“There is something about physically putting pen to paper, that connection between your mind and your body that is just very health-inducing. And it takes time. And often we do not dedicate the time to taking care of ourselves and something as simple as writing in a journal, writing these, you know, these pieces.

In eight minutes, you can get a lot done. It’s been amazing what people come up with. And so I think the first part is just committing the time and giving yourself the space to do something that is fun and really brings pleasure.”

Janet E. Patin is a family physician.

She shares her story and discusses her KevinMD article, “Stunning new medical conditions overlooked!”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at kevinmd.com/rate. Subscribe at kevinmd.com/follow. Today on the show, we have Janet Patin. She is a family physician. She wrote a satirical article, “Stunning new medical conditions overlooked!” Janet, welcome to the show.

Janet E. Patin: Thank you. Delighted to be here with you.

Kevin Pho: So we’ll get into your KevinMD article in a little bit, but first off, can you just share your story and journey to where you are today?

Janet E. Patin: Sure. I am a family doc. I grew up in the Midwest, in Cincinnati, Ohio, and did my undergrad at Yale. You know, I always knew that I was going to be a doctor. Two of my best friends growing up had parents who were physicians. So with a lifetime of medicine ahead, in college I decided I would do something else I was interested in, and I was a religious studies major and wrote my senior essay on Jonathan Edwards, our greatest theologian.

Then I did medical school back in Ohio at the Ohio State University and came out to Portland for residency at Oregon Health and Science University. We had studied the Oregon Health Plan in my medical school, and I really wanted to be part of that better way of covering patients.

Then I spent 18 years in a small town. I wanted to be a big fish in a little pond, and so I moved to the coast, to a town of 4,800, where we were not just clinic docs but also ER hospitalists, and I was a hospice director. I did a full spectrum of family medicine until my kids got old enough to need more intensive schooling, and then I made it back to the burbs. I’m now in Gresham, outside of Portland.

Kevin Pho: I’m a primary care internal medicine physician, and everywhere you read, primary care is going through a tough time. So tell me some of the challenges and rewards of primary care from your perspective.

Janet E. Patin: You know, we get to take care of the whole person, and it’s not so body-system focused. We try to see the whole family, and that’s been one of the delights, seeing multiple generations. It helps to understand people’s social situation. I have done home visits in order to better understand where people are coming from, and I have been able to indulge my own personal interests of helping people with chronic pain and, you know, end-of-life planning.

I’m no longer doing OB or deliveries, and I’ve shifted my focus toward helping people prepare, instead of for the beginning of life, for the end of life. Starting those conversations about meaning and purpose in life has been a real privilege.

Kevin Pho: So you mentioned that some of your interests are palliative care and chronic pain. I think those can sometimes be very difficult cases and difficult conversations. So tell me some of the challenges that you have to overcome in treating some of these conditions, specifically with patients with chronic pain or in end-of-life care.

Janet E. Patin: We are so focused on doing, and we have so identified ourselves, not just as physicians but, I think, in our culture, as what we do. You know, you go to a party, and the first thing people say is, “Oh, what do you do? What’s your business?” When you have disability or chronic pain or addiction problems, that shifts, and we have to change our conversation from doing to being. What’s important to you, and how do you change your goals of the day from accomplishment to relationships? And, you know, why should we wait until the end of life to have those conversations?

You know, doctors are stressed, and we deal with these intense things all the time. Adding joy and humor into our lives is really important at the end, but it is also important right now. And so that was the impetus, I think, for writing a little something lighter.

Kevin Pho: So let’s talk about that KevinMD article. It’s a satirical article titled “Stunning new medical conditions overlooked!” Now, for those who didn’t get a chance to read your article, just walk my audience through it and share the story of why you decided to write it.

Janet E. Patin: Well, you know, I had always done some writing as a kid. I sort of wonder if there’s a book in me. I have friends who have published, and I realize writing takes dedication and time, like anything worth doing. A book is not going to spring fully formed from my mind like Athena from the mind of Zeus.

During the pandemic, it was an opportunity. It turned out not to be the fantasy free time that I had always thought that big stuff, everyone stuck at home, would be. I have two full-time jobs, you know. I am a family doctor 40 hours a week, and then I’m a family doctor another 20 to 40 hours a week. But my reaction to stress is to add things to my schedule.

So I discovered writingmedicine.org. It’s through Stanford, and it is a Saturday morning writing course for medical professionals, and it was a lifeline through the pandemic. We get together for an hour. The writer and director, Laurel Braitman, gives us a little bit of a pep talk, some lessons, and a prompt, and we write for eight minutes and then read to each other. It’s just been delightful.

One of those prompts was to come up with some new medical conditions. So my article is 10 neologisms, from animaculism, the joy you get from your fuzzy pets, and the consequences there, and on from there. They’re all definitely related to the pandemic experience we have had.

Kevin Pho: So tell me about this writing course that you said you took from Stanford. Who are the clinicians who primarily made up the students of this course?

