The Intersection of Laughter and Bravery with Lady Glaucomflecken: Part Two

Episode Transcript

Dr. Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa.

Dr. Peters:
And I am Dr. Katie Peters and this is The Brain & Life Podcast. Well, it is dejavu today everyone, and welcome to our Brain & Life listeners. We have a second helping of Lady Glaucomflecken, AKA, Kristen Flanary, wife of Dr. Glaucomflecken and Social Media star in her own right, you can check her out online. And also they are touring in their humorous show, Wife and Death. Today she tells us more about being a co-survivor and highlights the importance of doctor-patient communication. Then we will hear from our doubly boarded, wow, it is a double episode today, from our medical expert, Dr. Jessica McFarlin, and she is doubly trained in neurocritical care and palliative care medicine. If you missed part one, definitely check it out and welcome again Kristen, and thank you for joining us.

Kristin Flanary:
Thank you. Thanks for having me.

Dr. Peters:
Now I totally understand your term co-survivor.

Kristin Flanary:
Oh, thank you.

Dr. Peters:
I totally understand that. I talk about care partners and caregivers, and I even have another term, care guiders, that's another one for people that are more like are a caregiver, but then flip to the advocacy space, so they're guiding others. But I think co-survivor is a great concept and I think that brings out the social psychology side of you.

Kristin Flanary:
Yeah.

Dr. Peters:
Can you sort of tell us more about how you conceptualize co-survivor and what it means?

Kristin Flanary:
Yeah, so that really came from, I mean, even with the cancers, the two cancers, I remember feeling like, "You know what? This is affecting my life just as much as his life, not my body, but my life in the same way. And no one's even looking at me. No one's asking me if I have questions. No one's asking about am I okay? They're all paying attention to him, and rightly so. It's not either or, but it should be both." If someone comes into the room with a patient that has a serious thing happening to them, that's an indicator that their lives are very closely intertwined. Let's just be humans to each other and check in. But that didn't happen even with the cancers. And then with the cardiac arrest, it was even worse because that was much more traumatic. And he always tells the joke that he didn't really experience it.
He just went to bed one night and woke up in the ICU with no underwear on. That was his experience of the whole thing. But I really had to live every moment of that. And it was extremely traumatic to watch your husband die under your hands. He was turning colors, he was making those sounds, which later I learned is agonal respiration. His body just was not moving in ways that humans move. When the paramedics moved him, it was twisting around the stairs and it just was not human. Everything that I saw happened to him was not what a human should look like. It was very bizarre and traumatizing to see at all. Even if you were a bystander for a stranger that would be traumatic and then having it be your husband, it really was traumatizing. So after he came home, I was very traumatized.
At that point, I could sort of exit crisis mode. I was good in a crisis. I have ADHD, so that paid off. But once the crisis was over, then I was traumatized. That's when it all set in. And this is going to get really nerdy, and I am a huge nerd, but even at the time I remember thinking, "Oh, this is really interesting." I have the cognitive neuroscience background, the psychology, and then I was working in marketing communications. And so what happened, I think in retrospect, I don't know, you might be able to speak to it better. I'm writing a book about it actually. And so I'm doing some research right now into what exactly was happening.
But what I experienced was I just sort of couldn't use my brain. I couldn't use my thoughts, I couldn't use... I couldn't really access language. I could talk about certain things like logistics. I could manage that and I could manage his care. But aside from that, I just was shell shocked, essentially my eyes and my face, my friends would tell me later that it looked like I was a ghost. I was just vacant. I felt very haunted by everything that had happened. And I remember just people would try to talk to me. They would call and check in, friends and whatnot, and I would really try to pay attention to the conversation and what they were saying, but couldn't.
It was just sounds, I acknowledged sound was coming into my brain and then it was just leaving. It didn't process at all, and I couldn't really respond. I could do maybe a one word answer, but it was just so slow and foggy up in my brain and I just wasn't there. And so in retrospect, I don't know, I'm trying figure that out, but even at the time I was like, "This is so interesting. I wonder, is my prefrontal cortex not working? Is it Broca's area? Is it what's going on?" Obviously not with that level of enthusiasm, but it did cross my mind.

