StoryCorps at SHC: Alpa Vyas and Kristan Staudenmayer

That remains the hardest conversation that I ever have to have.

Alpa Vyas (AV): Sometimes you have difficult conversations that you have to have with either patients or family members, just given the nature of your specialty as a trauma surgeon. And I can imagine that once you have a closeness to the patient and the family, I think about, especially you being a mom and being a surgeon, and being in this kind of environment, and then having to have those interactions, have you seen that change over the past 10 and a half years, after being a mom, those conversations getting easier, harder?

Kristan Staudenmayer (KS): Yes. I would say probably there are two changes over time. One is that when I had a child, I found having discussions with parents about their children to be a lot harder. It was like day and night it changed. The worst thing that I ever had to do before my child was born was tell a parent that they had lost the child. That remains the hardest conversation that I ever have to have. And I can tell you, I can't have it without tears in my eyes. That's one change that has stuck with me. I don't think it's ever going to go away. There's just something that feels unnatural about a parent hearing they're losing a child, so that will never go away, I think.

I think probably the more dominant trajectory as I've been doing this for a long time, is that I've come to have a way I have discussions that I think works for me, and at least best I can tell works for families. What I do is I start off understanding where patients or their family is at. Everybody's at different levels. Everybody has different levels of sophistication, the amount of information they want to know. There are different degrees to how paternalistic they might expect or want a doctor to be. And so I spend time before I start sharing, understanding where people are at. And the reason for that is I want to meet them wherever they are. And my goal is to, regardless of where they're at, still take everything that's in my head and put that in their head so that they have the same understanding. I try to meet them where they are.

I've found over the years, that being direct and honest and thinking about it in terms of it's my responsibility to make sure my understanding is in their minds, is the true shared decision making, is the true patient empowerment experience that we often talk about, but we don't necessarily always provide because it's hard. Difficult conversations, they don't scare me. They're of course hard, but I think sometimes that they're even more important than some of the other things that I do as a physician, because people need to have that full engagement, not just with their body, but with their mind. And that's how you get there.

Sound Editor: Amy Hu

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