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Children’s Health: Who Helps the Healers?

Tuesday, June 20, 2006 at 1:23 PM

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This week, we focus on the topic of children with cancer - stories of struggle, survival and loss. Starting Wednesday night on WVIZ, the PBS documentary A Lion in the House will plunge viewers into the lives of five families who are trying to cope with their children's struggle with cancer. Over the course of four hours, the filmmakers show how the stress of this often terminal disease affects not just the patient, but also nearly everyone he or she touches. It's the focal point of our look all this week at childhood cancer. This morning we begin with the perspective of those who are often left out of the emotional equation - perhaps mistakenly so. That's the medical staff. ideastream's David C. Barnett examines who helps heal the healers.

Justin Ashcraft, the teenaged son of a southern Ohio family, has just been rushed into the intensive care unit of Cincinnati Children’s Hospital. In a small room to the side of the ICU, members of the Ashcraft family are weighing their few treatment options.

Attending physician Ted Zwerdling’s pessimistic diagnosis really bothers Justin’s mom, Debbie.

Debbie Ashcraft: When Zwerdling comes in, he’s just Mr. Doom and Gloom. I just kind of avoid him, now.

Dr. Zwerdling’s matter-of-fact manner, in this scene from A Lion in the House, makes him seem cold to some family members. But, the fact is, he’s seen families try to hold onto a loved one too many times, and he doesn’t think it does anyone any good.

Ted Zwerdling: There’s a huge difference between being negative and realistic, although the line can be quite fine. I don’t feel I’ve been negative. Just realistic and giving them my best opinion.

Robert Arceci: I try very hard to do it as best as it can be done, but even then, you walk away feeling like, you know, ‘I could have done that better.’

As head of Oncology at Cincinnati Children’s Hospital, Robert Arceci and colleagues like Ted Zwerdling faced such issues all the time. And Arceci says it’s pretty much the same at Johns Hopkins University in Maryland, where he currently heads the Pediatric Oncology Division. He adds that his own medical training didn’t prepare him for the emotional costs he’d personally have to pay.

Robert Arceci: The first time you have to sit with a child and/or their family and tell them they have cancer isn’t something that you can just pull out of your hat.

Arceci thinks there are too many myths about physicians.

Robert Arceci: Most parents or patients figure, well, you must know the right answer, so tell me what to do. But, often in our field, we don’t know what the right answer is.

Canton native Marietha Woods is sympathetic to the plight of doctors who have to constantly face parents that are emotionally distraught. Woods is the mother of another teenager featured in the film, and she witnessed the psychological toll on the caregivers.

Marietha Woods: There were times when we’d be at the clinic and I’d see a doctor with his head down and he was just frustrated. Even up on the floors, when they would come from doing rounds, and they were just frustrated and tired and feeling like they didn’t have any options.

George Pallotta is a Pediatric Psychiatrist at MetroHealth Medical Center in Cleveland, and like Robert Arceci, he went to medical school with the hopes of helping families though traumatic situations. But he says, all too often, physicians are on their own to confront their own personal feelings.

George Pallotta: If you’re dealing with a horrible automobile accident of a girl or a child or a baby, you feel awful, but you become a machine. You just do what you need to do to save lives and then, if you’re healthy enough, you go home and you can bawl your eyes out and cry, or download. Or, if you stuff it, it takes a toll on you. You have to learn to deal with the stress.

Pallotta says, in recent years, he’s noticed a trend in his profession to pay more attention to the emotional needs of medical personnel. One tool that’s growing in popularity is called “critical incident debriefing.”

George Pallotta: Since 9/11, that’s been the big term. When so many of the rescue workers at the Twin Towers were so depressed from the get-go, because they knew there weren’t going to be very many survivors. It’s still ill-defined, but basically, it’s, at that moment, taking people aside and say ‘Tell me what you’re feeling. Let’s talk about it. Let’s get it all out.’

Robert Arceci says the technique has proven to be highly effective.

Robert Arceci: We have a team at Johns Hopkins that actually comes in and debriefs staff, together and individually, after a death. And I think this is an enormously important thing that every place should do if they don’t do it. Because, we don’t tend to take care of ourselves. And that eventually gathers steam over the years.

George Palotta thinks that, sometimes, doctors can be their own worst enemies.

George Pallotta: They have this image of strength, and if they show weakness, how can they help these families? But, I know that families really appreciate it when a physician will weep with them, or anything, as opposed to being stoic and at a distance, because they want to see the human side.

Pallotta says that if more doctors realized that, they might not turn into machines.

George Pallotta: I think that physicians think that if people see the human side, they’ll think that’s weakness. But, in reality, people don’t mind seeing the human side.

David C. Barnett, 90.3 News.

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