Dr. Peters:
We could have done a functional MRI and saw that half your brain was just turned off. I mean, I think it's more a survival mode, and it's almost like you already had to process huge amount of material. It's almost like your brain had to reset. And I can see something sort of just turning off. Maybe it was like you slowly have to add, I guess, life back to your life.

Kristin Flanary:
Right. It just did not feel important to listen to whatever people are saying, right? It's not the event that my brain is trying to process the most in that moment, but also there was a dissociative piece to it. That's the piece that was like, "Oh, this is fascinating." It was detached and even doing the CPR I felt like I was watching our life together flash before my... Memories were coming up, flashbulb pictures in my mind from college and just kind of running through the whole story chronological order. And it was kind of like when people describe watching floating on the ceiling and looking down or whatever, it was kind of like that. So I don't know, dissociative PTSD is the closest thing that I've found that feels like what the experience was.

Dr. Peters:
I can get that.

Kristin Flanary:
I know there's also selective mutism that might apply. I'm not sure. But so that was a legitimate trauma that lasted a year and a half before I could really fully come out of that and what got me out of it, this is another reason language becomes very important in this co survivorship story because the things that got me out of it, finally, I called it the quiet place. My mind went to some quiet place and there weren't any words. It wasn't language. I couldn't really access language very well. But then when I found language that explained what I had gone through, I came out of the quiet place and I was like, "That is profound. Something is happening."

Dr. Peters:
That is profound.

Kristin Flanary:
So the first thing I found was this guide. It was a lay responder guide written by a paramedic in Canada named Paul Snobelen, and he had noticed that bystander responders always were very upset afterward, and they tended to have the same questions. And so he just wrote a guide that answered all those questions, and basically it's very sensory. It's like, "Why did I see this? Why did I hear this? Why did I feel this? What is happening?" Your brain just ruminates on those questions until it has answers. And so by taking the time to explain it in accessible language to bystander responders, it lets our brains relax about that. It resolves it for us, and it brings some peace. And then I also read a book by Dr. Rana Awdish called In Shock that I recommend everybody read, but especially if you're in healthcare, she is a critical care physician.
And she became, while working as a critical care physician, became a critical care patient and went through a very harrowing ordeal. But the thing that really resonated with me is that as a patient, she saw all these gaps in the healthcare system and in how the healthcare system uses words. Things like the patient is circling the drain or they're trying to die on me. Things like that that are not malicious, but definitely insensitive and kind of an oversight of even if the patient seems non-responsive, they may still be able to hear you. There were times she describes that she wasn't able to say something, but it offended her. It's offensive and it makes you feel like you are failing somehow by fighting for your life. And you want to feel like your team is fighting with you and is on your side, that they're not using adversarial language about you. It's very, very provider centric to talk that way rather than patient centric, right? It's like this, "What's making my job hard right now?"

Dr. Peters:
Yeah, exactly. And I think one of the things that, and thinking that this happened during the pandemic, and I do think that when patients are in the ICU, they can hear things, they can sense things. So some of it is also being just alone for long stretches of periods of time, and then having somebody come in the room that's in a gown, that's in a bee suit, it's in that crinkly thing. And then trying to process what you're going through. And I can see why your husband, the first person he probably wanted to ask about was to ask for you because first of all, you were both in the bed together at that time.

Kristin Flanary:
Yeah, I was there when he went to sleep, but now it's like, "Where'd she go?"

Dr. Peters:
Where did she go? What happened? What's going on? But I think also it's a comfort level, and so I always try to encourage if my patients in that situation, I always encourage their loved ones because they can be in the hospital with them now. It's like, "Give them a hug, talk to them, talk to them like you talk to them normally maybe and be kind generally, be a little funny."

Kristin Flanary:
Exactly.

Dr. Peters:
I'm going to ask you also about your alter ego and you're going to have to help me. I'm going to try. It's a Lady Glaucomflecken.

Kristin Flanary:
Yes. Lady Glaucomflecken.

Dr. Peters:
Is that the best I've done so far?

Kristin Flanary:
Yeah, it was really good.

Dr. Peters:
I'm like, "Oh my gosh." So can you tell us about your alter ego and how it came about?

