want to address your nails and I want to address your elbow, but the chest pain moves to number one on my list.  So you have to be realistic, pick your top three and let your doctor talk about their top three as well.  So you have to be realistic, you may not be able to talk about 35 things.  OK, so going back to the before, so you have your medical records sent ahead of time, you have your questions all written down but make sure you bring your medications, that's very important.  I want to see the bottle, I want to see who ordered it; there's a lot you can get from the bottle, the pharmacy number, the previous doctor's name and number if you want to call and you have a question, but if you don't have the actual bottles, bring a list.

LOMAX-REESE: What about if you are talking supplements and vitamins and things like that?  Is that important to bring as well?

PATTERSON: Love that, very important.  People don't realize that over the counter medicines are medicines to us, we have to know what not to give you that interacts with what you are taking at home. Birth control, that's also a medication, people forget to tell us that, and vitamins, those things are very, very important to us.  Yes, bring a list of all that.  Oftentimes people bring me these bags of tons of things and they don't realize they are taking duplicates of medications or duplicates of vitamins and there are vitamins that you can get an overdose of so they have it hidden in one bottle and hidden in another and when I can see it, I can tell you, this is excess, let's get rid of that and we can downsize and save you some money at the same time and save your life sometimes too.

LOMAX-REESE: I'm curious Dr. Donee, in terms of diet, because it seems like, I know if you are going through certain procedures or you're on certain kinds of medications, there are certain things you are not suppose to consume and so I am wondering if in those kinds of office visits, if there is a conversation around what you are eating, not just what you are taking in terms of supplements or medications.

PATTERSON: Definitely, it should be a part of your physical exam that your physician asks you well what you are eating.  Well what kinds of things do you eat?  Do you eat fruits and vegetables; do you eat junk food, fast food, what kinds of things are you eating? There are certain medications that interact with food; there are certain medical conditions that interact with certain foods so yes, your physician needs to know what you are eating and that is all part of being prepared.  Another thing is to make sure you have your specialists listed and it helps to have your specialist's phone numbers and fax numbers because if I get lab work on your and you have a cardiologist or even your gynecologist, I can fax them a copy of your medical records so they don’t duplicate things that you don't actually need to have duplicated.  So bring your questions, brings a list of your medications, bring a list of your specialists, jot down a normal diet for you, the kind of things you might eat and it's real important that people remember not to be late because remember, you are part of a schedule and people don't rally like to talk about that but you are, you are a part of a schedule and just like on radio, it doesn't hold for anyone, so your time will pass so don't be late, because you want every single minute of that time to be yours, right? Then, think about the clothing you are going to wear, if you have a knee problem and you were the tightest jeans ever, it might be a little hard for me to examine your knee.  Well we can take off your clothes, but just kind of think about that, if you have a mole you want me to see and it's way in the back and you have on a long dress and we can't get it off, sometimes those things make a difference and it takes up time too.  So you want to think those things ahead.  Then, lastly, you want to remember to bring a friend because sometimes, especially if you have a lot to talk to your doctor about, sometimes two ears aren't as good as four ears so your friend may hear some other things that you may not hear and they are often helpful to have someone else there.  Sometimes it's a sensitive exam, you don't want to bring a friend but if you have a lot of serious concerns, you may want to bring a friend.  So that's before.  During, you just want to, again, be realistic about that exam and you don't want to be embarrassed.  We all have things we don't really want to tell our doctor and it may be sensitive.  Maybe guys have erection problems or women have GYN problems and they are embarrassed, but they are your doctor.

GRANT: A good question about that is how confidential is that conversation you have with your doctor?

PATTERSON: It should be 100%, 150%, 200% confidential.  It's between you and your doctor, that's it and anyone else you want in the room, but basically it is about you and your doctor.

GRANT: Is there a legal obligation?  The reason I am asking is because I have to say this, some folk who go to the doctor are doing little stuff that they maybe shouldn't be doing and they clearly don't want to tell their doctor about it but if people have confidence that that conversation is going nowhere and honestly won't be reported to authorities, they might be more prone to be honest.

