Volume 24, Number 6: June 2023
The IAHPC thanks its longtime members individually, and asks for their answers to a few questions. Below are answers by John Ely, a palliative care physician, geriatrician, and assistant professor at the University of Minnesota in the United States, and IAHPC member since 2008.
On His 10-Second Ritual Before Seeing Each Patient & More
"So many people in our field have stared into the gaping maw of unmet need around the world and done things that truly matter to patients and their families," says Dr. John Ely, citing inspirational individuals who have changed his life.
That is one of many interesting answers he gave to questions posed to him as a longtime member of IAHPC: loyalty, he says, is "meaningful to me; the things IAHPC does are of practical and tangible value around the world."
Describe something that you have you learned on the job that could help others in their palliative care work.
"Although it can be considered cliché, I perform a 10-second ritual when preparing to enter a patient’s room. As I wash my hands, I try to center myself and be more mindful and aware. I remind myself to not be lost in my own thoughts, but to listen to the patient/family with the intent of understanding rather than being in a hurry to offer up an answer. I remind myself to set aside my own concerns (Am I running late? Have I formed initial impressions that may not be accurate? Does something about this patient 'push my buttons' or cause me to have inaccurate bias? Am I becoming impatient because it’s 3 p.m. and I have three more consults? etc.). Performing this small ritual as I start each patient visit helps to keep me more consistently 'present.'
"Also, all of us are aware of the therapeutic effect of silence after delivering a piece of bad news, to give the patient/family time to process what they’ve just heard. We know it as the 'don’t just do something, sit there' response. These silences can last longer than usual pauses in conversation. If the patient doesn’t break the silence, I may ask, 'What was going through your mind during this last minute?' I have found that this open-ended question can extend their opportunity to respond."
What piece of advice do you have for someone considering the field of palliative care?
"If you’re still in training, try to access a palliative care rotation, and see how it feels. Find an advisor or mentor to support you in finding the right career path for you. I believe there’ll continue to be a lot of opportunity in our field, and if it feels like the right thing to do, go for it!"
What palliative care advance is needed most in your practice (or your institution, region, or country)?
"Here in the United States, development of primary palliative care services is a high-level need. Young clinicians, both primary care and sub-specialty level, will be caring for people with acute and chronic serious illnesses; it’s essential that they be able to communicate effectively in a patient/family-focused manner, and to provide pain and symptom management for their patients."
What drew you to palliative care?
"I began my career as a family physician, and while I enjoyed many aspects of this speciality, 'corporatization' was beginning to have an effect on how physicians practiced: increasing pressure to see more and more patients, and spend less and less time with them. At the same time, I saw how my own grandmother had access to end-of-life care that included effective symptom management and compassionate family support. It was a different sort of care than what I had learned. I decided to do a geriatrics fellowship, and this exposure to palliative care principles and practice cemented my decision that palliative care was for me."
Why did you join IAHPC the first time?
"I grew up in a small town in Nebraska. I credit the process of seeing health care and life in countries other than my own as having changed my life, personally and professionally. Shortly after my geriatrics fellowship, I followed my interest in Russian and Ukrainian culture by taking trips to Moscow and St. Petersburg. I saw firsthand—for the first time—what serious illness and end-of-life experiences were like in some countries other than my own, and wanted to participate in palliative care efforts in these places. I learned of IAHPC via an early mentor, Mary Callaway, and joining seemed the natural thing to do."
Delicious! Delicioso! Délicieux! Läckert! Köstlich! ???! ??????!
Heartwarming Tortilla Soup
By Lina Rozo, IAHPC Finance Officer
Houston, Texas, United States
I love this recipe because it is both easy to make and is a family favorite, especially during the winter months.
Tortilla Soup Recipe
(serves 4)
Ingredients
- 1 chicken breast, skin removed
- 1 cup chicken broth
- 1/2 cup water
- 8 ripe tomatoes
- 1 Tbsp oil or butter
- 1/2 onion, chopped
- 5 cups chicken broth, divided
- 8 corn tortillas, torn into small pieces
- 2 Tbsp cilantro, chopped
- 12 avocados, diced
- 1/2 cup mozzarella cheese, grated or cubed
- Totopos (corn masa tortilla chips)
- 1 jalapeno pepper, seeded and golden fried in oil for 1 minute (optional, use more for greater heat)
- Sour cream
Instructions
- Simmer the skinless chicken breast in the chicken broth and water for 20 minutes. Remove from the heat, drain off the liquid and let the chicken cool. When cool, shred the chicken and set it aside.
- Roast the tomatoes for 30 minutes in the oven at 400 degrees, remove the skin and set aside.
- Heat the oil or butter in a pan and add the chopped onion with a sprinkle of salt. Cook until the onion becomes transparent. Add the roasted tomatoes and 1/2 cup of chicken broth, and simmer for 15 minutes.
- Add the rest of the chicken broth and the torn tortillas to the tomato mixture. Simmer, stirring occasionally, for 45 minutes. Season with salt and pepper to taste.
- To serve, divide the shredded chicken between the bowls then add the broth. Top each bowl with cilantro, avocado, grated mozzarella cheese, totopos, jalapeno, and sour cream.
Submit YOUR recipe!
We invite members to share a favorite recipe and the story behind it: what makes it meaningful for you. Self-care is important, and eating well is a great foundation for it. These dishes are for caregivers and palliative care professionals to enjoy.
We want to publish recipes that reflect who you are and where you live, using low-cost, local ingredients and standard equipment. They should be easy and relatively quick to prepare. Please be sure to include a photo!
List of Members
A list of individuals who joined, or renewed their membership with, IAHPC during the past month.
Membership renewals
| Name | Country |
|---|---|
| Alyson Gundry | Australia |
| Kathleen Introna | Australia |
| Penelope Tuffin | Australia |
| Farzana Khan | Bangladesh |
| Erna Rochmawati | Indonesia |
| Andrea Martínez de la Vega Celorio | Mexico |
| Jose Miguel Guerra de la Garza | Mexico |
| Oladayo Afolabi | Nigeria |
| Norwegian Association for Palliative Medicine | Norway |
| Julia Ambler | South Africa |
| Marcos Lama | Spain |
| Cheryl Marks | United States |
| Cristina Montañez | United States |
| Andrew Amata | Zambia |
New members
| Name | Country |
|---|---|
| Seenas Kavumpuram | India |
| Erfin Firmawati | Indonesia |
| Jo-Ann Marie Mendoza | Philippines |
| Christopher PIromalli | United States |
| Reid Jacobs | United States |
See the full list of IAHPC members