Book Title: Resilient Threads: Weaving Joy and Meaning into Well-bein
Author: Mukta Panda
Publication Information: Palisade, CO, Creative Courage Press, 2020, 272 pp., $28.95, hardcover
Professor and Assistant Dean for Well-being at the University of Tennessee Health Science Center Mukta Panda, MD, wrote Resilient Threads to give voice to exhausted health care professionals and women in medicine and academia—groups that face “overwhelming and unrelieved stress” (p. xxx).
Part one of this memoir asks, “Who am I?” Dr Panda starts by tackling a question she has often been asked, “Where are you from?” She discloses the place of her birth (New Delhi, India), where she spent her early childhood (London, England), where she went to medical school (Goa, India), where she had her children (Saudi Arabia), and where she has lived for over 25 years, trained in internal medicine, and worked until this writing (Tennessee). She also talks about her upbringing by academic physician parents who modeled kindness and respect toward patients, learners, and hired staff. Next, she discusses life lessons she learned from her parents and grandparents. Then she delves into her experience of the “multiple hats syndrome” (p. 35), striving to be a perfect mother, sister, daughter, wife, physician, teacher, friend, colleague, and acquaintance. Thus, when she was program director and department chair, she gave faculty and trainees the “permission to let their family lives be part of their work life” (p. 39).
Part two explores, “Where do I belong?” Dr Panda starts by contrasting technology and touch: though technology has greatly advanced medicine, “compassion, clinical judgment, connecting with patients and humanism cannot be digitized” (p. 48). She details how one of her clinic patients in residency surprised her by making her a watercolor portrait; she had not known the patient was a painter, and the gift reminded her that “communication is the most important attribute in health care” (p. 53). Dr Panda also invites readers to live for others and strive to build open relationships, thus allowing spiritual dimensions of well-being to be explored rather than ignored. The author recalls encountering discrimination in her personal and professional life in the United States, and navigating this by going out of her way to build community and make others feel welcome. She describes her first American patient house call, and how it led her son into health care. This culminated in Bringing Back the Black Bag, a grant-funded resident house call program, and a simulation program called Walking in a Patient’s Shoes that explores effects of social determinants of health on patient adherence. Part two ends noting that evidence-based medicine is maximized by employing empathy and assessing other “E’s”: emotions, expectations, ethics, engagement, empowerment, effort, education, experience, error, equity, environment, and economics (p. 98).
Part three asks: “How do I heal as I strive to serve?” In a season of personal loss, the author discovered family is not just defined by blood. As she mulled resignation from her job, she won a national Courage to Teach award, found renewal at the associated retreat, and returned to establish weekly Relaxing, Rejuvenating, Rejoicing in Residency sessions that engendered positive coping skills in residents who attended at least three per quarter. She then relived her relationship with a long-term patient and his wife, which culminated in a sense of belonging that affirmed the meaning she finds in her work; successful disclosure of a medication error to them emboldened her to teach a senior resident to do likewise. She later called for “bringing back the ‘R’ in RVU – relationship value unit” (p. 144), on realizing she could no longer steward a volume (relative value unit collation) over-value (spending as much time with patients as necessary to provide comfort) paradigm in good faith. Soon afterwards, she found a colleague lifeless after death by suicide; she organized a posthumous lecture in his honor, worked with leadership on a study of institutional burnout rates, and created a wellness task force at the local medical society. And she pioneered a How-to-Live reflection curriculum for medical students enacted at a local museum. A back injury strengthened Dr Panda’s resolve to fight for holistic health care. She acknowledges passion, creativity, and innovation as both her strengths and weaknesses, and ends the book identifying wholeness as her core value.
Resilient Threads is written in lay language, fluidly using stories to illustrate self-diagnosis, “empathy-based medicine” (p. xxvii) and “relationship-centered care” (p. 47) as noted above. This memoir also applies personal experience of illness to practice of medicine as desired by the author. This book can inspire intending clinicians at various levels, encourage faculty wanting to hone advocacy and clinical teaching skills, and inform patients and their families seeking to understand how clinicians think.