The Quintessential Pain Care Provider

My dear friend, Debbie Tichenor RN, passed quietly and unexpectedly from this world on New Year’s Day 2015.

For more than twelve years, Debbie and I worked side-by-side, sometimes head-to-head, and always heart-to-heart. She was the quintessential pain care provider, possessing a unique abundance of clinical know-how, moral fiber, and you-can’t-outwork-me ethic. I trusted her with my business, my career, my family, and my life. She helped so many, loved so many, and will be missed by so many.

Today it would be my honor to participate in Debbie’s eulogy. And though I dearly wanted to serve in this role, I feared the challenge might overwhelm me, because Debbie was no longer here for me. You see Debbie was one of my vital touchstones. We shared core values, and I could always count on her for honest, intelligent, and constructive feedback. This time, however, I feared I was on my own. And my words, at best, would fall well short of the tribute due this humble angel of mercy.

Nevertheless, knowing that I owed it to my dear friend, sometime after midnight I began writing, not certain where it would lead. Hours passed, and as I fell into and out of exhaustion, the words on my computer screen gradually began to resemble verse. By 5:45 am I had composed a poem – Debbie’s poem. And when I read it aloud, alone in my room, I felt her presence, knew we had written it together, and knew I was not alone.

My sincere wish is that this poem for Debbie provides comfort to those who miss her, inspiration to those who never knew her, and encouragement to those who aspire to be like her. She was, is, and always will be the quintessential pain care provider.

 

A Poem for Debbie

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When she was born it’s right to say,
A blessing came to earth that day.

To ease our pain and bring us love,
Directly from the Lord above.

 A daughter, mother, wife, and friend,
With caring that would see no end. 

A nurse who’d go the extra mile,
Who always met you with a smile. 

If she was anywhere you were,
Then you were family to her. 

And could expect, as from God’s grace,
The blessing of her warm embrace. 

With such profound humility,
Her skill defied futility. 

And when she faced what most would fear,
With love and hope she’d persevere. 

But tending to the quiet needs,
Might count as her most noble deeds. 

And though this blessing we now miss,
God comforts us in knowing this… 

If love defines a life’s treasure,
She lived a life beyond measure.

*

 

~Written with your help, my dear friend,

January 6, 2015

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7 thoughts on “The Quintessential Pain Care Provider

  1. One of the last emails I received from Debbie was her response to my question “What are your thoughts?” in regards to this “Meaningful Use” article:

    http://community.the-hospitalist.org/2014/11/13/meaningful-use-born-2009-died-2014

    Debbie’s thoughts were poignant, honest, and astute and deserve to be shared.

    *

    December 18, 2014:

    I agree totally. Government supported incentives that assisted healthcare facilities and physicians with conversion to EHR systems were reasonable by assisting to offset the huge implementation costs. Stage 1 basically confirmed the provider’s adoption of EHR and promoted physician discussion of some public health care concerns such as alcohol, tobacco, and illegal drug usage. In Stage 1, EHR users collected health information in a more uniform manner with the potential to be shared with other physicians and facilities. EHR’s assisted with the issue of reading and interpreting hand written notes. These are positives and not hard to attest in Stage 1 MU.

    Stage 2 MU is mired in government bureaucracy and does not necessarily promote improved patient care. A great deal of time and effort is required in an attempt to understand and meet the requirements. The development of the patient portal is one of the most useful byproducts of the EHR; however, in Stage 2, providers will be punished if patients do not show participation. Though the percentage required to meet this measure in relatively low in Stage 2, it will increase going forward. Percentage requirements have increased from Stage 1 to Stage 2 for all measures. I agree that MU should be scaled back and not directly affect the provider’s reimbursement.

    In my opinion, the overall motive for the EHR adoption seems geared more toward data collection and not necessarily improved patient care. My concern is this DATA COLLECTION will be used in the future to determine IF health care coverage will be attainable and/or affordable for the individual especially as the move toward a one payer system looms on the horizon. For this reason alone, scaling back on government mandates and bureaucracy as it pertains to EHR development, adaptation, and utilization may be difficult.

    “Hard to kill a monster once it is created.”

    Debbie Tichenor, R.N.
    Practice Administrator
    Murphy Pain Center

  2. Notes for my tribute to Debbie
    By James Patrick Murphy, MD
    January 6, 2015

    A couple of years ago, Debbie told me that someone at her church had been to funeral and had seen something she had never seen before. When the eulogy was done and the people were leaving to go the cemetery, this man stood up and made everyone go back inside. He felt that not enough had been said about his departed uncle and he wanted to say more. Debbie knew right away that man was I. She made me promise I would not do something like that at her funeral. So here I am…on time. Don’t worry Debbie, I won’t be asking them to come back inside after the service.

    I asked to speak today and I consider it a tremendous honor. I think it is important that everyone, and especially the young people, know how talented and expert Debbie was in her clinical working life.