Kristin Flanary:
Yeah, so for that, we got to back up a little bit, rewind. That started because... So my husband used to do standup comedy starting from high school. He lived in the Houston area. He would go to these comedy clubs that he had to be kicked out of by a certain time because it had to be 21 plus after that, but it was just something he really loved and he was trying to decide, "Do I try to do comedy for a living or do I become a doctor?" Because those were the two things he was interested in. And he said he just saw all these older people in the club still trying to make it as a comedian, and he's like, "I think I might be a doctor." So he went that route, but he never really lost that comedy bug.
And after the first cancer, he really kind of relied on that to process, a lot of dark humor happening after that and light humor too. But it just gave him a way to sort of process his experience in a way that made him feel a little more in control of it and to be able to wrap his own mind around it to make jokes about it. So that happened then. And then once he was in residency and got cancer again, he went back to the same thing. Obviously when you're in med school and residency, you don't really have a lot of time to be going to comedy clubs though, and workshopping material.
So he did that online instead because at that point, this was like 2016, there was a website called GomerBlog, which was kind of like the Onion but for health care, and he applied to write for that website. And so all of their writers had to have pseudonyms, and they were all funny names to be on brand with this thing. And so he said, "Well, I'm an ophthalmology residency. What is the most ridiculous word in ophthalmology that's funny, and I'll go with that?" And so he picked Dr. Glaucomflecken.
That's literally how it was born, that's all it was. And then eventually he moved to Twitter and he started trying to workshop his ideas for funny articles. He would just do a little nugget of the idea on Twitter and see what hit. And then that just completely snowballed. That was around the time that med Twitter was really starting to pick up steam.
It was a fun place to be. And he just kept... I mean, this was for years. This went on for three or four years, and he would just be giggling in the corner on his phone. I'm like, "What is happening over there?" And eventually I'm just like, "I think if I'm ever going to talk to you again, I have to do it on Twitter. That's just where you're spending all your time when you're home." And so I got on to just sort of see what all the fuss is about. It just seemed fun. And I also wanted to be able to be in on the jokes and be able to talk about these people that I was hearing the same handles that he was talking about, the people that he thought were really funny and enjoyed talking to. So I just kind of wanted to be part of it.
And so I got on as Lady Glaucomflecken, again, all of this is just silly social media hobby, fun, free time things. And then I took my job very seriously. My job there at the time was to be his heckler. So that was kind of how I started, was basically just roasting him on med Twitter. But then once the cardiac arrest happened and all of that, then I sort of shifted. I had built up an audience as Lady Glaucomflecken of about 60, 70,000 people, small potatoes compared to his, but because I had the ears, the eyes of 60 to 70,000 mostly healthcare providers and students, I had some things to say about my experience in the healthcare system as a co-survivor. And so I really then pivoted to using that platform for advocacy.

Dr. Peters:
I think that is just awesome, and I hope that you continue and because-

Kristin Flanary:
Oh, thank you.

Dr. Peters:
... I think we need to have that happen. And you just did a tour, you did Wife and Death.

Kristin Flanary:
Still touring, yeah, we're working on setting our next dates. We had to kind of take a bit of a hiatus because of life and parenting, and he still works full-time as an ophthalmologist. But we're still setting dates for more shows. It's a live stage show called Wife and Death that is based on our story. And it's, believe it or not, it's a comedy show. It's kind of a dramedy, I guess, or a tragic comedy. We do get real about the hard stuff, but true to our brand, that's just how we cope is through writing and speaking for me mostly, and then humor for him. And so we kind of combined the two and made a comedy show about our story and sort of inadvertently about the healthcare system in America based on our experiences with it.

Dr. Peters:
And so when you've put yourself out there now sort of in this space of how you have interacted with the healthcare system, how you've interacted as a co-survivor and a caregiver, what have you learned from your audience?

