Author: Giskin Day

I am a senior teaching fellow in the Centre for Co-Curricular Studies at Imperial College London. I teach medical humanities and communicating science, and co-ordinate the Science, Culture & Society field of courses within the Imperial Horizons programme.

BMJ Careers dispenses some advice on doctors accepting gifts…

… and concludes that it is not a good idea. The article, which cites this blog, is here. It looks like sensible research on gifts from patients has not been done since the 1980s. The ethics of accepting gifts are well rehearsed and there are clear guidelines. An understanding of why gifts are offered, however, is lacking. There is much speculation about cultural reasons, or potential bribery, but getting the heart of the supererogatory actions that inspire acts of gratitude would help to inform policies on these issues, and also give us an insight into what patients think about the issue.

Automated feedback texts

An article on the Guardian’s ‘Comment is free’ website is attracting a lot of attention. Within two days of posting, it has been ‘shared’ on social media nearly 27,000 times and attracted 650 comments. The article is a first-person account of experiencing a miscarriage. The couple received excellent, sympathetic care, undermined somewhat by an automated text the next day asking, ‘How likely are you to recommend our A&E department to your friends and family if they needed similar care or treatment?’ The text presented a 5-point Lickert scale and asked respondents to text back 1 to 5 on the basis of how likely there were to recommend that A&E.

Patients bearing gifts

The online journal Hektoen International has an article this month by Anthony Papagiannis on unusual gifts he has received from patients, which includes a knitted waistcoat, a wooden model of temple, an icon and several signficant books.

He says, ‘the unselfishness of the act speaks louder than words. It is behavior like this that makes me forget the injustices of the system, the small and large tragedies that I encounter daily in the practice of medicine, and keep going.’ Gratitude for gratitude.

Gratitude poem

I love this poem by Sue Sun Yom (to whom I am grateful for permission to reproduce it here). It is published on p. 111 in an anthology called Body Language: poems of the medical training experience, edited by Jain, N., Coppock, D. and Brown Clark, S., published by Boa Editions, NY: Rochester.

Gratitude

Mr. H, taciturn and a little odd, Whose wife preferred another man, And who would come faithfully Late by fifteen regular minutes Each Friday. Mrs. V and her loyal Veterinarian daughter, the other An internet mogul in Hawaii, Who wanted only for us to spare The eyebrows, though she’d lost All sense of self and hair.

The ‘Thank you’ project

This is a sad story with a heartwarming ending. When Kellie Haddock’s son Eli was a few months old, the family was involved in a card accident that killed her husband and left Eli with serious injuries. A chance meeting at a prayer group led to a film being made of Kellie finding everyone involved in saving Eli’s life, thanking them personally, and inviting them to a concert to celebrate Eli’s recovery. The blog posting about how it came to be made is here.

Toasty thank you on ‘Saturday Live’

The programme ‘Saturday Live’ on Radio 4 has a regular slot where listeners say ‘thank you’ for good deeds. Health care professionals are regularly thanked on the show. Today (3 January) there was a lovely item in which a nurse was interviewed about thanks expressed by patients. The story started some months ago when a patient, Rami Seth (sp?), came on to express thanks for a slice of warm toast smuggled in by nurse Rosie Wilson while he was recovering from major surgery. Rosie spoke eloquently about how touched she was to hear the thanks expressed. It brought home how a small gesture, such as delivering a slice of warm toast, can mean a great deal to patients.

A creative expression of gratitude

Rina Dave has found a wonderful way to celebrate the healthcare professionals and her friends and family who are supporting her through he treatment for cancer. She has created large-scale photographs of caregivers, each personalised by an ‘accoutrement’ that gives a glimpse of their personalities. Read more about the exhibition, on display from  17 to 30 November 2014 in the main entrance of Imperial College.

Gifts as commodities in the NHS?

I have been reading an influential essay by Arjun Appadurai, ‘Introduction: commodities and the politics of value’ from Appadurai, A. (ed.) (1986) The Social Life of Things: Commodities in Cultural Perspective. Cambridge: CUP, pp. 3–63.

Although focused on ‘commodities’ which implies an economic context that is missing (overly at least) from the NHS context, points in the essay have made me think about how one might frame a critical study of gratitude and the giving of gifts to healthcare professionals.

It is not customary to give gifts in the NHS (although this needs further research). Most anthropological studies of gift-giving are focused on the trajectory of gifts within relatively isolated, small-scale societies.

Gratitude for whatever

Angus D H Ogilvy has written a cycle of poems in response to his diagnosis and treatment for cancer, called Lights in the Constellation of the Crab. He performs his poem, ‘Gratitude for whatever’ here.

Gratitude for Whatever

I can’t be anything other than grateful.

What’s the point?

Anger? Hatred? Jealousy? Lamentation?

It is too hard work.

Gratitude is the point of least resistance.

Through the casualness of ‘whatever’ in the title, and spelled out more explicitly in the poem, the poet suggests that gratitude is the default emotion – the one that requires least work to achieve. The tone of the poem is one of resignation.

‘Yours gratefully…’: the Frimley Sanatorium correspondence

Frimley Sanatorium, established in 1905, was the country outpost of the Brompton Hospital for Consumption and Diseases of the Chest. Its purpose was to provide a healthy environment for patients who were deemed capable of making a good recovery from TB. After a few years it was realised that follow-up records were vital for understanding the impact of the changing treatment regimes at Frimley. It fell to the Lady Almoner at the Brompton Hospital to persuade patients to keep in touch with the hospital after they were discharged.

Report on the after-histories of patients discharged from the Brompton Hospital Sanatorium at Frimley, in Surrey, during the years 1905-1910, emphasising the need for follow-up.