Vicki Jackson, MD on Palliative Care and Why Small Things Matter

Dr. Vicki Jackson is the Chief of Palliative Care at Mass General Hospital (MGH). 

As a pioneers in palliative care who has over 15 years of experience in the field, Vicki completed her clinical training in Internal Medicine at the Cambridge hospital, Palliative Care at Dana-Farber, as well as her research training through the Harvard Medical School General Medicine Fellowship and the Harvard University School of Public Health. 

Palliative care isn’t only helpful to doctors, patients, caregivers but also for everyone. This is a rare opportunity for me to explore such a topic with an industry leader.

If you can't see the player above, click here to listen.

In the clinical area, Vicki spearheaded the development of a novel outpatient palliative care clinic in the MGH Cancer Center. As an educator, her work has focused on the development and evaluation of communication curricula for palliative care fellows and attending physicians caring for seriously ill patients. 

Along with Dr. David Ryan, Chief of Oncology at MGH, Vicki has co-authored a book called "Living with Cancer" to be published in May 2017 by Johns Hopkins University Press. This book provides step by step guide for coping medically and emotionally with a serious diagnosis.

Because palliative care isn’t easily accessible everywhere in the world, "this book teaches individuals by teaching patients and caregivers how to ask the right questions to get the best possible care, beginning at the moment of diagnosis." 

Right before our recording, I had the pleasure to meet Doris, Dr. Jackson’s golden retriever who also happens to be the MGH Palliative care dog. Dories greeted me with much love.  


Dr. Robert Leffert

Dr. Robert Leffert

This episode is dedicated to all the members of the MGH Palliative Care Unit, as well as the Leffert Family. 

Dr. Vicki Jackson cared for Robert Leffert, MD, as he faced a terminal cancer diagnosis, she had to learn about all aspects of who he was – not only an MGH physician and Harvard professor, but also a decorated veteran and kid who grew up in Brooklyn New York. In honor of Leffert’s memory and to support the work that helped him and his family through his final days, Dr. Jackson and the Leffert Family together established the Leffert Palliative Care Memorial Lecture in 2011.


Show Notes:

  • [07:00] How did you get started with palliative care?
  • [12:00] What is palliative care? How do describe it?
  • [14:00] You are about to publish a book. How does it help patients and their families dealing with serious illnesses?
  • [16:00] How do you typically approach patients about palliative care?
  • [21:00] Do you remember your first conversation with a patient? What was that like?
  • [25:00] How do you teach patients and their families about how to ask the right questions when they are diagnosed cancer?
  • [30:00] What are some of the interesting stories that you remember?
  • [38:00] What would you recommend to future doctors that want to specialize in the area of palliative care?
  • [41:00] What are some of the courses that people can get involved with and learn more about palliative care? 

Favorite Quotes

[09:00] ‘He just wasn’t sure if the burden of the treatments were really worth it for what his quality of life was like. Having that conversation, that insight, allowed us as a treatment team to have a deeper discussion with him about what was important. [...] What do you understand about your treatment, [...] how can we partner with you and care for you in this phase in your life. [...] It was this very powerful experience to realize that we needed to really ask him what was important to him.’

[17:00] ‘One of the big misconceptions about palliative care is that it is the same thing as hospice, and it’s not. Hospice is a medical benefits for patients at the very end of life, and palliative care is medical support for patients with a serious illness at any time, and for patients that are also maybe going to be cured.

[21:00] ‘I said to my patient: what if I had information that I think is honest but I’m afraid it is not particularly hopeful, what should I do? I asked his advice, and he said: ‘I just want to know that you hope that I would be someone who would beat it, even if intellectually you are not sure that can happen, I just wanna know that you hope that I can beat all the odds’. And I definitely can get on that hope train. I’ve learned a lot from my patients in terms of techniques to be able to talk about difficult things.’

[30:00] ‘The reason I love this work so much is that you see how patients, when the world has been turned upside down, and that they know that many of us think of it as an abstract concept that life can be shorter than what they’d hoped, it is not abstract for them, it is very real. In that, I think it allows many patients to hone in on what’s important to them, and live truer to that mission…’

[33:00] ‘When patients are able to both have an awareness that life isn’t what they had thought and not let that overwhelm that either, and see the beauty and the joy of those little things.’

[36:00] ‘It’s just biology, it is what it is, nobody did anything wrong to get that cancer. The vast majority is just damn luck. I think the challenge to all of us living with a serious illness is to have a little bit of that zip into our world so that we can appreciate things.’

 

Acknowledgements/Music

Music by Gabriele Tosi. More info on: http://www.newagemusica.com