Kristin Flanary:
I think I have learned, and I should start with like you mentioned at the beginning, I have been with Will since college. So I have been married to medicine from pre-med all the way to private practice. I've seen the whole thing from this insider, outsider perspective. And I know because of all the training journey and stuff, I know so many people who are doctors and they are wonderful people. The vast majority of them got into medicine because they wanted to help people. And of course, you have to make a living doing something.
And so the salary is somewhat appealing, less so the more that student, the debt comes into play. But mostly they want to help people and they just really enjoy science. And so I have such softness and tenderness in my heart for physicians. I wouldn't be married to one if I didn't. So all of that is to say I had some really, really awful experiences, especially in my cardiac arrest. There's a whole part I didn't get into of I got to go into the hospital briefly, and a lot of... I didn't get to see him while I was in there, but I got to interact with some physicians.
And those interactions were just as traumatizing, honestly as the cardiac arrest itself. So for example, one of the cardiologists from the emergency room told me, "Well, I would've liked it better if you had seen him collapse." And I know what he meant. I was not offended, but it was still hurtful. What he meant was if we knew how long it had been between the time he collapsed and the time CPR was started, that would give us a lot of information that would be helpful right now.
And I knew that, I interpreted that in the moment that way. But it also felt like that language, again, back to language is so important, that language put the blame on me. It made it feel like I did something inadequately and I had just fought for his life so hard, and I wanted to feel like they were fighting for his life just as hard and we're all on the same team. And that kind of damaged that feeling, and it made me feel like I had not done enough. So that was one example. Another example was they... And again, I understand this and I have so much sympathy for it because it was COVID and we didn't know at that time if he had COVID, if I had COVID, there was no vaccine for COVID, there was no treatment. It was a very scary time, but they put me in a waiting room in a part of the hospital where the walls, it was radiology, the walls were lined with lead and there was no cell signal.
And so here I am alone after having just done CPR on my husband. And not only am I completely in shock and traumatized, but I'm now also the liaison between the whole rest of our family and close friends, as word is getting out about what has happened. And of course, they all have questions and I'm trying to get answers for myself. I'm trying to pass those answers onto them. And without any cell phone signal, I can't do any of that. And so I would walk down the hallway a bit to where I could get signal, but I could still see that room. And again, it's an empty hallway and I'm at the very end of it when I am out there using my phone. I would go out there, use the phone, go back to the room, wait some more.
Next time I needed to use the phone, I would go out there, use it, come back, so on and so forth. I did that maybe three or four times, and they came up to me, the people from the front desk who had let me in, which I saw that I was entering only because it was an end of life case because of a sign on the door. That's how I found out that it was an end of life case. Anyway, that same person from the front desk came over to me and said that I had to leave the hospital because I was making people nervous.

Dr. Peters:
Oh my gosh.

Kristin Flanary:
And I get it. Again, I understand what she meant was, we don't know about this COVID thing, and it already made us nervous to let you in here in the first place. And so we're already on edge, and then now you won't stay where we put you, and so we have to ask you to leave. I understood logically, but again, it's like... So now I don't get to be with my husband even though it's an end of life case. I don't get to be there. And then I had to go home and hear everything else through very infrequent updates.
And again, I get it. They're busy. They're doing other things. I want them to be attending to my husband. I want them to be doing those things. But it's still hard. It's still hard to only get updates. And when you're not there, you don't get to see what's his color like, is he breathing normally? The little tiny signals that when you know someone so well, you can kind of tell, "Okay, I know he's intubated and all of that, but I think other than that, he seems like he's holding up okay or he's not. This isn't normal. I know my husband." I didn't get to do that. I just had to hear occasional updates. And those are just two examples.
So there were many others. And so this is all a long way back to your question of what have I learned, it's that there are all these gaps in the healthcare system, and none of them, again, I love physicians, none of them are being malicious. These gaps aren't there on purpose. They're not there because people think that family members are not important. They're not there for any of these reasons, they're oversights. It's that the system was not designed for those things. And so there are gaps in those areas. So that's all I try to do is shine a light on the gaps that are there. Not to blame, not to shame, not to say anyone should have done something a particular way, just to show people like, "Hey, we should probably patch this up."
And some of that might be, "Hey, physicians, be aware of your language. Just be a human. Think about how this is going to affect people on a human level or how this person that's in the room, they're having their own experience of this illness, even though their illness isn't in their body, it is still very much affecting them. So let's be kind." I don't expect physicians to be providing psychological support or to be doing things that are outside of the scope of their practice. I want physicians to be doing what they're best at. I want them to be in there working on that disease, that event, whatever it is, I want them to fix it, but I want the system to provide psychological support. I want there to be some avenue that people can utilize if they need to. And so I'll hear from some people that say, "Oh, well, at our hospital we have a chaplain or we have a social worker or whatever." And I'm like, "That is great. That should be standard."

