A Partnership for the Ages
At 86 years old, Sonia Booker is one of Boston Medical Center’s radiant octogenarians (a term used to describe those who are in their eighties) and someone who makes an instant splash with her upbeat outlook on life. She has been part of the BMC family her entire life, from being a pediatrics patient to having her own children at the hospital. Now, she is part of BMC’s geriatrics home care program, which is offered to patients 70 years and older who are unable to come to the hospital for their primary care visits. Sonia’s blindness makes trips to the hospital difficult, so her physician of eight years, Ryan Chippendale, MD, director of BMC’s Geriatrics Fellowship program, visits her home to provide care.
On the surface, home care is just as one might imagine. “It’s very similar to the old school vision of doctors going out with their bags and seeing patients in their homes,” explains Chippendale. However, these visits are about so much more than check-ups and check-ins—they’re an opportunity to help patients lead fulfilling lives on their terms. “Geriatrics is about shifting our lens to think about the big picture, not just ‘fixing’ every problem,” Chippendale says.
Chippendale works with patients to set and achieve goals that revolve around being as functional and independent as possible, for as long as possible. “I always ask my patients, ‘What are you hoping to get out of this? What are your worries? What are your hopes?’” Chippendale explains. “We make an individualized plan together. There’s a ton of outside-the-box thinking and putting the patient perspective first, above anything else.”
Having these conversations and visits take place outside hospital walls offers a unique, immersive experience. Sonia’s case is certainly no exception. From the moment Sonia opens the door, Chippendale is welcomed into an environment that brings Sonia’s personality to life, beginning with Sonia’s greeting, “I’m blessed by the best. Not stressed, depressed or oppressed.”
More so, topics that usually come up in casual conversation in the exam room, like Sonia being a concert pianist or her recent engagement to fiancé Freddie, are tangible during home visits: Sonia’s keyboard and stacks of old records in her living room serve as a backdrop for their appointments and Chippendale gets to know Freddie on a personal level.
“The more I know my patients and their goals and preferences, the better,” notes Chippendale. “Those factors underlie every single decision we make together.” Sonia finds the trusting relationship and openness to be invaluable, adding, “I feel like I can talk to her like an old friend. Every time she comes I am so happy to see her. My friends tell me, ‘I’ve never been able to talk to my doctors the way you talk to yours.’”
Understanding Sonia’s personality and seeing firsthand how she lives her life has proved instrumental for Chippendale, especially when navigating through times of illness. A few years ago, Sonia was diagnosed with a fairly invasive form of bladder cancer, which required the removal of her bladder and chemotherapy. Despite the gravity of the situation, Sonia’s positivity was unwavering. “We gave her the diagnosis, and I was distraught,” notes Chippendale. “But Sonia was so brave. She never got down about it.” In fact, Sonia looks in the mirror every day and says, “‘You are beautiful. You are strong. You are healthy. And you will live!’”
The typical chemotherapy regimen recommended to treat Sonia’s cancer would have had a significant impact on her energy levels. Knowing how much Sonia valued being active, her medical team worked closely together to think through all possible treatment options that would best support her lifestyle, instead of hindering it. “We knew Sonia wanted to live life to the fullest, and standard chemotherapy would have kept her from doing that,” explains Chippendale. “We couldn’t do that to her. That’s not what she wanted. So, we put our heads together and opted for a less traditional therapeutic agent with fewer side effects.” The collaborative, patient-centered approach to care—signature of BMC’s mission—paid off: Today, Sonia’s disease has virtually disappeared and she maintains an incredible quality of life.
Sonia’s gratitude to her medical team is boundless. And the feeling is certainly mutual. “Sonia has taught me what a positive attitude, strength and optimism can do in order to treat illness. I fully believe that’s why she’s done so well despite a life-threatening condition,” concludes Chippendale. “She teaches me more lessons than I could ever teach her.”