Supportive Care

As an internist-psychiatrist, I have led many counseling sessions with patients, often individual therapy, which can have profound impacts on patients health and quality of life. In academic medicine there are often arguments about what type of therapy has the "best evidence" for efficacy for treating illnesses such as depression or anxiety. What I have often found however, is that the most potent form of therapy is that which is found accidentally. By that I mean, most patients come by their therapy, in whatever form it may take (Social Worker, Psychologist, Clergy, Bartender, etc.) by happenstance, and it is this happy accident that often proves to be the most beneficial.

Today our team hosted a "day care" session for the patients throughout Moi Teaching and Referral Hospital. I discovered that our team of nurses and clinical officer, rounded up nearly every ambulatory patient on our service and their families (nearly 40 people), and brought them to the chemotherapy tent next to the AMPATH building. We met in a circle and for the next two and a half hours, the patients and I were treated to a spiritual sermon, a teaching lesson on nutrition for wellness, and an information session led by our Clinical Officer on the dosing of morphine and safety of opiate storage at home. The meeting was capped off by singing, some dancing, and finally chai tea, mandazi (Kenyan donuts) and sausages. It was quite amazing to see Kenyan's from nearly 15 different tribal communities and villages, young and aged, singing, praying, and eating together. The therapeutic value was not in the sermon, the teaching topics, but in the community of patients and families struggling with living with cancer.

I was pleased to see the patients from different cultures speaking to each other over hot tea. Patients from various wards tending to each others wounds and care needs after the session. Some patient's families helping other patients with ambulation needs back to their wards and beds. I was told by our RN and Clinical Officer that it was helpful to the families to see the "Dakatari" joining in the session and just showing "love and support." I told our RN, that in fact, this experience was personally moving, warming, and in many ways therapeutic beyond words, to my own self care to share this experience with our patients and families.