Dr. Peters:
Exactly. I think pointing out the gaps is extremely critical because there could be people that have other solutions, right? There could be solutions.

Kristin Flanary:
Exactly.

Dr. Peters:
And again, what you're saying is you're probably not going to change a lot of people's personality, right?

Kristin Flanary:
Sure.

Dr. Peters:
But maybe you can make things where a little bit of shine a light on the fact that there are some problems with empathy at times. And I think because you've adopted the word co-survivor, and I know I keep on coming back to that, and I loved how you said, I'm also dealing with this disease. I'm also the one affected. I think that it brings it back to really the experience of when you're in the room, you need to be part of the process, of a part of the system. It's not going to be perfect. No system is, but you're part of the process. And I think that's so great of what you're really shining a light on. And so I would predict this is going to continue to grow because you're going to continue to have these conversations.

Kristin Flanary:
And I hear from so many people in my DMs that say, "Oh my gosh, I have not had a word for this, but this is me. You have just put a label on 10 years of my life that I've been struggling with." And that's what that word meant to me. I found it in an article by Katie Dainty and Kirstie Haywood talking about... They used words forgotten patients and co-survivor. And when I saw that was back when I was in the quiet place, it was one of the things that got me out of there is when I saw that, I was like, "Yes, that is it.
That is the thing that I am trying to resolve emotionally and psychologically. That is why this has bothered me so deeply is because I also... I am a co-patient. I'm a co-survivor of this cardiac arrest. It happened to me too," and just nobody thinks of it that way, ourselves included, the co-survivors included, because we don't have a name for it that's widely adopted through society. So I'm trying to really spread the... I've got it on my shirt even.

Dr. Peters:
I love it.

Kristin Flanary:
I'm trying to spread the co survivor word so that we can have this framework to understand this experience.

Dr. Peters:
Well, I would say you've opened my eyes. I cannot wait to read everything you told me about. I'm totally going to take it. I've drunk the Kool-Aid. I'm going to use it for my patients because one of the reasons why I do this is I learned so much from talking to care partners and caregivers and patients and advocacy people. And then I'm like, "I can bring that back to my patient. I can't wait to tell somebody that." And that's why we do this podcast. But first of all, Kristen, you are a gem, a true gem.

Kristin Flanary:
Oh, thank you.

Dr. Peters:
I really appreciate... You spent so much time with us. And I just want to say thank you for really sharing your experiences and your unique thoughts about being a caregiver, a parent, a wife, a loved one, and also a co-survivor. So you have to check out Kristen at her alter ego Lady-

Kristin Flanary:
Glaucomflecken.

Dr. Peters:
Glaucomflecken. Glaucomflecken. I will someday get it. Glaucomflecken. It's at Lady Glaucomflecken. What is it again, Kristin?

Kristin Flanary:
Yeah, Glaucomflecken. So you can go to glaucomflecken.com and that sort of houses everything we're doing. But I'm also on social media as Lady Glaucomflecken or Kristin Flanary, either one. You'll all come up. And then if you go to our website, you can see everything that both me and my husband are up to.

Dr. Peters:
Well, that is so awesome, and thank you again. You've spent so much time with us. I really appreciate it.

Kristin Flanary:
Oh, thanks for having me. This was fun.

Dr. Correa:
Is this episode leaving you wanting more? Get the latest tips on healthy living and management for more than 250 neurologic conditions by visiting brainandlife.org where you can learn more about neurology every day powered by trusted neurologists.

Dr. Peters:
Let's continue our discussion with our medical expert from last week, Dr. McFarlin. And your practice really hones in on the idea of communication training for providers with sort of that idea of maybe physicians are not necessarily the best communicators. And one of the things when you listen to the episode with Kristin Flanary is she said one of the doctors actually said to her, "I wish you could have been there earlier so we know more about how this started." And she felt like at that moment, she did not know necessarily how to process that. But later on, in hindsight, she felt like they were blaming her almost. And so how do you make medical providers better communicators in these kind of situations?

