by Zara Cooper ‘91
Assistant Professor of Surgery, Harvard Medical School
Associate Surgeon, Division of Trauma, Burns and Surgical Critical Care, Brigham and Women’s Hospital
I’ve had to have a lot of hard conversations in my career. Most of my work is with acutely sick patients who are facing difficult decisions. Just last month I was visiting a patient with advanced cancer and had to give him and his family a poor prognosis — in the middle of the night.
Hard conversations can be uncomfortable, but they’re also essential. I came to my career in medicine later in life than some, and my experience and training in communications at Northwestern has put me in a unique position. I’m able to help surgeons improve the difficult conversations they have with their patients. That’s my passion.
I went to Northwestern specifically to become a journalist. But I didn’t end up getting a journalism degree. One of my classes required travel, but I felt like I couldn’t leave campus because of my involvement in student organizations! So I transferred to the School of Communication.
As a senior I was co-chair of Dance Marathon, which raised money for the Les Turner ALS Foundation that year. After graduation, I got a great job at an advertising agency then known as DDB Needham. At the same time, I still felt connected with the Les Turner ALS Foundation, so I joined its junior board for young professionals.
One day the ALS Foundation asked me to write a short profile of Michael Minieka ’89 GME, a neurologist who’s still an assistant professor of clinical neurology at Northwestern’s Feinberg School of Medicine. As it turned out, Dr. Minieka had also worked in advertising before making a career switch to medicine. And as I followed him around his clinic that day, I was amazed. I saw the interactions he had with his patients and how meaningful they were. It was an inspirational moment — a turning point.
I worked out a deal with my boss that allowed me to start taking pre-med classes to prepare to apply to medical school. And the rest is history. Today I’m an assistant professor of surgery at Harvard Medical School and a surgeon at Brigham and Women’s Hospital in Boston. I work primarily with critically ill patients, focusing on the intersection of palliative care and surgery. Palliative care is simply a philosophy that’s focused on a patient’s comfort and quality of life.
People often say that doctors don’t communicate that well, especially when it comes to end-of-life care. Explaining the intensive care unit to someone who has never been in one can be like explaining a foreign country, and doctors who are used to that kind of chaos can have a difficult time seeing it through the eyes of a scared and sick patient. Much of our poor communication leads to what I call “non-beneficial care” — care that doesn’t achieve goals aligned with our patients’ preferences or sometimes even their best interests.
So I convened an interdisciplinary panel at Harvard with my colleague and friend Atul Gawande, a surgeon and writer. I gathered a host of internationally recognized experts from many fields, and we came up with an innovative framework: recommendations for how surgeons should talk with families and patients who are faced with an acute surgical emergency. Our recommendations are having a real impact; I’m excited to keep making it easier to have hard conversations.
I think my particular background allows me to approach these problems in a special way. I was fortunate to have been given a lot of opportunities to lead in my time at Northwestern. This was essential to me, as was my Northwestern communications training. Now I’m in a rare position to change the way that surgical patients receive care. I want to help my fellow surgeons and doctors do things for patients and not just to them. That motivates me a great deal.
I’ve taken a circuitous route but one that I think has some kind of logic. Improving lives by improving communication is something I could only have accomplished with my experience at Northwestern. And for that I’m truly grateful.
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