Dan & Deb Hamilton's bio Synapse

From the Hospital: Literature & Medicine at Togus Veterans Administration Medical Center
Dan Hamilton ::: bio, Deb Hamilton ::: bio, by Lizz Sinclair ::: bio

Lizz Sinclair
Lizz Sinclair

Founded at the end of the Civil War, the Veterans Administration Medical Center in Togus, Maine was the first VA hospital in the country. Togus was also the first to host Literature & Medicine. In fact, it was the strong response to the program from participants at Togus—and later at the VAMC in White River Junction, Vermont—that prompted us to offer the program to other VA hospitals across the country.

Dan Hamilton, a Physician Assistant who has worked at Togus for twenty years, has been the driving force behind L&M at Togus, where he serves as the program’s liaison. Both he and his wife Deb Hamilton, a Home Health and Hospice nurse, have participated in Literature & Medicine for the past nine years. With a number of VA hospitals slated to host the program in 2010 for the first time, I wanted to ask them about their experiences with Literature & Medicine.

 

Lizz Sinclair: Dan, you were the first person I approached about starting Literature & Medicine at the Veterans Administration Medical Center at Togus ten years ago. I remember that you were eager to get involved, and soon had support from the administration. Why did Togus VAMC want to participate? What were you hoping to get out of participating personally, and what did you hope for Togus?

The most important part of the group for me is to interact as a community of health professionals and to realize our interconnectedness in the whole process of caring for patients. The readings were very important in understanding the diversity of patients and veterans with their intricate problems.

Dan Hamilton: Dr. Betsy Hart, who is a friend and colleague, facilitated a Literature & Medicine group at another hospital and had told me how the program brought staff from all departments within the hospital together to share their perspectives about the care of patients and about their roles in such care. Enoch Albert, who was on the nursing staff, and I were willing to act as liaisons and work with the Maine Humanities Council to set up the program here at Togus. We presented Literature & Medicine to the administration as a program sponsored by MHC that had been successful in many hospitals throughout the state, stimulating great discussion and bringing staff together with the goal of better patient care. It was stressed that Togus would be the first VA Hospital to participate in the Literature & Medicine program, and the administration was excited about this. Personally, I was thrilled to be able to talk about books and my role in the care of veterans and how this was connected.

LS: I know people often worry about how much time it will take to be the liaison, or organizer, for the program in the hospital. What is your experience? Do you have other people helping you?

Dan Hamilton: Initially it took several hours to set up the program, work out the syllabus with you, MHC's program officer, and the facilitator, set up times, the meeting place, obtain and distribute the books, and get all in order with participants and the administration. Before Enoch retired, he helped with recruitment. The clerical staff assisted with information distribution and the janitorial staff assisted with room maintenance. This has been followed by a couple of hours a month to set up sessions. It’s really a small amount of energy for a big gain.

LS: Did you have difficulty recruiting people to join the Lit & Med group the first time? Was it difficult to get a diverse group of health care professionals?

Dan Hamilton: No difficulty whatsoever—many people were excited about the possibility of a book club related to their work in the hospital. They had also heard positive feedback about Literature & Medicine programs that were ongoing at other hospitals in the state. It was not difficult to get a diverse group of heath care professionals to participate.

The first group included doctors, nurses, physician assistants, nurse practitioners, lab technicians, social workers, clerical staff, and health care professionals from the community. We got the word out with posters and an email about the program. It is pretty amazing that, when you directly contact people about discussing books, the people with that love come out of the woodwork and look you up.

Lizz Sinclair: How about now—do you find it easier to get a group together every year? Do new people join? Are people who have participated before able to participate again?

Dan Hamilton: It is not difficult to find 20-25 people to enroll and many times there is a waiting list. People who have participated previously do participate again and look forward to it every year. New people also join the group. It seems to be a good balance.

LS: Deb, you come from a slightly different perspective as a Home Health and Hospice nurse outside of the VAMC who sees patients, some of whom are veterans, in their homes. What has it been like for you to participate in the Lit & Med group?

Many of the readings spoke to the experiences of the family members in dealing with both PTSD and serious and/or chronic illness. I always recognized this as an important piece of my job but now I feel much more in tune with what my patients’ needs might be.

Deb Hamilton: One of the wonderful things about this program is that I have gotten the opportunity to learn a little more about what the roles of social workers, librarians, physicians, medical assistants, etc… are in providing patient care. Members of the health care team view patients and illnesses from different perspectives, depending on their jobs, and contribute those perspectives to the group as we discuss the readings. As a Home care and Hospice nurse, I was able to speak to the hurdles of providing care at home—the obstacles and joys of dealing with all that goes with the home situations. My experience of working with dying patients and their families was an unfamiliar field for many of the participants.

So many subjects that might not have been read or talked about were. I felt this helped me move out of my safety zone. What has touched me most is the stronger understanding of veterans and, more specifically, their PTSD.

