Too busy to take in what I have to tell her: Physicians' work-flow with an electronic medical record

Joyce Adams' wry observations:
A doctor I see is one of the 4% of doctors who make full use of electronic records to assist their practices. It seems obvious to me that having lab results, previous clinical observations and recommendations at her fingertips enhances the care she provides.

On the other hand, visits to this doctor involve minutes spent while she locates my health records on the computer, and minutes spent as she enters new data, all the while with her gaze and attention fixed on the computer rather than on me. The tap-tap of her fingers indicates that she is too busy to be taking in whatever I have to tell her, and that the electronic task has been elevated over the old-fashioned hands-on approach to clinical care.

Once records are enshrined in my doctor's computer, they are available for her use and the use of other doctors in her clinic. However, they fail to travel beyond the clinic to the office of my primary care doctor because apparently the task of faxing them over is too onerous in this high-tech age.

Getting electronic records to my primary care doctor, who oversees all aspects of my health, requires a more basic effort: a hand-carry by the patient.

So much, and so little, progress!

Advice: Choose a physician who has both an electronic medical record and high patient satisfaction ratings.

Read another story on the work-flow of physicians with an electronic medical record.

Thanks to Joyce Adams for her letter to the editor, published in today's NY Times.

Stronger than I've ever been: A heart transplant athlete

The heart transplant survivor Kelly Perkins has added another first to her long string of mountaineering feats since getting a new heart 13 years ago – a dangerous climb up a sheer, 2,000-foot face of Half Dome in Yosemite National Park.

Kelly, age 46, and her husband, led by guide Scott Stowe, began the climb on Thursday and reached the top of the 8,842 foot high dome early on Saturday afternoon.

"I feel great," she said by phone from the top of Half Dome. "Physically, I feel I'm stronger than I've ever been."

Advice to transplant patients: Live your life as fully as Kelly.

Read another superstar athlete’s story.

Thanks to the NY Times for publishing the source article today.

The furthest you could be from courageous: Attitudes toward one's own cancer

Although public figures like Teddy Kennedy promote enduring impressions of the stalwart, pumped-up spirit, Dr. Joseph Finns says patients themselves often describe a more nuanced, evolving journey.

When Robert Kosinski was told he had a tumor on top of his brain stem, entwined with his optic nerve, "Everything went dark, went blank," he recalled. "I was overwhelmed by the idea that I had a brain tumor stuck inside me. The train ride home lasted so long and I just kept wondering, 'How long do I have to live?'"

Faced with potentially harrowing repercussions from a biopsy, Robert, a husband and father in Jersey City, said he felt depressed and ultimately alone with his decisions.

He chose not to have the biopsy, and went through chemotherapy. He would endure a dozen blood transfusions. Optimism, or even stoicism, were not part of his emotional makeup during those grueling months. "I never felt brave or courageous," he said. "I don't know what that means. I was scared. I was the furthest you could be from courageous."

That was 15 years ago. Now 61, he paints and attends a monthly support group, where he ascribes his odds-defying survival to luck and medical expertise, rather than personal will. "Some people in my group don't want to hear the upbeat scenario," he said. "The way they're coping is completely the opposite because they feel they may not make it."

Dr. Finns' advice to patients: There's no scripted way to handle this. Write your own script based on your own narrative.

Read a story about Teddy Kennedy’s brain cancer.

Thanks to Jan Hoffman for her source article in the June 1 issue of the NY Times.

I'll do anything to save money: Patient testimonials for face-lifts

For Dave Gibson, 53, a New York actor, who had his Lasek surgery in May, posting a video on Facebook and YouTube was a no-brainer. He even added his own blow-by-blow narration. ("The first thing the doctor does is place a round apparatus in the center of my eye…") At the doctor's request, he also sent an email message to 100 of his closest friends, racking up a $1 credit for each one. As soon as the doctor had mentioned the rebate, Dave thought to himself, "I'll do anything to save money."

Another patient asked to remain anonymous because he is still undergoing treatment for an operation he had done about six months ago. Never mind that the video went up almost immediately, before he had time to heal. "Regardless of whether I'm happy – that's not going to stop me from posting," he said. "It's money in my pocket." As it turns out, he isn't satisfied with his results, but he hasn't taken down his glowing endorsement.

Advice: Take patients' testimonials with a grain of salt.

Read another plastic surgery story.

Thanks to Abby Ellin for the source article in the NY Times of June 26.

