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Join us on this emotional episode as we hear the touching story of a patient’s journey with cancer and the irreplaceable radiologist who played a crucial role in her care. Our guest Kim Downey, a physical therapist and three-time cancer survivor, shares her personal experience and pays tribute to her late radiologist. We explore the challenges facing clinicians and the importance of promoting physician well-being in health care systems. Tune in for a heartwarming conversation on the impact of health care providers on patients’ lives and how we can honor their memory.

Kim Downey is a physical therapist.

She shares her story and discusses her KevinMD article, “An inspiring tribute to an exceptional radiologist who made a lasting impact.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Kim Downey. She’s a physical therapist, and her KevinMD article is titled “An inspiring tribute to an exceptional radiologist who made a lasting impact.” Kim, welcome to the show.

Kim Downey: Thank you.

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

Kim Downey: Sure. I feel like I have to share a little bit of my recent medical history, because that is what brought me here today. In November 2020, I had surgery for thyroid cancer, and during the surgery, three of my parathyroids were inadvertently removed, and the fourth one never kicked in. That caused some problems with calcium regulation and kidney function, so I was referred to nephrology, and I was put on additional medications.

During the summer of 2021, I wanted to reduce the medication, so my nephrologist was working with me, and I blacked out, fell, and hit my head. In retrospect, they think it was low calcium that caused a cardiac arrhythmia. Over the next two months, my brand-new primary care doctor, my nephrologist, and my physical therapist figured out that I had Lyme disease, a concussion, thoracic outlet syndrome, a whiplash injury, and a broken toe. They were all excellent clinicians.

I went through four months of physical therapy for some neck issues and dizziness related to those issues, and I was in good shape by December 29th, when my PT discharged me. But the very next day, I was back on the operating table, because during that month of December, we discovered I had breast cancer. So on December 29th, after I left my physical therapist’s office, I drove straight an hour to the hospital where the surgery was going to be performed the next day, for the insertion of a magnetic clip. And that was the day that I met my irreplaceable radiologist.

Kevin Pho: All right, well, tell us the next part of your story, which you wrote in your KevinMD article, “An inspiring tribute to an exceptional radiologist who made a lasting impact.” How did your article come together?

Kim Downey: Sure. So as far as the things I’d like to share about the article, promoting physician well-being has recently become my life’s purpose. Having someone acknowledge that your work is valuable and that you’re appreciated can have a positive impact on anyone’s well-being, and physicians are no exception. Patient gratitude is part of my mission, and I’ve made it a point to let my physicians know how much I appreciate what they do and their commitment to their patients, despite all the burdens that they face practicing medicine today.

My article is a tribute to Dr. Steven Sferlazza, who is my irreplaceable radiologist, because I feel that radiologists are unsung heroes of cancer treatment, and I felt the need to draw attention to how important Dr. Sferlazza was to my physician team.

Kevin Pho: All right, so tell us: How did your radiologist impact your care?

Kim Downey: Well, he was really incredible. I guess I’ll just try to say a couple of things about when he performed a couple of miraculous feats of technical skill. So that first day when I went in, in December, what I hadn’t really been thinking about at the time, because I had just found out I had breast cancer and I wasn’t thinking about these technical aspects, was that the tumor had only been visible on MRI. I had had a mammogram and ultrasound, and it wasn’t seen. It had only been nine millimeters to start with, and seven millimeters was removed during the biopsy. But then when she tried to get the metal clip in as close to the site as she could, somehow it got displaced that day, so it was pretty far off.

So what I wasn’t thinking about when I went for this magnetic clip insertion was how he was going to figure out how to get it in the right spot, because we didn’t have an MRI. So the tech had me do about 15 mammogram images, and she had me do everything but hang by my toes. I went to the left, I went to the right, I fell into the machine. So finally, she said, “He wants to see if he can visualize it by ultrasound.”