Janet E. Patin: Well, we’re still going. It started every week; now we’re on the first and third Saturdays. There are about 100 to 120 people who Zoom in from all over the world, and it is not just doctors. There’s definitely a lot of primary care, but there are psychologists, there are art therapists, and there are pediatricians in other parts of the world. There’s a delightful guy from South Africa. There is just a huge range of people, and it’s not all practicing clinicians. Family members of people involved in medicine are also welcome, and so we’ve had all ages too.

Kevin Pho: So a writing coach, professor, or teacher asks you to do a writing prompt in a certain period of time, and then you read it all out. What happens next?

Janet E. Patin: Well, with this piece, I only got three of them done in eight minutes, but it seemed like a good enough idea that I was able to flesh it out. And then the next step is sharing it with a wider audience, so I greatly appreciate the opportunity to share it with you.

Kevin Pho: Talk about how therapeutic writing is, because as we know, practicing medicine, especially primary care, is very, very stressful, and you talk about sometimes dealing with a difficult patient population with chronic pain. Comment on how writing can be an outlet for you.

Janet E. Patin: Absolutely. You know, I used to keep a journal when I was young. It’s a little embarrassing to go back and read those middle school entries. But when we talk with patients about having problems sleeping, with their minds just racing all night long, one of the strategies that we suggest is getting up, going somewhere other than your bed for 20 minutes, and doing something quiet and non-electronic. And I always suggest journaling.

There is something about physically putting pen to paper, that connection between your mind and your body, that is just very health-inducing. And it takes time. Often we do not dedicate the time to taking care of ourselves, and something as simple as writing in a journal or writing these pieces, in eight minutes, you can get a lot done. It’s been amazing what people come up with. And so I think the first part is just committing the time and giving yourself the space to do something that is fun and really brings pleasure to life.

Kevin Pho: I’ve had other physician authors on this podcast who have written on KevinMD, and they all say similar things to what you say about how therapeutic writing is. Now, I also get physicians, and other health care professionals for that matter, who say, “I’m not a writer. I’m terrible at writing. I don’t know how to get started.” So for this group of health care professionals, who may not be the most accomplished writers or may not be comfortable writing, how would you advise them to get over that hump and get started?

Janet E. Patin: You know, I think if we argue our limitations, then we’re going to have those limitations. So start by not saying, “I’m not a writer.” We are such deep and varied people, and writing is not hard. It’s a part of us. It’s been part of our education.

So I think the first step is to just set aside that inner editor and critic, and that’s one of the things that they tell us on Saturday mornings: “For this next hour, you are the best writer in the world.” There are no apologies, and we just go for it. That can sometimes be a big hump, because, you know, our perfectionism is what got us to where we are today, and it has served us well in certain ways, and in other ways not so much.

So just getting started. I mean, that’s why it was so wonderful to have this Saturday group: You show up. Showing up is a big and easy first step. Having a place, having a dedicated spot or journal, and having a really nice pen that is fun to use, you know, they’re little things.

Kevin Pho: We’re talking to Janet Patin. She is a family physician. She wrote the satirical KevinMD article “Stunning new medical conditions overlooked!” Janet, what other tips can you share from this writing course with my audience, in terms of other prompts that they’ve had you do or other pieces of advice that your fellow classmates and your writing professor have given during this course?

Janet E. Patin: I would encourage anyone who’s interested to check out writingmedicine.org and join us, because I am not a professional writer. I am, you know, aspiring, and I am hesitant to offer too much advice on something that is not my area of expertise. I am more excited about encouraging people to try something new, to try something they’ve always wanted to do, and to add a little bit of fun into our very intense lives.

Kevin Pho: And my final question: What are some of the take-home messages that you want to leave with the KevinMD audience?

Janet E. Patin: Well, I do believe that you can do it all, just not at the same time, and that we do make time for what is important to us. And so take a look at how we’ve been spending our time: Does it really reflect what is important to us? Our lives are so intense, and writing has been a way to let me pause and refocus.

We are so used to putting our heads down, you know, putting your nose to the grindstone, that I do think it’s worth taking the time to throw your head back and laugh. You know, take your vacation and leave your laptop at home. Throw a little fun into your workday. I have these sticky notes for interoffice things from Knock Knock, and they say things like “Awesome” or “Just adulting over here” or “High five,” and they add a little color and a smile to our day-to-day stuff.

You know, can you wear silly socks or fun earrings or a lapel pin on your coat or something hanging off your stethoscope? Those little things definitely add up. I get the Funny Times, which is a newspaper that is just humor, and it’s a great way to decompress. We can’t be serious all the time, and I think our patients appreciate humor. Bringing joy to what we do helps everybody’s health, and it’s doable.

Kevin Pho: Janet, thank you so much for sharing your time and insight, and thanks again for being on the show.

Janet E. Patin: All right. Thank you, Kevin.