Apr 20, 2009

26.22 miles

Today is Patriot's Day and over 26,000 people have come together to run the Boston Marathon.

It's 26.22 miles. That's about the distance from Fort Lauderdale, FL to Miami, FL. That 35-40 minute drive is one of the main reasons why I don't make the trip down to Miami more often.

On average, it takes about 4.5-5 hours to run the marathon. In my world, that's how long it takes me to get from Boston to New York on Bolt Bus. If it wasn't for the promise of good company in New York, I would never board the bus.

Training usually takes a minimum of five to six months of running at least 3-4 days a week. The only things I can think of that I have done consistently for that length of time include eating, sleeping, going to class, and going to work!

Running the Boston Marathon or any race is an achievement that extends beyond the triumphant moments of fist-pumping at the end of the race, beyond the length of the race, and far beyond race day. The finish and the race are just short episodes in a much longer narrative journey. Only when the race is taken in the context of the journey does it become truly meaningful.

Take Dick and Rick Hoyt for example. Of the thousands and thousands of runners who have run the Boston Marathon, Dick and Rick are just two in a sea of people. Their best time is an astonishing 2:40:47. This moves Dick and Rick into smaller and distinguished group of people. But more important than the numerical time accomplishment is their narrative story.

Dick and Rick Hoyt are probably the most recognized duo in the history of the Boston Marathon. Dick is Rick's father and Rick has cerebral palsy. After Rick's diagnosis, doctors had recommended that Rick be institutionalized, but his parents refused and promised to help Rick lead as normal of a life as possible. Upon realizing that Rick loved sports, Dick and Rick began participating in races with Dick pushing his son in a wheelchair. The two truly embraced their passions for racing and began to participate in marathons and triathlons. Dick would tug Rick in a little boat for swims and Rick would sit on the front portion of his father's bike for cycling. According to Wikipedia, Dick and Rick as of August 2008 have competed in 66 marathons and 229 triathlons!

Now consider their best marathon time of 2:40:47. This father son duo are in the top 90th percentile of all runners. 2:40:47 is no longer just good, it's a remarkable and inspiring time.

Dick and Rick are running the Boston Marathon right now. This is their 27th Boston Marathon. Dick is 68 years old and Rick is 47.

For those 26,000 runners out there today, the Boston Marathon is just an episode of their narrative stories. When they cross the finish line this afternoon, we are not cheering for their marathon time or bib number. We have gathered to celebrate and honor this one achievement in the context of their personal and individual stories. Similarly, in an 8-hour work day, assuming the average 17 minutes a doctor spends with each patient, a doctor sees about 28 patients per day. Patient X at 2PM is not just the 2PM appointment or the girl with the common cold. The 2PM appointment and the common cold are short health care episodes in her individual story.

Anyone who has ever been sick or experienced any discomfort, and that's everyone, will understand that health care is personal. It's a scene that would take at least a second of film time in the average movie. And because it's personal, health care is important to everyone. It is imperative for those who work in health care to not only acknowledge this fact, but honor it. Health care providers have been given the gift of being guests in the lives of others and thus must see their work in the broad context of a patient's family, community, and life as a whole. It's the least we can do as a token of thanks for this invitation into a patient's life.

So, while a cold or any other ailment is not something to be celebrated, please make the effort to remember the name and story that the cold is nestled in. It may seem like a silly reminder since the business of health care is patients, but I'm sure you would all agree that this is often times forgotten. Though when it is remembered, it's magical.

CONGRATULATIONS to Melissa! Our very own IHI Boston Marathon runner!


Eva said...

Is there a patient-centered care component in your curriculum? For example, following one or a few patients throughout the year and experiencing their disease/illness in the context of their daily lives? If so, please share! What kinds of insight do you gain?

Patient Voices is an audio series produced by Karen Barrow of The New York Times that is composed of first person narratives about the challenges patients face with different health issues. Click here to listen!

Eva said...

Paul Levy, CEO of BIDMC, shares with us an example of when patient-centered care works in this blog post.

Notice it's not just an individual that this new family thanks, but an entire care team.

Eva said...

Here is another fantastic post on Paul Levy's blog that includes several narratives on transparency and patient-centeredness. Click here to read.

Eva said...

Steve Spears, an IHI Senior Fellow, studies high performing organizations like Toyota and applies characteristics of high performing organizations to health care. Read his post about the Boston Marathon and how he relates it to high performing organizations here.