AMA Journal of Ethics^®

This painting is a rendering of my experience with what I call patient-centered medicine. It reveals a medical community, family and friends addressing both the body and the mind. This is the level of support my husband Denny and I would like all patients to experience. In this painting, sacred serpents like those of the Caduceus and Aesculapius' staff represent healing forces and rise from the circle of wholeness and original perfection to support my body and my mind. My body is shown scarred from a life-saving mastectomy, a TRAM-flap reconstruction, a new navel off-center, and a swollen right arm and hand due to lymphedema. My mind is focused introspectively, altered forever by the experience. These eight powerful serpents tenderly suspend my figure upon the background of an hourglass suggesting the heightened element of time. Crystal blue water fills the glass representing the conscious and unconscious. Its shape hints at the ideal shape of western woman. In the distance is the earth's horizon at sunrise - above a dark sky, below black ocean waters - the deeper recesses of my psyche.

Each sacred serpent represents a different force - individuals who focused on healing me.

My Medical Team

(all within a medical cross) 
- my primary surgeon (Aesculapius' staff), 
- my reconstructive surgeon (two closely connected halves of a circle), 
- my anesthesiologist (wave length of gamma ray), 
- my radiologist/oncologist (atom), 
...all working together to fight this cancer (crab), talking to each other as well as to Denny and me,

My Breast Care Clinic Coordinator

(anchor within a medical cross) 
- who acted as an anchor at the center of the clinic: 
- directing us to resources, 
- scheduling consultations with a primary surgeon and a breast reconstructive surgeon together so we could consider our option of only one major surgery, 
- connecting me with a woman who had gone through the same reconstructive operation I was considering,

My Clinic's Office Staff Assistant

(flame of knowledge over a medical cross) 
- who wrote everything on a 3 x 5 card when my mind could not accept another thing even directions within the hospital,
- who called me countless times to schedule me sooner during the more urgent times, 
- and who told me whom I had an appointment with and why,

My Husband

(Leo with heart)(ring) 
- who took on all the gathering of current medical data and opinion so we could make decisions we could live with, 
- and who loves me,

My Mother

(pelican, symbol of parental self-denial) 
- who would do anything for her children, 
- who has a strong empathetic nature, 
- and who raised her children to have the same,

My Support Group

(ribbon within medical cross)(knot) 
- whom I shunned at first for fear that I would be expected to contribute to the healing of others when I needed to concentrate on my own healing, 
- but whom I still stay in touch with while we share experiences, educate each other and laugh a lot,

My Physical Therapist

(pair of hands)
- who helped me get my arm functioning to 98% or so, 
- and who worked with my lymphedema (right arm larger),

My Male Friends

(male symbols) 
- who offered their compassion, not their personal fear, 
- and who braced my self-confidence as a woman.

"Patient-Centered Medicine," 28 x 39, water color on cardboard, was painted by Francoise G. Hultzapple in October 1999.