A commitment to compassion

Throughout his 18 years as an oncologist, Kenneth D. Miller, M.D., has always tried to go above and beyond what many consider to be adequate care for patients and their families. But it wasn’t until his wife was diagnosed with acute leukemia in 1999 that he gained a personal understanding of what it is like to live with cancer. That experience prompted him to reflect on how patients are cared for not just during treatment but afterward, and it has culminated in his work as the first director of supportive oncology services at Yale Cancer Center (YCC).

Miller, assistant professor of medicine, traces his interest in oncology to his childhood in Hartford, when he accompanied his father to the medical appointments of a number of friends who had cancer. After graduating from Tufts University School of Medicine, Miller returned to Connecticut for his residency at Yale-New Haven Hospital and then completed two fellowships, one in hematology at the National Institutes of Health and another in medical oncology at the Johns Hopkins Oncology Center.

He practiced medical oncology in the community, and then went on to work for Connecticut Hospice as associate medical director for two years. Miller took a position at YCC in 2005.

With support from the Kenneth B. Schwartz Center, Miller has instituted a regular forum in which YCC doctors, nurses and social workers discuss the difficult emotional and social issues that can arise when caring for patients who are severely ill. Although the sessions focus on the caregivers’ feelings, their ultimate aim is to provide more compassionate care to patients.

Miller’s parents lost many friends to cancer as they aged, but today patients are surviving longer, sometimes with acute disease, creating a new demand for strategies to address psychosocial as well as medical issues. In October 2006, as part of Yale’s effort to offer patients a broader range of care, Miller helped open the Connecticut Challenge Adult Survivorship Clinic, where he serves as medical director.

The clinic, named for an annual bicycle ride in Fairfield, Conn., that benefits survivorship programs at the YCC, helps patients who have finished treatment to reflect on the experience and begin to rebuild their lives.

Another of the clinic’s programs assists cancer survivors who are still undergoing treatment and are experiencing complications.

“There is a spectrum of things that happen to people who have been through the cancer experience,” Miller says, “and we’re trying to address some of these issues in a meaningful way.” Miller is also in the process of building a palliative care team at Yale to ensure that people receive the same level of medical attention at the end of life as they do while they are undergoing treatment. “We’re all going to reach the end of life,” he says. “Everyone we treat should be offered the best that we can give in terms of holistic and compassionate care.”

Along with Edward Chu, M.D., professor of medicine and YCC deputy director (see related story below), Miller co-hosts the weekly Healthline show on WTIC-AM radio in Hartford. He frequently gives lectures to spread his message about how caregivers can contribute to patients’ quality of life, and he is distilling his insights into a book, tentatively entitled Walking in Our Patients’ Shoes: The Role of Empathy in Medicine. Another book, Choices in Breast Cancer, is now in press.

Miller says that caring for his patients, developing programs to help improve the quality of life for cancer survivors, and working on end-of-life issues are all pieces of the same puzzle: how to provide compassionate care to cancer patients at every stage of their illness. “It all fits together as a package.”