"Come on, buddy, let's talk", he said, as I saw the twinkle in his eye.  He put his arm around me and entered the exam room.  We had just excused his daughter, also a patient of mine, from the exam room, and as we walked back into the room together,  I marveled at the transformation I had seen in him over the last year.  Was this the same man who once sat across me, hunched over and hollow-eyed, a year before?

Celebration.  

A word you often won't hear when discussing the patient-physician bond.  But working with patients over the years, I have had the privilege in participating in many such celebrations.  However, they don't usually come easily.  Or without a price.   

 In my own experience, patients with serious chronic illness related to allergic disease often seem to go through three phases on their path towards healing---and celebration...

First, patients often present in a state of confusion and despondency--"Why am I sick?"  "What's wrong with me?"  "Can I ever get well?"  Many of my patients suffer from classical allergic disease, but may also come in with a host of other concerns, such as chronic fatigue, fibromyalgia, a progressive loss of food and chemical tolerance, etc.  The physician, as my mentor taught me, is "stepping into the third act of a play that has been on stage for years...the characters and plot are initially confusing, and the story is unclear".  The play needs to be watched, the characters studied and observed, and the plot ultimately discovered...

The second stage, what I term the "discovery stage" often involves answering two key questions:  

1.  What is the patient getting too much of that isn't good for him/her

2.  What is the patient not getting enough of that would be good for him/her

This stage, a stage of exploration and intimate collaboration between the patient and physician can last weeks, months or years.  The patient/physician bond is cemented and confirmed during office visits, and a working relationship grows, matures, and can bear fruit.  The stage for recovery is set.

If despondency and confusion over one's illness is overcome, a program for healing is begun, then the third stage of recovery can begin.  

And gradually, as the patient begins to experience recovery from chronic illness and daily symptoms abate, despondency is replaced with optimism, and confusion with confidence. The "patient" is no longer "controlled" by their illness... The patient feels--in a word--empowered.   It's a cause for celebration.

Is celebration a necessary part of the recovery process?  I believe it is.  It is a confirmation for the patient that his/her hard work has paid off.  It gives an opportunity for the physician to congratulate--and reinforce--the treatment program that the patient has been following.  Often I will re-read my first paragraph of progress notes from my initial visit with the patient, to highlight to him/her how far they have come.  

In its simplest terms, "renaissance" means a "rebirth" or revival.  The Renaissance Allergist seeks not only a rebirth in his profession, but a "rebirth" in each and every patient he or she cares for. We're obviously not always successful.  But with patients who experience a "rebirth" should come celebration--by patient and physician.

The allergist who broadens his/her horizons, both diagnostically and therapeutically, can expect cause for celebration with his or her patients.  

Let's celebrate!

Later, Dude