practice partner
Family Histories
To promote better outcomes, explore how health issues interact with the family dynamic
DOC TALK
By Stuart Foxman illUSTRATION: ian mitchell
In a way, any physician is a“ family” doctor. That’ s because family dynamics are at the centre of so much of what matters to a patient.“ The whole family is affected by disease and the experience of disease,” says Dr. Maria Muraca, Medical Director at the North York Family Health Team. Consider a patient of hers who has breast and ovarian cancer. This woman is dealing with more than just her treatment.“ She’ s struggling with keeping the family together,” says Dr. Muraca. The illness has had enormous ramifications for the patient’ s family. There is worry in all corners about the future. Family dreams, big and little, are in flux. The patient has two adult daughters, and one moved up her wedding because of the prognosis. Beyond that stress, both daughters decided to get tested; they each carry the BRCA1 mutation, which has taken an added toll on the mother.“ That was her biggest fear,” Dr. Muraca says.“ She has guilt.” Those family issues are as real as a cancer diagnosis. And Dr. Muraca has had to help her patient work through them. How can doctors acknowledge such issues and help people through them? That’ s an underappreciated part of doctor-patient communications, suggests Dr. Muraca. If doctors are to understand the whole person when they treat their patients, then embedded in that is understanding the context of family. Here’ s how Dr. Judith Belle Brown of Western University puts it:“ Families can either aggravate or ameliorate
ISSUE 3, 2016 Dialogue
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