The “Favorite Uncle” Standard of Care
Denise Logan

Fifteen years ago, my parents were running three businesses and, within a three-month period, each of them was diagnosed with cancer. Dad with late-stage colon cancer, mom with mid-stage breast cancer. They were suddenly in over their heads, and everything began to unravel.

I lived in another state and, like many of us who find ourselves with older parents to care for from afar, I needed to know that the professionals who were walking with them on a journey none of us had ever taken before were fully up to the task. The stakes were high, we needed to trust them, and we only got one chance to get it right.

The morning after my dad’s diagnosis, I flew to Detroit to be with them when they met with the surgeon. In the airport convenience store that morning, as I fished some money out of my purse for a bottle of water and a pack of gum, I noticed a book leaning against the cash register. What Your Doctor May Not Tell You About Colorectal Cancer.

 “Ok,” I said to the cashier, “I’ll take the water, the gum and THIS book,” thinking it was obviously something I needed to read on my flight to help me get up to speed before this meeting.

When we’re faced with unfamiliar experiences, our minds naturally want to know what we’re up against and how to prepare for the obstacles we’re likely to encounter on the road ahead. Our business owner clients and their families desperately need that same peek into what lies ahead, not just the technical parts which they can wrap their intellectual minds around, but the things that no one else talks to them about – the emotional changes they’re headed for.

Certainly, what I read in one book on my flight to Detroit didn’t make me as knowledgeable as the surgeon (or even the receptionist at his office at that point, if I’m honest!)  But it DID give me enough of a framework of what we were in for and what he might not think to prepare us for because it was so routine for him.

Of course, our questions were probably ones he had heard (and answered) a zillion times before and probably came out in an emotional string of gobbledygook. I knew that’s to be expected when uncertainty plays such a big part in any significant decision-making. You know it, too, because there are plenty of times when your business owner or their family members seem to have just lost their danged minds!

But I wasn’t prepared for just how dismissive the surgeon was. How he kept checking his watch, impatient to move this all along and “get on with it already.” When my dad asked in a shaky voice whether he was going to have to live with an ostomy bag, the doctor sneered and replied something like “just be grateful if I save your life and stop worrying about things like that.”

Dr. Meany (as I immediately nicknamed him in my mind) wanted to schedule the surgery two days after our meeting. My parents were scared and asked if it needed to happen so soon, couldn’t they have a couple of days to think things through. Dr. Meany was clearly exasperated! His demeanor told us that he thought we were being ridiculous, and he had a busy schedule. Hand on the door, Dr. Meany blurted out, “Fine, it’s your life. Go ahead and roll the dice but time isn’t on your side. Call my scheduling assistant when you make up your mind and we’ll see how long it takes you to get back in my calendar.” And then he was gone, leaving my father trembling on the table in a paper gown and his black socks.

Sadly, many of you have walked some version of this frightful journey yourselves or with someone you have loved.

Some of you, in fact, have even displayed this heartless lack of “bedside manner” or witnessed a deal partner doing it to your own clients who dared to challenge the way you decree the process must go or when they expressed the need to slow things down so they can catch up to all the change that’s making their heads swim.

A good many of you have even said, “Time isn’t on your side, here, Mister” to hurry things along because your own fear about losing a commission reared its head. Or maybe you slammed out the door or abandoned a deal because you were exasperated with your client’s “ridiculous” refusal to just fall into line. You’ve left them metaphorically exposed and shaking in a paper gown and their black socks wondering what the hell just happened and what on earth they’re going to do now.

I have no doubt that Dr. Meany was technically proficient. He had come recommended by their family doctor. Someone they trusted. He probably had no idea what an egotistical cruel man Dr. Meany was because he was an “expert.”

It’s even possible that Dr. Meany wasn’t a bad man, perhaps he was just overworked or fed up with a system that made him feel like he needed to treat the people who brought their precious lives to him like one more cog in a system he needed to churn out. At one point, he might have been someone who cared.

When we met him, Dr. Meany only saw parts for him to mechanically operate on and move on to the next one. He had forgotten that these were people, with lives and loved ones who would be forever changed by their interaction with him. Much like some of you, who have forgotten that your clients think of their business as their baby. What feels like “a frustrating busted deal” to you, is a devastating loss to them.

Have you, like Dr. Meany, forgotten that we are not technicians, we are entrusted with the lives of the people who come to us at vulnerable moments in their lives?

