Personal rapport helps calm patient's fears


Edith Skinner, left, and Dr. Lindsey Tyler.



Monday, July 22, 2019

Edith Lewis Skinner, 89, says she appreciates the value of a spry and well-working brain at the age of almost 90.

“It can be a little scary when something goes haywire, so I’m so blessed to have found Dr. Tyler to help me when I needed some help,” Skinner said. “And she’s just the most kind and compassionate person. She means a lot to me.”

Skinner is talking about her new friend and neurosurgeon, Dr. Lindsay Tyler, MD, a neurosurgeon at UNC Neurosurgery at Nash UNC Health Care.

Tyler was the neurosurgeon on call at Nash UNC Emergency Department one day this past March when Skinner was brought in by her daughter, Susan Frazier, after a fall.

“I dropped a piece of mail by my mailbox, bent down to pick it up — and next thing I knew, I was on the ground,” Skinner said.

While nothing was broken and she wasn’t in a lot of pain, she had hit her head on the curb and it was bleeding.

“I mean, that spot was really bleeding,” Skinner remembered. She said a good Samaritan who was walking in the neighborhood helped her to her backdoor and her daughter drove up shortly after that.

“We immediately went to the ER,” Frazier recalled. “It was a lot of blood.”

Tyler was on call when Skinner arrived at the emergency department. Skinner and Tyler became fast friends and Skinner and her daughter were impressed with Tyler’s thoroughness and her compassion. It was a little over two weeks before Skinner got to return to her home.

Later in April, Frazier took her mother to Tyler’s office for a follow-up visit.

“We had started noticing a few things,” Frazier said, “Mom seemed confused and was having short-term memory loss. My friend Beth Carrico, who is a critical care nurse, told me to get her in to see Dr. Tyler.”

Tyler said she could tell quickly that her friend Edith was not herself.

“As we age, it’s common for a minor injury like Edith’s to cause a tear in the blood vessel and form a subdural hematoma,” she said. “We confirmed Edith’s compression on her brain with a CAT scan — this is what was causing her brain to misfire and causing the forgetfulness and the confusion.”

A subdural hematoma is usually associated with traumatic brain injury. It is a “bruise” on the brain where blood gathers between the tissues outside of the brain. This area will put extra pressure on the brain, causing symptoms like Skinner experienced.

The answer for Edith’s problem? Brain surgery.

Frazier said hearing “brain surgery” was a little jarring. Edith said she was concerned, but not scared.

“Well, I really trust Dr. Tyler,” she said. “I felt that she was going to do what was best for me and if she thought having brain surgery was what I needed, I had faith that she was right and would do a good job.”

Frazier said she, too, had confidence in Tyler.

“I think I might have been a little more shocked by the words, ‘brain surgery’ than mom was, but I agree, we both trusted Dr. Tyler. I just followed mom’s lead and there was no complaining or talk of fears,” Frazier said.

Frazier said there was a sense of calmness about the whole thing that she attributes to her and her mom’s religious faith and their trust in Tyler.

“It wasn’t just Dr. Tyler’s surgical and medical skills, it was knowing that she genuinely cared for my mom, that made a difference. In all of our dealings with her — after the fall, in the hospital, in the doctor’s office when she was explaining the surgery — she never rushed us. We always felt like we were her only patient and she had all the time in the world to take good care of mom,” Frazier said.

Tyler said while Edith and Susan are easy to get to know and care about, she does make an effort to connect with all her patients.

“I think building a rapport and even a relationship with patients is important to give them the best care,” Tyler said. “By getting to know them, I can best allay their fears and understand the kind of outcome they’re expecting. From there, I think we, as surgeons and doctors, can communicate better with our patients — be on the same page, so to speak.”

“From our time in the emergency department, during all the days mom was hospitalized and weeks at Bryant T. Aldridge Rehabilitation Center, I felt very confident and so impressed with the care she was getting – we were getting. Everyone was as kind to me as they were to mom,” Frazier said.

Skinner said she’s looking forward to many more days with her family and she is grateful for all her blessings, including Tyler and all the staff who took care of her during her recent hospital stays.

Her advice to others?

She says to concentrate on what needs to get done and push your fears to the back of your mind.

“When you’ve got to do something hard or scary, you’ve just got to push through and get it done. Don’t wallow in it — just do it and have faith it will be fine when it’s over,” Skinner said. “My faith and my family and my church family give me great comfort. That’s what helps me the most.

“I wish every doctor had the compassion and care that Dr Tyler has.”