Thoughts and Podcasts for the day

Before going on leave, I put pen to paper and managed to write two blogs to be published while I was away.   In case you missed the blog last week, called ‘Let’s be honest about ourselves’ you can read it here.   The second is as follows …..

Thoughts and Podcasts for the day

Although now a distant memory one of the benefits of having some down time over the summer break was the opportunity to do a bit of reading. One book that struck a chord was by surgeon, writer and public health researcher, Atul Gawande, called Being Mortal – Medicine and What Matters in the End.

If you are looking for an eye-opening and riveting book, I’d recommend this one. In “Being Mortal,” Atul Gawande takes on a question that everyone faces: How can we make our last days more comfortable, meaningful, and affordable?

In a medical age where we can do so much more to prolong life for the aged and terminally ill – the question that Gawande explores is just because we can do a lot more, doesn’t mean that we should.

He talks about how poorly equipped a lot of clinicians are to deal with issues around end of life care –   mainly because many physicians were trained in an era where the focus was on doing more.   While there is always a desire to prolong a person’s quantity of life, in some instances aggressive treatment of a person with a poor prognosis can be associated with more physical distress.

Doctor Gawande uses the example of a patient who had metastatic prostate cancer and had become paralysed due to the spread to his spinal cord. He pleaded with his doctors not to give up on him, which included an operation which would not improve his quality of life. He died very soon after surgery, hooked to a ventilator, unable to put his affairs in order and unable to say goodbye in a way he would have liked to.  

As a person’s life draws to a close, Dr Rawande, through the experiences of his patients and his own personal and moving stories asks us to focus on doing the right thing for our patients and ensure we never sacrifice what people really care about.   He introduces us to a range of people who provide advice on how we can have those critical and difficult conversations about end of life care and the implications in brings.

The book also examines, in a very potent and clear way how different countries approach the care of the elderly and how much society is changing on the issues of ageing and chronic disease. All things that we will professionally or personally face in one way or another.

It strikes me that our previous debate in healthcare has been about quality and safety – and indeed this is very much the flavour of Gawande’s past books such as The Checklist Manifesto. How to Get Things Right. But now we are facing the challenge of how we get the best possible outcomes for our patients and whaanau with a focus on patient experience and patient and whaanau centred care.   It’s an important debate to have.

This is worth a listen …..

I’m hooked on podcasts at the moment and recommend tuning into the BBC Radio podcast from Desert Island Discs. You can download this from ITunes. Desert Island Discs is a long-running BBC programme run from the UK. Each week a famous person is asked the question, if you were cast away alone on a desert island, which eight pieces of music, a book and luxury item would you choose to have with you? Each item brings up wonderful memories and stories, and you get to hear about people’s lives. On one occasion, I listened to Professor Peter Piot, a Belgium professor of infectious diseases. Professor Piot was one of the co-discoverers of the Ebola virus during its first outbreak in Zaire in 1976. He also became the chief advocate for worldwide action against AIDS and was instrumental in negotiating the reduction in cost of antiretroviral drugs in the 1990s that have done so much to halt the disease. Like the everyday heroes we come across in healthcare, Professor Piot, diligently works with passion, commitment and humility across his professional life.   His quiet heroism has made a huge impact across the globe.

If you have any books or podcasts you would like to share, please get in touch via email.




Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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