I got my mother back: Overuse of antipsychotic drugs in nursing homes

Last fall, Theresa Lamascola of the Bronx, suffering from anxiety and confusion, was put on the antipsychotic drug Risperdal. When she had trouble walking, her daughter took her to another doctor, who found that she had unrecognized hypothyroidism, a disorder that can contribute to dementia.

She was moved to a nursing home to get the problems under control. But things only got worse. She "was screaming and out of it, drooling on herself and twitching," said her daughter, a nurse. The psychiatrist in the nursing home stopped the Risperdal, which can cause twitching and vocal tics, and prescribed a sedative and two other antipsychotics.

"I knew the drugs were doing this to her," said her daughter. "I told him to stop the medications and stay away from Mom."

Not until another doctor took her off the drugs did she begin to improve. He prescribed Aricept. "It's not clear whether it was getting her hypothyroid and other medical issues finally under control or getting rid of the offending medications. But she had a miraculous turnaround," said the new doctor.

She still has dementia but she went from confinement in a wheelchair – unable to sit still and screaming out in fear – to being able to walk with help, sit peacefully, have some memory and ability to communicate, understand subtleties of conversation and even make jokes.

Or, as her daughter put it, "I got my mother back."

Researchers estimate that one third of all nursing home patients have been given antipsychotic drugs.

Advice to people with elderly relatives in a nursing home: Ask the doctor about alternatives to antipsychotic medicines.

Read another story about drug side-effects in the elderly.

Thanks to Laurie Tarkan for the source article in today's NY Times.

Blind-sided by my reaction: The role of attitude in surviving cancer

Richard Haimowitz, 62, a lawyer in Queens, New York who was found to have pancreatic cancer in January 2007, thought of himself as a warrior, fighting with all available ammunition.

"The day of my last treatment, people congratulated me, but I felt blind-sided by my reaction," he said. "I thought, 'Oh my God, I have nothing left to fight with,' and I felt angry that there was nothing left for me to do." Statistics to the contrary, he has had two clean scans, is back at work and takes spinning classes. As he soldiered through treatment, he did not fear death, even though he did not want to die.

Many studies published in oncology and mental health journals have looked at whether attitude is a factor in survival or recurrence rates, a core belief in many cultures and faiths. Some studies say Yes; others say No. They all have their critics.

Advice to friends and families of cancer patients: Try to empathize with them regardless of their mix of feelings.

Read another story about the role of attitude in recovering from cancer.

Thanks to Jan Hoffman for the source article in the June 1 issue of the NY Times.

He has resumed athletic activities: Attitudes toward one's own cancer

Brian Wickman, a manager at a luxury hotel in Manhattan, needed to refrain his loved ones' language. Two years ago, an oncologist told him there was little published data about the aggressive tumor on his ankle because it was so rare and because "no one wants to publish when all the subjects die." A month later, Brian, then 30, a skier and a rock climber, had his left leg amputated. He was also found to have thyroid cancer. He reacted severely to chemotherapy, and spent two months in intensive care.

His awestruck friends would say, "You're so brave, I don't know how you do it; you're my inspiration." "They would put me on a pedestal," Brian said. "That doesn't allow me to be human an in pain, angry or depressed."

His email messages reveal a spirit of great equanimity and eloquence. He now wears a prosthesis and has resumed athletic activities, and will attend graduate school in the fall for a joint degree in social work and divinity.

But in his darker moments, he refused to construct a front. He would write bluntly about feeling grumpy, frustrated and afraid nobody would date him. "This is not a call for pity responses," he would add. "Just let me be where I am."

Advice to friends and families of cancer patients: Try to just let them be where they are.

Read another story about the role of hope.

Thanks to Jan Hoffman for the source article in the NY Times of June 1.

Coming from several blocks away to gawk: Privacy and neighbors

Dear Amy,
I have a sensitive issue and nosy neighbors. Three weeks ago, I was taken to the hospital because I suffered from major depression and was suicidal. I was in the hospital for eight days.

One week to the day of my release, I had four police cars, eight officers and two paramedics at my home to take me back to the hospital. Literally, every one of my neighbors was outside wondering what was happening, and they saw me being carried away on a stretcher. I was gone for three days and was diagnosed with bipolar disorder.

That weekend I had the police at my house four times because of my son running away, becoming violent and threatening suicide. The last incident ended with five police cars, 10 officers and the obligatory ambulance and paramedics. They blocked the roadway in both directions. Everyone was outside and watching, some coming from several blocks away to gawk.

What do I say to these people? Do I tell them I was suicidal, depressed and now diagnosed as bipolar? Do I tell them my son has a drug and alcohol problem along with also being bipolar?

Or do I just ask them why they're so interested in something so personal?