Dr. McFarlin:
Right. Oh, and that's devastating to hear that. And I think that most of us go into medicine because we really want to help our patients and families. And when we get into our medical training, sometimes we don't get taught some of the skills we need to have high quality communication with families. It becomes what we call part of the hidden curriculum that we're supposed to just pick it up on our own sometimes by seeing people do a good job at communicating and sometimes by people seeing a bad job communicating. And I think as we're seeing that as physicians in training, we decide for ourselves either like, "Oh, maybe I'm not really good at this or they're better at me than this." Not realizing that there are skills that we can learn to be better communicators, and we have to, as well as learning skills, we have to have some capacities that we work on as a physician too. So those capacities are things like making sure we're listening, making sure that we are building in reflection, making sure that we're being kind and patient.
And as we always think about those in our practice, then we add skills to those capacities. So skills like asking open-ended questions, letting patients and families lead, letting them tell us what they understand before we tell them what we understand. Responding to emotion is really important because if we're delivering serious news, families are going to have an emotion around that. And we have to give that emotion space so that they can hear what we're trying to say or teach. And then really learning how to deliver serious news, really learning how to help patients understand prognosis and how to make a plan for the future based on what they value, what their goals and values are when they have options in their medical care. But those are a lot of the things I think that we don't realize we can learn and practice along the way to help our communication. And that there's great training in it. There's great ways to get better. There's great ways to learn from your mistakes. We're going to make mistakes when we're trying to communicate hard news.

Dr. Peters:
And you mentioned before that a lot of your conversations, they're not happening with the patient necessarily, it is with the caregivers in those critical situations. So how can we provide the best support to those caregivers in critical situations such as an unexpected or lengthy neuro-intensive care unit stay for their loved one?

Dr. McFarlin:
Yeah, I think that the best way to do it is really thinking about the patient and the family from lots of different perspectives. So not just the medical perspective and do they know what's going on, but also how is this affecting them physically? How is it affecting them emotionally? How is it bringing up old events that they've had that might be impacting this care and how to attend all of those things, and one person can't do all of those things. So in an ICU setting, one of the things we have the benefit of is an interdisciplinary team. So it might be a chaplain, a social worker, a bedside nurse, the doctor, somebody like a music therapist, somebody that we can bring in to support the patient and the family during the unknown, because the unknown is really, really scary.

Dr. Peters:
I agree. There's a lot of fear in the unknown, and a lot of... I one time did a early radio recording, not a podcast, that was just about the Fs of cancer, and one of them was fatigue. One of them was fear. And I remember that fear can be really palpable, especially if you don't know what's going to happen. One of the other things that Lady Glaucomflecken, also known as Kristin Flanary said to us is that she felt like a co-survivor after her husband's battles with cancer, two cancers and also with the cardiac arrest. And he is hence recovered, but she feels that she's given herself that moniker because she's part of that process. I wonder, what do you think about the paradigm of co-survivor for caregivers?

Dr. McFarlin:
Yeah, that is such a good way to describe it. We know that even if the outcomes out of an ICU stay, say for a cardiac arrest, for example, even if the outcome for the patient is good, that their caregivers suffer increased risk for anxiety and depression and increased risk for post-traumatic stress disorders. So we have to make sure that for those co-survivors, we're honest about that. We tell them about that so that they don't feel surprised or embarrassed to ask for help because they've put all of their attention on their loved one and maybe aren't taking care of themselves. And there's some shame and guilt that comes with feeling scared or shame and guilt with feeling like, "Gosh, this affected me, but I wasn't the real sick person." But so letting them know too that that might happen to them and how to set them up with mental health providers, with primary care physicians, with support groups to help take care of that.

Dr. Peters:
So in this space, sort of with palliative care medicine in the critical care unit, are there any sort of new interventions or new strategies that are bubbling up that are affecting either research or medical education?

Dr. McFarlin:
We are working to really understand how patients and their families are affected long-term by serious illness. And one of the things that's been emerging are post-ICU care clinics.

Dr. Peters:
Oh, cool.