    Debbie was the Practice Manager at our pain management center. She loved her job, and she was great at it. She was also a great friend and advisor. I get asked to speak to groups frequently and I always tried to run my speeches by Debbie for some encouragement and constructive criticism. I was up until 5:45 a.m. this morning running this one by Debbie.

    Before I left home this morning, I tried to print out my notes and found that the black ink had run dry. The only way the notes would print was in Kentucky Wildcat blue ink. Debbie always kidded me because I am a big Louisville Cardinal fan. So I guess she got the last laugh on me!

    She made us a better organization.
    She made me a better doctor.
    She made me a better person.

    She had a wealth of experience. First she worked in the OR at Baptist East – then in the recovery room – and then in the pain clinic, which is where we met twelve year ago.

    I offered her a job right away and even bought a Christmas wreath she had made. I guess that was a good investment, because about three weeks later she called me to ask if the offer still stood. It did. That wreath was the best $20 investment I ever made.

    Debbie did it all at Murphy Pain Center. She learned it from the ground up. Although she was comfortable and skilled at nursing, she really wanted to be the overall practice administrator. In retrospect, I think she just thought we needed a mother.

    Pain management is very challenging. But Debbie had a knack for it. She possessed a unique combination of knowledge about chronic pain, addiction, and suffering.

    She also worked hard to be up to speed on the new healthcare laws.
    In fact, her comments on a blog article about electronic medical records was so good I encouraged her to send it to the website for publication. Here is part of what she wrote:

    In my opinion, the overall motive for the EHR adoption seems geared more toward data collection and not necessarily improved patient care. My concern is this DATA COLLECTION will be used in the future to determine IF health care coverage will be attainable and/or affordable for the individual especially as the move toward a one payer system looms on the horizon. For this reason alone, scaling back on government mandates and bureaucracy as it pertains to EHR development, adaptation, and utilization may be difficult.
    “Hard to kill a monster once it is created.”
    Wow! Does that sound like our Debbie?

    She was always a little shy about the fact she was “only a RN” and had not gone on to get her bachelors degree in nursing. This emotion was unfounded. Make no mistake, Debbie was very smart and earned numerous certifications in healthcare, business, and information technology. Debbie was well known as an expert in these matters. People knew of her and knew I was successful, in large part, because of her.

    She was a symbol of hope.
    She was a very good listener

    I trusted her so very much and held her in such high esteem that I knew that no matter what we might face as a medical practice, Debbie’s honesty and integrity would carry the day. And she, in turn, trusted me.

    When you have earned the trust of someone like Debbie, you have been honored immensely.

    For all who have met Debbie and have found ourselves within her circle of love, we have been blessed, and we have obligation to pass it on.

    Debbie loved life but she was never afraid to die.

    As I said, she managed but she didn’t like my management books. She knew the Bible. That was her management book. She loved God. Her faith was unshakable.

    2 Corinthians 1:3-4 New American Standard Bible (NASB): Blessed be… the Father of mercies and God of all comfort, who comforts us in all our affliction so that we will be able to comfort those who are in any affliction.

    Debbie made me a better person…
    She read all of my reports. She knew my strengths and my weaknesses.
    She was filter for me in clinical and personal life decisions. Debbie understood me as a doctor as a person and understood pain and addiction.

    I found this in a frame in her office along with a picture of Debbie and Gary holding hands:

    God is faithful to you in little things, in big things, in all things.

    We all wanted to be the way she was. So kind. So sweet. So loving.
    Was she just born that way? Did her parents raise her that way?
    Gary, Brian, Stephen, Mr. Ockerman. Jo Carol, Sherry, Wendy,
    Aunts, uncles, cousins, friends, church members, co-workers, staff…
    Everyone here has a bit of Debbie in them.
    That is indeed a blessing.
    It is a gift.
    And I intend to do something with that gift.

  3. Posted by me in the Barlow Funeral Home Visitors Book
    – January 5, 2015

    Debbie has been a blessing to so many people… loved ones, family, friends, patients, and even to many she never met but who benefitted greatly by her life’s works – ripples of love, selflessly created. She was the consummate nurse who set an unmatched standard for caring. It is impossible to adequately describe the comfort and inspiration she gave to the many lives she touched. At our chronic pain center, Debbie was our backbone and our heart. She brought hope to countless patients over the years, but to Debbie, they were always more than patients – they were God’s children. Though too humble to ever accept such praise, she was, is, and will always be one of God’s greatest gifts to our world…and to me. She made everyone around her better. She made me a better doctor. She made me a better person. I love you, my dear friend. I miss you but know you will always be with me. I am grateful to all you have done for my career, my family, and me. I will carry on with the Lord’s work and try to make you proud. Give your mom a hug for me and please put in a good word for me in heaven. You are home now.

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