I need a subtle way to tell them that it's none of their business without revealing the true reasons. Any suggestions?

Amy's Advice to Wondering:
First of all, I hope your situation has stabilized. I can imagine that you feel very exposed because of the public drama brought on by these crises.

You don't have to reveal anything to your neighbors, but if you choose to, you can say, "I realize that things have been very dramatic at our house lately I've had some health issues that brought on a crisis for me and my son, but we're hoping things are better now."

Browse for related stories in the index at the very bottom of this page, or read another privacy story.

Thanks to Amy Dickinson for the source letter in her column, published in the June 16 issue of the Philadelphia Inquirer.

The physician ordered the methotrexate as listed: A wrong dose near-miss

An 85-year-old man who'd been getting treatment for severe psoriasis was admitted to the hospital with a three-week history of confusion, forgetfulness, and weakness. Home medications listed on his medication reconcilation sheet included oral methotrexate, 25 milligrams every Saturday at breakfast and lunchtime. The hospital used patients' medication reconciliation sheets as order sheets, and a physician ordered the methotrexate as listed.

A typical dose of methotrexate for psoriasis is 2.5 milligrams at 12-hour intervals for three doses once a week. Doses may be gradually adjusted but generally should not exceed 30 milligrams/week. The pharmacist recognized that a 50 milligram weekly dose was high, so he asked the nurse to confirm it. The patient verified that he was taking 25 milligram doses.

Before dispensing any methotrexate, a second pharmacist questioned the order. The pharmacist called the patient's family and asked them to read the prescription container. It indicated that each dose was supposed to be 2.5 milligrams. The order was changed because of the pharmacy intercept, and the patient received the correct dose.

Advice: Bring your medication containers and a list of your medications when you go to the hospital.

Read another near-miss of a drug error story.

Thanks to Michael Cohen for the source story in the June issue of Nursing2008.

A buffer and enabler for the patient: VIP care

Dr. Victoria McEvoy on VIP care:
One Emergency Room doctor told me recently about a VIP patient who came to the ER complaining of chest pain. The patient's visit triggered a cascade of events at the hospital administration level. The "VIP Office" sent a delegate to smooth the way, and the patient came with his own personal physician, who was there to serve as a buffer and enabler for the patient. Not only was the "physician bodyguard" not in the right specialty for the complaint and age of the patient, but the physician gave orders: "Call the cardiologist and get an echocardiogram."

Both the resident and the responsible physician thought the patient's problem was gastro-intestinal: he had swallowed a huge antibiotic pill without water, and the esophagus was irritated enough to cause the chest pain. Instead of quickly looking at the patient's esophagus, hours were wasted getting cardiology and cardiac tests which were not needed. His VIP status delayed him getting proper care.

Advice to Very Important Persons: If you bring in your personal physician, make sure they will listen to other doctors' opinions.

Read a celebrity drug error story.

Thanks to Dr. Victoria McEvoy for the source article in yesterday's Boston Globe.

National Marrow Donor Registry

The Dana-Farber Cancer Institute is encouraging everyone to join the National Marrow Donor Registry today from 10 am – 3 p at Tufts University's Cousens Gymnasium in Medford, Massachusetts. Former Red Sox pitcher Bill Monbouquette, recently diagnosed with leukemia, is among thousands of people who are awaiting a transplant.

Advice: Look for a time and place to register with the National Marrow Donor Registry. You might save someone's life.

Read a donor story.

Thanks to the Boston Globe for the source article in today's newspaper.

A pictogram in return for another pictogram: Diabetes patient education

Consultations with Mrs. L are difficult: sometimes, she comes
without her diabetes logbook, or forgets to have the requested
HbA1c assay. Above all, she comes either alone or accompanied
by someone who, like herself, speaks nothing but Chinese. All I
can do, in order to understand her repeatedly high HbA1c
levels, is to look at her logbook and try to understand the
documented insulin doses and the blood glucose concentrations.

Recently, I admitted her to hospital. Firstly, we verified that
the technical aspects of blood glucose determination and
insulin injection were perfectly correct. I also told her that
I needed an interpreter. A Chinese neighbour who was fluent in
French came with Mrs. L on the following day. I first checked
with Mrs. L the basics of adapting insulin doses and began to
ask her questions through the interpreter. No answer. I
therefore asked the interpreter if he, himself, had understood
the meaning of the questions. He was positive. I then asked Mrs.
L to tell me what she thought of insulin. No answer. I realised
that she knew nothing about it and that the treatment made
absolutely no sense for her.