PATTERSON: It's the oath that we take and doctors are human, but it's the oath that we take and that is what we have to live by.  I often have said this to my patients, if you can't talk to your doctor and be honest with your doctor how can I help you?  You come to me, how can I help you.  Often times I say it to my patients, I appreciate that you felt comfortable enough to say that to me because that's what I am here for.  It is not our job to be judgemental; it's not my job to judge or to give advice about what you've done.  It's just my job to help keep you healthy and move you forward.

LOMAX-REESE: Yeah, but doctor's are human.  I have been judged by doctors before and it doesn't really serve any purpose other than make you feel bad but I think that is a really important question and especially when we start talking about medical records being electronically stored and all of those things because I think to Barbara's point, the confidentiality of what is going on in your medical history becomes that much more prone to being breached if things are electronic.  

PATTERSON: I hear you, that's a whole other issue, a whole other show but I do want to comment that I like the concept of an electronic medical records because it keeps things from being duplicated; it keeps specialists talking to each other; it keeps everybody on the same page.  The confidentiality issue is a concern for all of us and it's a genuine concern, it really is but as far as doctors being human, they are, but really you should have a doctor that you trust, if that's not the person for you then you should have someone else.

LOMAX-REESE: Absolutely, I think that is the other piece in terms of how do you find a doctor and what do you do.  A lot of times if you are pretty healthy you just stick with who you have, even if you don't love them, you don’t think they are great, and then heaven forbid something happens and you really need to have that relationship with that doctor, it can sometimes be more difficult to find somebody new when you are in crisis as opposed to when you are in a maintenance mode to find somebody who you really have a great kind of connection with.

PATTERSON: That's an awesome point.  So Sara is emphasizing that people should find their doctors when they are not in a crisis mode and I think that is perfect because you can go and you can in a sense interview your doctor and find if you are comfortable with them.  If we were at a bank that was messing up with our money, would we stay at that bank?  No, so you have to have someone that you feel comfortable with and I love the fact that Einstein has outside satellite family practitioners and internists and you can actually go and search based on the location and you can search based on the name and you can look on Einstein's website and see some of their interests and see some of the medical conditions that they specialize in and yu can do your research ahead of time and maybe kind of think kind of pensively about how to pick your doctors I think that's an excellent point.

GRANT: You also had some of the before, during and after algorithms set up, is that were you were going?  What do we do after?  How do we follow up?

PATTERSON: So a little bit about during just real quick.  You have to make sure that you understand everything your doctor has said to you.  Does he want you to exercise, does he want you ….


PATTERSON: He or she.  More fruits or vegetables, you need to know exactly what they are expecting of you to do and then make your follow up appointment before you leave and if you go home, I think one of you said, if you go home and you forgotten what they said, call back and leave a message because I would much rather you know the correct answer than to wonder about it for three months before your follow up.  So if you have more questions, either you can schedule a follow up or you can send a phone call in and say you know what, I had another question can someone answer this question.  But then after the visit, you need to have your things in order.  Does your doctor want you to do lab work? Does your doctor want you to see a specialist?  Is your doctor expecting for you to get that x-ray or ultrasound before your follow up?  So you need to be very clear about what your homework is.  I call it a honey do list, I probably shouldn't call it that, but what your homework is before you go back because it's a little useless if you go back to your visit and your doctor was expecting you to get blood work, ultrasound and see a specialist and that is what he or she is basing their next step on and you have done nothing.

LOMAX-REESE: Well that is really comprehensive.  Before, during, after.  That is much more than I have ever prepared for an office visit and I think it is really valuable because you are right, those moments are so precious and they can either be really helpful and healing or they can be very, like a drive by.  I think that the strategies that you suggested are outstanding.  I know that we are just about out of time.  You are going to be coming back in about two weeks?


LOMAX-REESE: What are we going to talk about then?

PATTERSON:  February is heart month so we have two dates in February, and I believe it is February 7th is the first one and we are going to be talking about heart disease in African Americans.

LOMAX-REESE: All right, that is a very, very critical issue that all of us need to pay attention to. I want to thank you Dr. Donee for being with us on this difficult day and for kind of being flexible and moving in and out of some topics with us as we move on.

PATTERSON: Thank you for having me, always.


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