Translating medicine into real life

Claire McCarthy, MD

The Boston Globe recently reported on a Children’s Hospital Boston study that shows a preventative approach to treating asthma can keep kids out of the Emergency Department (ED) and save money on health care spending. Here, Dr. Claire talks about the medical professionals whose commitment to keeping children healthy supports these innovative approaches to medicine.

I have known Susan Sommer, a nurse in the Community Asthma Initiative (CAI) at Boston Children’s, for nearly twenty years—we met at Martha Eliot Health Center when we were both working there. I was so happy when she started working with CAI, because she is the perfect person to do that kind of work. There are three things that are undeniably true about Susan. First, she really cares about people. I mean really cares, as if each and every one of us were family. Second, she’s really smart. Third, she gets real life.

That last one isn’t to be taken for granted, especially when we’re talking about medical professionals. Sadly, it can be said about us that we often have our heads up in the clouds. We prescribe things based on science and studies—which is good, don’t get me wrong, medical treatments should be based in science and studies. But when patients leave the hospital and go home, real life has a way of, well, getting in the way.

We can come up with the most elegant plans—but they don’t work if the patient can’t afford the medication or doesn’t understand how to give it or can’t give it because of work or school schedules. And our plans rarely take the home into account, and how people live has everything to do with their health. This is particularly true in asthma; allergies to things like dust mites or pets, or exposure to cigarette smoke, or even certain cleaning fluids can make it hard for a child to breathe.

Everyone at CAI is a hero. They make lives better. They save lives, really. They do it by being the bridge between the hospital and the home.

It’s this translation between elegant and real that Susan does brilliantly. She visits people and learns about them and listens to them. She sits in their homes and visits and makes friends with them. They show her around. She asks to see the medications, asks how they give them, and they show her. She finds the problems—and then she does everything she can to fix them. She teaches about medications and better ways to clean the house, gets families vacuum cleaners, finds lawyers and exterminators, talks with school nurses…literally, she does whatever it takes. She works with the primary care docs like me as well as the specialists, bringing us information we need (often the key bit of information to explain why someone isn’t getting better), relaying advice from us back to the family. And the families love her. The moment she gets involved with caring for one of my patients, things start to get better.

Everyone at CAI is a hero. They make lives better. They save lives, really. They do it by being the bridge between the hospital and the home; they do it by translating medicine into real life. And to top it off, it turns out that what they do cuts health care costs by decreasing emergency room visits and hospitalizations.

This is how medicine should work. It just makes overwhelming sense that the best way to give care is to do it in a way that brings medicine and real life together—and we can’t do that without understanding what real life is for each person and each family. Wouldn’t it be amazing if we could have an army of health care workers like Susan and her team, going into homes and learning and listening and teaching. Think of what we could do not just for asthma but for other health problems like diabetes or obesity or—or anything, really.

But for now, I feel blessed having Susan.