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A Simple Grand Rounds Presentation

Hey all!

Happy Friday and, as always, my mind has a great deal of gratitude for this community to be able to share wins, successes, and Stories of PCBH.

A few years ago, Bridget and I were able to give a presentation on infusing a functional contextual approach to smoking cessation at our local hospital’s grand rounds. We did our usual, “behaviors don’t happen in vacuums… context is paramount… be curious with your patients and the behaviors, like smoking, and find the function of the behavior, etc.” My mind doesn’t remember anything truly unique about the presentation (i.e., materials or delivery). I do, though, remember my mind wondering before, during, and after (which, lol, is quite a common experience for me when presenting), “will anyone get what we are saying?”

Last night while at a social function for the hospital and going through introductions, a physician came up to Bridge and I and said, “hey, I know you two, I went to your smoking cessation grand rounds a few years ago.” The physician went on to share that immediately after the talk he was in clinic and had a patient who was trying to quit smoking. During the conversation he asked the patient, “when you started smoking, what was happening in your life, how were things going,” which, as he described, was his attempt at trying to figure out how the behavior of smoking made sense. The patient responded, “you know, honestly, I was probably walking around with a shirt saying, “please, don’t (assault) me.” Meaning, the patient was going through a number of life hardships at the time she began smoking. The physician went on to tell Bridget and me, “I have never looked at (the behavior of) smoking the same again.”

As Bridget and I were driving home, we reflected on how normal it was for us to give a presentation on smoking and contextualism, something we have probably done hundreds of times. How I remember my mind saying before and during the presentation, “are medical providers really going to ‘dig’ this idea of contextualism, are they going to even understand what we are talking about?” How fortunate we are to have careers, jobs, etc., where we get to have these moments that may ripple out exponentially. How PCBH allows us to impact health systems, as Jeff has always said, way beyond just seeing patients.

As said earlier, my mind has so much gratitude for this community, as well as for the conference last week. It was healing, it was inspiring, and it allowed more awareness to what we get to do every day. It reminded my mind that things that are so normal, like doing a presentation at grand rounds, or closing the feedback loop with a PCP after a handoff, or writing PCP recs in a patient note, can ripple out in incredible ways. My gratitude for you all and, without question and as Robert Rosenbaum so eloquently says, don’t underestimate what a moment can do.

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