This situation reminded me of John Searle’s "Chinese room"
argument. Imagine a Westerner, speaking English but not
Chinese, in a room with a window. Through the window, a Chinese
person shows Chinese pictograms. The Westerner has a manual,
written in English, instructing him how to show a pictogram
specific for the pictogram he sees through the window. He is
not aware that the pictogram he sees is a question, and that
what he then shows is the correct answer. The Chinese person
outside cannot work out that the Westerner does not understand
Chinese.

In the case of Mrs. L, we doctors were the Chinese. We had no
direct way of recognising that the blood glucose determinations
or the insulin injections that she performed impeccably had no
meaning for her.

I decided to start her education from scratch. What is
diabetes? What is a normal glucose concentration,
hypoglycaemia, hyperglycaemia, etc? Repeatedly, I asked the
interpreter whether he understood and whether he thought that
Mrs. L understood. He was affirmative. I arrived at a problem—
how to verify that the dose of insulin was correct. At this
point, I was unsure whether the interpreter understood the
question, and I decided to stop the session, giving him another
appointment for the next day. In fact, I doubted the
interpreter’s comprehension of the real sense of what I had
said. It seemed to me that the Chinese room was now separated
from me by two walls and windows.

The next day, a different person accompanied Mrs. L to the
appointment—her nephew, also perfectly fluent in French.
Needing to go through my explanations all over again, I decided
to use another strategy and asked the nephew to imagine that he
was diabetic, and that he had to listen to my explanations as
if they concerned him, in order to give a meaning to the
therapeutic education. Only then would he translate the
information to his aunt. I had the sensation of trying to enter
the Chinese room by climbing through the first window.

To a lesser degree, this story may be relevant to many
consultations, even when there is no obvious language barrier.
It is vital that the patient understands the message as a whole
and not just the words, or else the treatment routines may be
analogous to nothing more than showing a pictogram in response
to another pictogram.

Advice for speakers of a foreign language: Get a good interpreter.

Thanks to Dr. Gerard Reach for the source article in the Feb. 16 issue of the British Medical Journal.

Including her favorite meals and TV shows: Web-based caregiver communities

When Stephen Dworkin's father was diagnosed with pancreatic cancer in 2005, he and his two siblings began to share in his care. But Stephen was in Newton, his parent lived in Florida, and his brother and sister lived in Connecticut. "My dad passed away relatively quickly. And then we were completely unprepared to care for my mother," Stephen said.

At the time, Stephen's business partner, Jonathan Quint, saw the challenges his wife was having in caring for her mother, and the two knew they'd hit on a much-needed service: helping baby boomers care for aging parents.

They came up with Caregiver Helper, a secure online community resource that houses information about medications being taken, emergency contacts, doctors' appointments, and even the patient's favorite activities.

"Anytime a new caregiver came to my mother's house, all the information was available, including her favorite meals and television shows. And each time there was a new doctor, all of her medications could be printed out."

One in four American families are juggling similar caregiving responsibilities, according to the National Alliance for Caregiving.

Advice to Baby Boomers caring for parents who live far away: Consider a resource like this one.

Thanks to Susan Chaityn Lebovits for the source article in the Feb. 25 issue of the Boston Globe.

An hour after being discharged from the Emergency Room: Conflict of interest on a potential malpractice suit

Dr. J.R.'s question:
I am a family physician. A patient I'd not seen in months passed away about an hour after being discharged from an emergency room. Her mother, also my patient, asked me to review the records and autopsy to see if she should bring a malpractice suit against the E.R. physician and the hospital. I am friends with the physician and on the hospital's board. Ought I comply with this request?


Ethicist Randy Cohen's answer:
You should not. Indeed, you cannot – not properly, not without risking charges of bias. Your attachment to your friend and your position on the hospital's board create – or may seem to create – divided loyalties. You should recuse yourself from this task, explain to the patient's mother why you are doing so and refer her to a disinterested physician with the expertise to review the records and advise her how best to proceed.

Update: J.R. met with the family but did not offer a medical opinion, explaining that the records provided insufficient information for him to do so. He said he believed that they would not be satisfied unless the matter were investigated further and so suggested they speak to a lawyer who would have a neutral expert review the case.


Advice to family members considering a lawsuit for a medical error: Consult a doctor or nurse who was not involved.


Thanks to Randy Cohen for the source article in the Ethicist column of the New York Times Magazine of May 25.

Cancer is not a football game: Teddy Kennedy's brain cancer

The mantra of "fighting" cancer drives me nuts. The caring behind it is wonderful; the metaphor is not. Cancer is not a football game. The fighting metaphor is insidious because it implies that if you fight, you can "win." And if you don't fight hard enough, you are therefore a "loser."

