Mukta Panda, MD, remembers an important lesson she learned as a resident on her first cardiology rotation. The teacher was not an impressively credentialed professor, but a patient.
Because she was not the primary caregiver on the case, Dr. Panda recalls feeling embarrassed that she was not doing more as it progressed. “All I did was hold her hand,” she said.
That gesture resonated with both patient and physician and endured after the patient recovered. “I still have the card she made for me with two hands on it,” Dr. Panda says.
A professor in the University of Tennessee Health Science Center’s College of Medicine in Chattanooga, Dr. Panda believes this scenario illustrates the value of building relationships in health care. This is a central theme of a new book she has written in which she aims to humanize health care for those who administer it and those who receive it.
The book, “Resilient Threads: Weaving Joy and Meaning into Well-Being,” was published in the spring by Creative Courage Press, just before the coronavirus circled the globe. However, its focus on personal reflection and self-care, as well as community awareness and connection, may be applicable now more than ever in the health care arena and the general public.
In the book, Dr. Panda, the assistant dean for Well-Being and Medical Student Education in Chattanooga, uses stories from her life to deliver her message of the power of personal connection in any interaction.
“I speak in this book, not only as a physician,” she explains. “I speak as an immigrant. I speak as a woman in academia. I speak as a daughter and a mother with gratitude for family. And I speak as someone who is human, and to say this with humility, as someone who has gone through the same and similar paths as many stories I have heard from others, I feel like I want to give them a voice and permission to know that they are not alone.”
An internal medicine physician, Dr. Panda was born and grew up in India. She is the daughter of two physicians and the mother of two adult children. She studied and practiced in India, London, and Saudi Arabia. A Fellow of the Royal College of Physicians (RCP–London), she came to the United States in 1990 as the Gulf War commenced. “Coming to the United States had been on the horizon while I was training in London and the Middle East, but the Gulf War certainly expedited it,” she says.
Immersed in a new culture with two small children, she knew she had to redo a residency training to practice. She took time to be a mom for two years, but realized she missed the long-term relationships and cognitive detective work of internal medicine and decided to retrain and complete her residency training in internal medicine.
A natural storyteller, she feels her own history has shown her the value of personal relationships, something that may get lost in the urgency of health care and in the training of those who practice it.
“Having been blessed with the opportunity to train in so many different countries and cultures and then having role models growing up, especially in my parents as physicians, that (personal connection) had sort of been the norm,” she says. “When I came to America and was in an educator role myself, I found myself struggling to find the words and the correct ways to really make sure that we were taking care of the whole patient. And over the past years, in my own experiences as a physician, as an educator, and as a leader both in education and in health care, I have held the tension of how do we humanize medicine. It often feels that we are speaking two different languages.”
In this dissonance, she says, patients and their families can get lost, even though everyone involved wants to do the right thing. At the same time, physicians may feel frustrated and experience burnout from the stress of always caring for others and not taking time to care for themselves.
“So, the book I have written is meant to give hope to everybody that by building relationships, with really caring for the person, we may be able to bring the patient back into the center,” she said. Physicians, too, may find more joy in the connection with their patients and be kinder to themselves in the process.
In “Resilient Threads,” Dr. Panda recounts the story of a well-dressed older woman who came to her for a check-up and continued to schedule appointments regularly every six months over three years, though nothing particularly demanded attention. The personal connection between patient and physician was the draw. When the woman moved away to be near family, she painted a portrait of Dr. Panda, which still hangs on the doctor’s wall.
“I never knew she was a painter, but she taught me a lesson that she connected with me and she had no expectation,” Dr. Panda says. “And I was glad for that lesson, because now, it has even given me more reason to tell people my story and for me to get to know a person better.”
Such connection is a two-way street in the best health care, she believes.
“We teach our medical students to take a history,” she says. “What is history − his story, her story. And we (physicians) are human beings. How can we dissociate our stories from their stories? So, when we give permission for people to share, what we do is we listen to that person’s story and we reflect it back to them. Isn’t it important that we reflect our own story, too, and claim it as our own story? And then we give invitation and say, ‘we’re in this together, so let’s try to work together with the system and build a relationship.’ ”
Helping the Next Generation
Dr. Panda has dedicated her career to encouraging physicians do that.
In 2009, she helped establish the statewide Gold Humanism Honor Society for the UTHSC College of Medicine on the Chattanooga campus, and currently serves as chapter leader and adviser to the group, which recognizes medical students who serve as role models for the human connection in health care. The chapter’s efforts recently were recognized by its parent organization, the Arnold P. Gold Foundation, with its Exemplary Award, the highest given by the foundation to a chapter that continuously strives to increase engagement and empathy in the community, encouraging resilience and team building, teaching advocacy and leadership skills, and highlighting compassionate patient care.
In May, Dr. Panda was invited by the College of Medicine’s 2020 graduating class to deliver the Hippocratic Oath at graduation. She is also working to establish another oath as a fixture of medical education at UTHSC to strengthen the physician-patient bond. The Oath to Self-Care and Well-Being offers permission for physicians to care for themselves in order to be able to care for others.
“This is something that all medical students are going to have to have, because this is a stressful career,” says Jeanne Jemison, MD, an associate professor of Medicine working with the Office of Student Affairs in the UTHSC College of Medicine. “It’s only getting more so. And it’s not a matter of if, but when, they will face incredible challenges. So, I think she is hopeful, as I am, and she put in her book, maybe the next generation of doctors will be more resilient because they didn’t wait decades into their career to gain strength through self-awareness and storytelling.”
Shelly Francis, founder of Creative Courage Press and publisher of the book, believes it has the potential to change some views on health care. “I wanted to capture a story of a woman in medicine, who can help this generation pay attention to their inner life and their health and wellness at a soul-deep level,” Francis says “She can’t be a medical educator for everyone, but with her book, she can reach out to not just students, but the leaders who are teaching them, too.”
“Resilient Threads: Weaving Joy and Meaning into Well-Being” is available in hardback, paperback, and ebook from all booksellers and at Creative Courage Press.