So many subjects that might not have been read or talked about were. I felt this helped me move out of my safety zone. What has touched me most is the stronger understanding of veterans and, more specifically, their PTSD. Previously, I think that it had been one of these dark subjects that I had not wanted to read about. I feel that my knowledge and understanding has been greatly enriched. An instance where I specifically remembered something from one of the discussions was during a home visit to a veteran late at night to help him with some issues he was having with pain control. Despite the hour, and knowledge that this was after my shift had ended, he persisted in giving me the blow-by-blow of how he lost his leg in battle 30 years ago. I started feeling that we were never going to get around to discussing his pain issues, and then I realized that for him, this battle was still in his very near past and that we were, indeed, already on the issue of his pain.

I had worked professionally with several of the other Literature & Medicine participants previously. I was amazed at the growth I witnessed in some of them around issues of pain management, end of life care and even issues of discrimination. I can only hope that they have witnessed the same in me. I think that the books and discussions have helped us to better walk in the shoes of our patients. My relationships with the other participants flow much easier now—as if we are coming from the same place of understanding.

LS: How about you, Dan? What have you gotten out of participating in the group?

Dan Hamilton: The most important part of the group for me is to interact as a community of health professionals and to realize our interconnectedness in the whole process of caring for patients. The readings were very important in understanding the diversity of patients and veterans with their intricate problems.

LS: The administration seems very supportive of the program. What do you think a VA hospital in general, and Togus in particular, gains from having this group?

Dan Hamilton: Togus is a very large spread-out hospital with little interaction between departments. This program fosters communication and helps us feel less isolated. Also, anytime an employee feels valued by an employer, the employer wins. It is good to see that our work is appreciated, that we are being supported. This is a way to value employees. Veterans are a specialized population requiring expertise to care for them. Any way that we can work together and better understand our roles can only improve patient care.

LS: What are some readings that provoked especially good discussions? (and what did you talk about?)

Both: The Things They Carried by Tim O’Brien and Achilles in Vietnam by Jonathan Shay brought up very sensitive issues about veterans in general and helped participants to step into the shoes of veterans, to get a tiny glimpse of their experiences. The Spirit Catches You and You Fall Down, Sweetness in the Belly, Bailey’s Café, People of the Whale and The Heart is a Lonely Hunter created enlightened discussion around the diversity of different cultures and races. Many participants developed a greater appreciation of poetry from the wonderful poems that were discussed during the sessions. Short stories and film were also used to stimulate discussion with good effect.

I had worked professionally with several of the other Literature & Medicine participants previously. I was amazed at the growth I witnessed in some of them… I can only hope that they have witnessed the same in me. I think that the books and discussions have helped us to better walk in the shoes of our patients. My relationships with the other participants flow much easier now— as if we are coming from the same place of understanding.

Deb Hamilton: I think being in the group has greatly increased my comfort level. Many of the books were about different cultures and were written from perspectives that I had not been exposed to. I cared for a Cambodian man in Hospice Care. He did not speak English. I think that I took the time with an interpreter on the phone to listen to the stories of his experiences—the great losses that he had suffered in the Vietnam War and in having to immigrate to the US—because I had a better understanding of the value of doing this because of the group.

Many of the readings spoke to the experiences of the family members in dealing with both PTSD and serious and/or chronic illness. I always recognized this as an important piece of my job but now I feel much more in tune with what my patients’ needs might be.

LS: Do you have advice for those at other VA hospitals, or at non-VA hospitals, who are considering stating a program?

Dan Hamilton: Here are my thoughts:

  • Food and atmosphere are very important. Socialization around food helps bring barriers down. People are hungry at the end of the day and it’s a good draw. The room we had the first year was really comfortable because it had a large table that everyone could sit around and see each other with only a little accommodation.
  • It’s important to establish a commitment to the program when signing people up.
  • It’s a small amount of energy for a big gain.
  • It will change the way participants work with each other and veterans.
  • It creates a sensitivity to diversity in patients and opens one’s eyes to issues never seen before.
  • It creates closeness within the community of health care professionals participating in the program.

LS: What was it like being in the group together, as colleagues and as a couple?

Both: These are issues we don’t talk about normally as a couple, but being in the group, we did and were able to see one another in a different light. We each learned a lot about our individual roles in working with our patients—things we never thought about. The literature really makes you think about issues that you don’t usually address. We have a better idea of how we each think about our individual work with patients, and gain more appreciation for each other’s viewpoints especially when we function in different roles or feel differently about the same patients or issues. We have felt a closeness and respect for each other, and the other participants, that has led to our own personal growth. We are better people due to our interactions and hopefully this will lead to increased sensitivity between ourselves and with our patients.

LS: What else should people know about your experience?

Both: We both love it. It has been especially exciting to have community members in the program. We had Hospice nurses, a naturopath and several retired physicians who brought different perspectives to the group.

 

From the Hospital is a column for program liaisons. Submissions may report success stories, describe challenges, offer advice or pose questions relating to organizing and/or participating in Literature & Medicine seminars. Additionally, the editor welcomes any responses or reactions to pieces published in this column. To contact the editor, send an email to lizz@mainehumanities.org

printer friendly article

back to top
Design : Harley Design
Web : West End Webs

Literature & Medicine has received major support from the National Endowment for the Humanities.

  Literature and Medicine Home Forward Synapse to a Friend Subscribe to Synapse