Dr. McFarlin:
Yeah, it's really great. post-ICU care clinics kind of acknowledge that this person may get better from their brain injury, whatever that looks like. But the way they're cared for has to be different because they're more at risk for illness. They're going to come out probably with more debility than what they went in with, which means we have to think about things like physical therapy, occupational therapy, cardiac and respiratory therapy. We have to think about care for anxiety and depression. We have to think about care for their families. It changes everything from where is someone living now? Are they going back and forth to tons of doctor's appointments? Are they no longer working? So that's really a growing field to sort of understand how do patients post-critical illness improve and how can we make both not only the medical support, but the psychosocial support better for family members.

Dr. Peters:
And I think that I feel very close with my patients and they deal with a cancer diagnosis, but when something sort of traumatic, like a cardiac arrest happens and then seeing recovery later on in those outside clinics, I would think that that would be a satisfying experience for both the patient, the caregivers, and the providers to see that they've recovered full circle. And I actually had that happen to me on Tuesday because one of my patients had a cardiac arrest. He was coded three times and was in the Duke Neurointensive Care unit, but now I'm seeing him six months later and he looks like a gem. He looks great. He's playing tennis again, shout out.
It's really amazing. And so that whole experience, and I remember just going to visit him and his wife. I wasn't really doing anything from a neuro-oncology perspective. There was nothing going on in his tumor. But I think going to see him while he was the neuro ICU and being like, "Hey, you're going to be okay," and giving his wife a hug was really important that those kind of... So I like the idea that you're going to have post-clinics because I think that you're going to get that experience of the other side of what happened for those patients.

Dr. McFarlin:
100%. One of my favorite things when I'm in the neuro ICU is a lot of patients, they don't remember anyone in the neuro ICU, right? But we remember them. So when someone walks back through with their family member who we've gotten to know and they are walking and they are talking and they're back to doing some of the things that they did before, it is such a light for us, and it's like a light bulb moment. It's like, "Yes, this does happen. People do get better." And it just is a really good reminder. So I would encourage families if they do have a good outcome, go back and see the ICU if it's safe, if it feels safe for them and safe for the patient because it's a really good teaching moment for all of us that are working in those spaces.

Dr. Peters:
Because we want good outcomes. It's sometimes a good outcome is not necessarily like that someone is still with us. Sometimes a good outcome is peace. It's a sad outcome, but it can be peaceful, and I'm sure you deal with some of those transitions too.

Dr. McFarlin:
Right. And I think I always think about how do we best care for families that have lost a loved one? And one of the things that we do on the palliative care side is we always send letters or a note after someone has died to sort of, A, wish them peace and give them a contact information for how to contact our team if they need help with bereavement care. Because part of that being a co-survivor is grief and bereavement. So whether that's access to their local hospice, even if the person was not enrolled in hospice care, hospices provide 6 to 12 months of bereavement care for anyone that's lost someone in the community that they serve. So we try to make sure we make those connections.

Dr. Peters:
Yes, it's so important to have access to those. Thank you so much for sharing your insights and expertise with us, and of course, thank you so much to our listeners.

Dr. McFarlin:
Thank you.

Dr. Correa:
Thank you again for joining us today on The Brain & Life Podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life magazine for free at brainandlife.org.

Dr. Peters:
Also for each episode, you can find out how to connect with our team and our guests along with great resources in our show notes. We love it when we hear your ideas or questions. You can send these in an email to blpodcast@brainandlife.org and leave us a message at 612-928-6206.

Dr. Correa:
You can also find that information in our show notes, and you can follow Katie and me and the Brain & Life Magazine on any of your preferred social media channels. We are your hosts, Dr. Daniel Correa, connecting with you from New York City and online at Neuro Dr. Correa.

Dr. Peters:
And Dr. Katie Peters joining you from Durham, North Carolina and online at Katie Peters MD-PhD.

Dr. Correa:
Most importantly, thank you and all of our community members that trust us with their health and everyone living with neurologic conditions.

Dr. Peters:
We hope together we can take steps to better brain health and each thrive with our own abilities every day.

Dr. Correa:
Before you start the next episode, we would appreciate if you could give us five stars and leave a review. This helps others find The Brain & Life Podcast. See you next week.

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