So anyway, in the end, he thought he got it, and my surgery was a success. When my surgeon came in the week after, he seemed so pleased and relieved that he got clear margins. I guess I never thought about it; I thought you could see cancer. I didn’t realize that you couldn’t see it, but he had said that there was no way that Dr. Sferlazza could have ever visualized those two millimeters of cancer. So it was his high degree of skill and intuition and experience; he must have seen the shadow where the tissue had been displaced during the biopsy a few weeks before that. So my surgery was a success because he got that magnetic clip exactly where it needed to be, when there were only the two millimeters of the cancer left, and because I have an excellent surgeon as well. So being a health care professional myself, I could understand medical things, and I fully appreciated that, and I sent them thank-you notes.

And then I went through a course of radiation, and then unfortunately, the month after radiation, I needed another MRI, because actually, in December, there had been something visualized on either side, but the day of the biopsy, she couldn’t see the one on the left. So I had another MRI, and then unfortunately, that one was cancer as well, so I had to do it all over again.

So when I went on June 1st for Dr. Sferlazza to insert the clip on the other side, he was just really nice. He stood at the door, and he gave me a look and said my name. And I said, “I don’t really want to do all this all over again.” And he was like, “You need a hug.” This was the time of COVID, and we were all wearing masks, and my first thought was, “Is he allowed to do that? It’s COVID.” But then I was thinking that he just thought, “This poor woman needs a hug.” And so he just gave me a hug.

And then he got the mag seed in, and then he called me over, and he says, “You’ve got to come see this. This never happens.” And I was like, “What now?” Because I’ve only told you the bare minimum of what’s happened to me in the last two years; it’s only a fraction, what I’ve already told you. So I was like, “What could it be now?” So then he showed me. He goes, “I had to look at a few angles to make sure,” because he couldn’t believe what he was seeing, but he had gotten the magnetic clip to pierce the metal clip, and they’re both really tiny.

So after the first surgery, my surgeon had said it was like looking for a needle in a haystack, and that’s what Dr. Sferlazza found. And then this time, after the surgery, my surgeon said it was like threading a needle when you can’t even see the needle. So he just had such a high level of skill. But that day I left, I didn’t know that that was the last time I would ever see him.

Kevin Pho: So it sounds like Dr. Sferlazza technically was excellent, but tell me about that personal interaction that you had with him. You told that little story about how he gave you a hug. What did that personal interaction, talking to him, mean to you?

Kim Downey: Well, a lot. At every turn, he was kind. Even before that, and this is what’s not in the article, because I couldn’t tell the whole thing, he knew when I needed the other MRI. And then he let the surgeon call first, and then the next day, he called me to see if I had any further questions. Because then I also needed the biopsy and the mammogram and ultrasound, to see if they could see it other ways. He knew I wanted to do it, but he called to tell me that he was going to be on vacation the next week, and if I wanted, I could wait until he got back. So I thought that was really nice of him, but my surgeon didn’t want me to wait, because I was going on a trip as well.

And then even before he was done, he drew a circle around the area with a Sharpie, and he put a piece of tape over it, and he said, “This is just a little something extra I do to help him out,” for the surgeon, so he knows exactly where to put the magnet. And then before I left, he said, “You need another hug.” So he knew this was hard, and a lot. At every turn, he was just as kind as he could be.

And then afterward, when I sent him and my surgeon another round of thank-you notes, because they got clear margins again and a successful surgery, he called me to thank me for my thank-you note. He was just incredible.

Kevin Pho: So you mentioned earlier that, as part of your journey, you now focus on clinician well-being. So tell me about that pivot point. What about your journey made you focus specifically on the well-being of physicians?

Kim Downey: Sure. So well, actually, I came across your site around February or March of last year, and I had already sent my physicians thank-you notes, because I realize now that I need a team of physicians. I’ve seen about 33 in the last two years, even if it was one test or procedure. So I’ve had all kinds of experiences, from wonderful to not so much, which made me appreciate the ones who had a positive impact on me even more, and I wanted to make sure they felt appreciated. So I had sent them all thank-you notes.

