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Interview with Dr Grazyna Cholewinska - How we perceive the humanisation of medicine in infectious diseases

10 December 2022

Dr Lewicka, we are honoured to have you as our guest speaker. We are impressed by your passion and commitment to the topic of humanising medicine in infectious diseases. We know that there is a lot of work to be done in this area, but we would like to focus on the coronavirus outbreak that has been affecting us all for the past few months. What is your opinion on the shortcomings in our system that have been exposed by this situation?

The COVID-19 epidemic has revealed many weaknesses in our health care. Therefore, it is important that decision-makers in our country start to learn lessons today and develop a national strategic plan for such a situation. In Poland, as a country of 38 million inhabitants, the lack of such a plan is particularly worrying. Currently there are only local and regional strategic plans, which often do not include health care.

Such a plan should include several scenarios for action, including a humanitarian component. An example of the lack of such a plan is the situation on 6 September 2020, when the Ministry of Health began to notice the problem of patients not visiting hospitals. Such a plan should cover different pathogens and provide for appropriate diagnostic and therapeutic actions.

Pathogens, i.e. pathogenic micro-organisms, can be present in large or smaller quantities. It is therefore important to respect all humanitarian solutions in hospitals aimed at protecting human beings. As someone who has witnessed many human tragedies, I know how difficult it is to hospitalise patients and have often seen them die alone. Also, the families of sick people often very much want to be present at the death of their loved ones, but our country lacks standards on how to deal with such situations.

The moment of the patient's death also requires a specific procedure, which should be described in detail. To this end, the involvement of lawyers and the Patient Ombudsman and Ombudsman should be taken into account. Some issues to be considered include informing the family of the patient's death during the night, or allowing them to pray for the deceased during this difficult moment.
 
The doctor must be able to contact the patient's family at any time of the day or night, even when the patient has died. It is therefore necessary to provide appropriate central solutions and to educate medical personnel, from medical students to doctors of various specialities, as well as officials responsible for decisions in this area.

The education of doctors and medical staff is very important during the COVID-19 pandemic. This pandemic has shown that we often forget loved ones who are waiting for any news from our loved ones lying in hospital, often in critical condition. In many medical facilities, nurses and doctors tried their best to inform families of the patients' condition, but unfortunately there were also places where families were completely cut off from their loved ones. Therefore, it is important that doctors and medical staff receive adequate education to better handle such situations and provide appropriate care to both patients and their families.

The COVID-19 pandemic took many of us by surprise and perplexed us because we did not know how to behave and how to deal with the situation. Fortunately, some entities, such as hospitals and clinics, decided to take matters into their own hands and solve the problem.

One such solution is to appoint a dedicated member of staff to provide patients with an online platform through which they can contact their family via an app on tablets or laptops. This allows family and patient to see and talk to each other, which is particularly important for older people who are often unable to use a mobile phone or tablet efficiently.

A bottom-up initiative is needed for such a solution to be implemented, as it does not require a decision by the Minister of Health. What is important is that someone thinks of the need for such a platform and takes charge of its implementation.

Your presentation was on the extremely interesting topic of naming things. I remember that she quoted a recipe or an excerpt from an article that showed how difficult it is for us today to communicate through language. This topic is particularly important because language is an essential tool for communication between people and has a huge impact on our relationships with others. It is therefore worth paying attention to how we name things and ensuring that our language is clear and understandable to others.

Medicine is an art in which each case is unique. Therefore, two times two does not always have to be four. Sometimes it is five or something else. It is important to approach each patient individually and not treat them all the same. Unfortunately, the language that is often used in medicine is difficult and incomprehensible even to the doctors themselves. It can be used to discipline, but in the wrong sense of the word. Therefore, it is important to use language that patients can understand so that they can understand their illnesses and treatment more fully.
 
"Some medical documents also reach doctors and patients. Unfortunately, they are often written in difficult language that patients do not understand. This is why it is important that such documents are prepared in a clear and understandable way, so that patients can make an informed choice and sign consents for certain medical procedures."

HIV infection is a special area where a group of passionate people have been active since the mid-1980s. Thanks to their determination, many barriers were overcome and people infected with this then still unknown infection were placed at the centre of HIV-related activities. Today, thanks to their efforts, we can enjoy a truly effective response for people infected with HIV.

The patient is at the centre of attention and this attention develops more on all fronts to take even better care of the patient. We strive to address his needs both professionally, mentally and socially. Thanks to our passion and willingness to fight against administrative barriers, we are able to act effectively for the patient. This shows that you can be successful if you just see a problem and want to solve it.

Doctor, in the absence of contact between the patient and the family, the role of the chaplain seems extremely important. Could the chaplain be present in the hospital and be close to the patient during these difficult times?

A hospital is a place where people receive medical care when they are ill or injured. Many patients also need spiritual care, and having a chaplain in hospital is important for their wellbeing. Unfortunately, in situations of isolation caused by the coronavirus pandemic, it has been difficult for chaplains to provide such care.

However, in many hospitals, chaplains have found a way to still provide spiritual care to patients. At the hospital where Chaplain W. works, he would wear a white jumpsuit, a Google mask and have the word 'chaplain' written on his back so that he could safely enter the patient room. In this way, he was able to provide patients with much-needed spiritual care.

It is important for hospitals to provide not only medical care to patients, but also spiritual care. In the era of the coronavirus pandemic, when many things are difficult to do, priests are looking for ways to continue to provide such important care to patients.