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 Diane Rapaport, MD |
Practicing What She Teaches
Originally published in Chicago Hospital News, March 2006
By Sharon Rostoker
As medical director of the Ambulatory Care Center at Mercy Hospital for 17 years, Diane Rapaport, MD, knew all too well the gritty realities of an inner-city hospital and the miracles demanded of medical technology.
As senior medical director of VITAS Innovative Hospice Care of Chicagoland Northwest for almost six years, Rapaport knows that when technology can do no more, there are still miracles: There are music and touch therapies. There are house calls, conversation, an interdisciplinary team and all the knowledge gleaned from one-on-one patient care at the end of life.
“We want to control symptoms,” she says. “But consider cancer or dementia patients, for example. No one touches them! We at VITAS foster touch. A patient may be fearful because of pain. Music therapy is helpful in controlling anxiety and stress and improving socialization. And there are no side effects.”
At VITAS’ Chicagoland Northwest, massage and music therapists add to the expertise available when a physician, nurse, aide, social worker, chaplain and volunteer collaborate. Rapaport is a humble member of that team. “I highly respect the skill set the nurses, social worker and chaplain bring to the bedside,” she says. “I’m not an elite scientist. Home care relies on observation, and our nurses have a lot of offer.”
Patient and family have something to offer, too. Rapaport urges families to express their goals for the last weeks of a patient’s life; she urges physicians to offer realistic options.
“It’s a privilege to be in the homes of my patients,” she says. “But it’s a challenge. My hat is off to the nurses who do it every day. We walk into a hospice patient’s life at the end of the story. They often feel the medical profession has failed them, and they’re not necessarily grateful for the care we give. That’s why we try to work in concert with their primary physician.”
It’s why she enjoys teaching clinical students. And why she’s always looking to mold or find a good potential team member. “The ideal team physicians are willing to learn all over to be the best diagnostician possible at the bedside,” she says wishfully. “They learn symptom control and pain management. They read, go to conferences, learn things we were never taught in our original training. It’s a new field with its own body of literature.”
As a VITAS medical director, Rapaport has the opportunity to practice what she teaches. “Dr. Rapaport has built a team of physicians here that are hospice savvy,” says Patient Care Administrator Susan Yendro. “She is down to earth. She is someone with whom you can be a colleague on the basis of doing the right thing for the patient. And we have filled our program with physicians a lot like her.”
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