And then when I started following all your articles, and I’ve read every one for over the past year, a lot of them were related to burnout and things like that, so that became more and more of a concern of mine. So I reached out to my large local health care system to see how I could help, and they had given me a suggestion, but then it wasn’t really followed up on, on their part, at that time. So then I reached out again this January, because after I had the surgery, I had to have radiation again and everything. So I reached out again, and I said, “I have to do something to make a difference.”

So I’ve spoken with our chief physician executive. I’ve spoken with our chief wellness officers. But then I’ve also, and this is a story for another day, but I have a physician coach now, who you’re familiar with, and he’s really helped me. And then I’ve been reaching out to physicians around the country, actually all from your articles. If they write something that resonates with me, I’ve been reaching out, and there’s a great team of doctors who have been helping me and giving me ideas and suggestions.

Kevin Pho: Well, that’s wonderful to hear. And as a physician, oftentimes we only hear from patients when something goes wrong, when there’s a negative interaction. So hearing gratitude and hearing these notes of thanks really means a lot to pretty much every physician that I talk to. What do you recommend for other patients if they wanted to do something similar to what you’re doing, in terms of showing gratitude to the health care team? What are some things that other patients can do?

Kim Downey: Well, I’ve actually shared it on our town’s Facebook page, and I’ve told people, like on Doctors’ Day or really anytime, if you have a doctor or clinician, or even other clinicians, even if it’s a dental hygienist. I wrote my dental hygienist, and she said it made her month. So anyway, just when you’re there, let them know that you appreciate them and that you’re not taking them for granted. And they can send thank-you notes as well. And do your own part not to overburden the system, not calling with needless questions and things like that.

Kevin Pho: So you went into this earlier. Tell us some of the responses you receive when you’ve given notes of gratitude or written some thank-you notes to your health care team. Just express some of the reactions that you receive.

Kim Downey: Yes, well, sure. So my initial radiologist, before I had Dr. Sferlazza, I let her know that my surgeon and I both thought she did a good job of identifying both the cancers at such an early stage, and I thanked her, and I said I know that she did her best. And she said things like, “Thank you so much,” and exactly what you said, that we only hear about the bad things. She said some people don’t even know we’re doctors.

And that’s why, when I reached out to the community and said, “Send doctors thank-you notes,” I said especially radiologists or anesthesiologists, because I’ve also had a great one of those. I could tell you a story about that another day. People might think of their primary care doctor or their surgeon, but some of those other doctors you don’t think of. A couple of doctors have actually called me to thank me for my thank-you notes, or when I’ve seen them in person, they’ve just said that they really appreciated it.

Kevin Pho: We’re talking with Kim Downey. She’s a physical therapist, and her KevinMD article is titled “An inspiring tribute to an exceptional radiologist who made a lasting impact.” So you talked a lot about Dr. Sferlazza, a radiologist. Tell us how you would like us to remember him, for those who didn’t know him.

Kim Downey: Sure, thanks. So Dr. Sferlazza was an incredible doctor and an incredible person. He had many talents, including photography and creating beautiful paintings and drawings throughout his life. From what I understand, he also loved music and dancing and ice cream. And as his wife told me, people need to know what a great, caring radiologist he was. So I want to thank you, Kevin, very much for giving me the opportunity to get this story out and honor the life of this wonderful man, so that others could know the gift he was to so many.

And so my other takeaway message would be that I hope we can all work together to discover ways to make changes in the health care system that improve the experience for both doctors and patients. And if you’re part of a health care system that’s had any success at all, please write about it and send your articles to KevinMD, so we can all learn from what’s actually working.

Kevin Pho: Well, thank you so much. And let me end by sharing a paragraph from Dr. Sferlazza’s memorial. Quote: “He had an intuitive gift as a physician in diagnosing and managing breast cancer. His expertise helped countless patients, and he was deeply appreciated by those he cared for. He felt an enormous sense of gratitude to be able to help his patients and be an integral part of their care.” Kim, thank you so much for sharing his story, your story, and your time and insight. Thanks again for being on the show.

Kim Downey: Thank you, Kevin. You take care.