I stayed up most of that night in my hotel room searching for a cancer team that would bring compassion to my family as we traversed one of the most frightening times most of us can imagine.

As the sun rose the next morning, I drove to my parents’ home to talk about choosing a doctor who could care about them. They hadn’t slept either. My parents were reluctant to look for someone else. They no longer knew if they could trust themselves and wanted to just rely on “the experts”. They didn’t know if we could find a caring and skillful doctor. The weight of making the right choice hung over all of us.

The surgeon I found for them to meet with next was just as highly credentialed as Dr. Meany and his website and the reviews seemed like his humanity was intact, but he was far from home. Dr. Meany practiced close to home, they offered. I reminded them so did the veterinarian, but we weren’t going to make choices based on proximity or speed with something this important.  They were worried about the travel distance to the new doctor in an unfamiliar hospital, they worried about starting over. Dr. Meany had terrified them out of being able to think for themselves. They were traumatized by the process and by the absolutely heartless way they were treated by someone they desperately needed to trust.

The new surgeon was part of an integrated cancer team. This team reassured my dad that they would treat him like a member of their own family. He joked with them, does that mean you’ll pretend to ignore me and roll your eyes at my jokes like my daughter does? I’m not saying whether I did or I didn’t roll my eyes at that moment, you’ll have to guess. They promised that they would care for him like he was their favorite uncle.

 

In fact, this team met once a week to staff all their patients’ cases. The oncologist, the surgeon, the radiologist, the pharmacist, the nursing team, the patient advocate, and lots of others we didn’t even know were “on the case”. Every one of them was fully dialed into the technical aspects of my father’s medical care, but even more importantly, they were equally tuned in to his (and our) emotional care.

What would it mean for your clients to feel like they had an integrated team of caring professionals where every single person was fully dialed in to their experience as they navigated this journey through not only the transaction you’re hired to handle but also the transition they’re undergoing?  Can your clients say they feel you care for them as if they were your favorite uncle? That you are committed to placing them safely on the other shore, that you will not abandon them mid-stream because things get rough and you have other deals that seem easier or more lucrative in the moment?

This new surgeon (who I think of as Dr. Caring) recommended they use radiation to shrink the tumor first, giving them a greater chance of avoiding a long-term ostomy. Of course, he shared the risks of waiting, but he took to heart what was most important to my dad. Do your clients feel like you truly understand what matters most to them in the outcome, even if it isn’t what you recommend?  Can you help them get what they need and allow them to make their own informed decisions?

The team encouraged my mom to involve her primary care doctor in the process, too. At first, she balked, she didn’t see the need. They gently coached her about preparing for the extra strain she might feel as the spouse of someone undergoing such a life change. Thank goodness they did and that her doctor was receptive to being part of a collaborative effort, because a wellness check revealed that she had a fast-growing and aggressive breast cancer.

Now the “team” expanded to also include those professionals who would address my mom’s surgery and recovery.

Together, this integrated team made sure that their surgeries and follow ups and chemo treatments were scheduled taking into account what the other spouse was going to be experiencing.  They made sure they each had support groups – people to talk to who had been through this – so they didn’t feel alone. They made sure they had knowledge and support before, during and after the process to help them make good decisions and make sense of the significant changes that they were undergoing physically and emotionally.

Dr. Caring wasn’t able to avoid a permanent ostomy, the cancer had spread too far for that.  He was aware of just how crushing that would be. He didn’t send someone else to break the news, he didn’t rush my dad to just “look at the bright side and move on” and he was actively involved in helping him grieve this loss. How do you deliver bad news to your clients?

All told, my family spent close to eighteen months intertwined with the many members of this team. Many of your clients will be with you for the better part of a year, or longer, and it’s going to get emotional. They walked side by side with us through what, to them, was undoubtedly at times the mundane and routine parts of their jobs. Through times when their schedules were hectic and they were worn out, too. They earned and kept our trust with every interaction, and they always brought their own humanity to the table with ours. No one person could do it all. But, together, they created a carefully woven safety net without losing the thread of what really mattered.

Think we remember their names? You bet. Think we tell everyone who comes to this fork in the road about the kind of care this team brought as they traveled with us through a journey that could have been even more treacherous than it was? For sure.

Ask yourself, which one are you – Dr. Meany or Dr. Caring? It’s a choice, you know. Have you created the collaborative environment with other caring partners who can attend to their unique piece of the transaction while offering comfort to the precious human being who has invited you into their life for this journey?

Are you applying The Favorite Uncle Standard of Care?

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