The challenge for Teddy Kennedy, just diagnosed with brain cancer, is to figure out where the locus of our limited control lies. He can't change the fact of his diagnosis. But he can, and already has, chosen his doctors wisely. He is putting his resources now, appropriately, into learning about his cancer, what drives it, and what might slow it down. He may have to choose additional doctors, anywhere in the world. That's great. That's the stuff that really is under his control. As is choosing how to spend his time and energy. He is already doing all the right things.

So, I would change the mantra to "Breathe, Ted, breathe." Sail your boat. Kiss your wife and your kids. Trust your doctors. Keep doing the work you love.

Advice to cancer patients: Focus, like Teddy, on what is within your control.

Read last week’s post on Teddy.

Thanks to Judy Foreman for the source article in the May 27 issue of the Boston Globe.

I should be an indignant patient-plaintiff: Apology for drug interactions and other medical errors

Amy Silverstein’s story:
For the many errors that I have witnessed as a heart transplant patient at a well-regarded New York City hospital over the last 20 years, there has been only one doctor with the courage and character to say "I'm sorry."

I should be one of the "indignant" patient-plaintiffs who send legal costs and insurance rates soaring, but I am not. Money cannot heal the ways that I – and many other patients – have been damaged.

It does not take the surgical removal of the wrong kidney or arm – the stuff of lawsuits – to bring about the kind of injury worthy of a hospital's attention. A patient fills a prescription written by her doctor, only to be warned by the package insert that the drug interacts dangerously with another medication prescribed by this same doctor, and there is error, destruction of trust and near loss of life. And no one pays attention.

Even without the threat of lawsuit, a wronged patient deserves some long, hard thought among doctors and hospital administrators.

The writer is the author of "Sick Girl," a memoir.

Advice: Read the package insert after you pick up your prescription.

Read a celebrity’s fatal drug interaction story.

Thanks to Amy for her source letter to the editor, printed in the May 26 issue of the New York Times.

Memorial Day: Veterans’ medical misadventures

We remember these Iraq veterans who have had medical errors:

Sgt. Michael Boothby
(Delayed treatment)


Corporal Cody Hill
(delayed rehabilitation for extensive burns)


Lance Corporal Jeffrey Lucey, deceased.
(lack of access to services)


Cpl. Casey Owens
(delayed approval of surgery; lack of access to services)



Sgt. John Daniel Shannon
(delayed treatment for traumatic brain injury)


Lance Corporal Michael Stubbs
(delayed diagnosis; lack of access to services)


Staff Sgt. Mark Taylor
(misdiagnosis)


Sgt. Edward Wade
(delayed care for traumatic brain injury)

Memorial Day: We Remember

This weekend we recall these victims of medical errors, among many others:

Doug Bonderud


Elaine Bromiley (anesthesia error)


Armando Castellanos
(medication error)


Jasmine Gant
(medication error)


Betsy Lehman (medication error)



Brendan McDowell


Cheatum Myers
(nursing home neglect)


Naomi Press (nursing home neglect)


Jesica Santillan (transfusion error)

Seventeen weeks today: Quitting smoking with a buddy

JLynnJ’s story:
My sister and I took the quitting plunge together. We have both smoked since we were in college, she's 36 and I'm 31. She puffed her last cigg on Jan 15th, mine was on Jan 23rd, of this year. We both used the patch and followed the directions to a "T". It's been over 4 months now, and neither of us have cheated. We even took a trip to Vegas and made it without smoking. To me, this is proof that the buddy system does work!!! So smokers, get a buddy and quit, you will be sooo glad you did.

The urge to smoke is contagious, but quitting apparently is, too. A team of researchers who showed obesity can spread person-to-person has found a similar pattern with smoking cessation: A smoker is more likely to kick the habit if a spouse, friend, co-worker or sibling did as well. What's more, smokers tend to quit in groups and those who don't stop puffing increasingly find themselves pushed to the edge of their social circles, the researchers found.

"Your smoking behavior depends upon not just the smoking behavior of the people you know, but also the people who they know," and so on, said Dr. Nicholas Christakis, a medical sociologist at Harvard Medical School and lead author of the report.
The findings back up previous studies showing that peer influence plays a key role in a person's decision to stop lighting up and provide evidence that the "buddy system" used by smoking cessation, weight loss and alcoholism programs to change addictive behavior works.

The study appears in the most recent issue of the New England Journal of Medicine.

Advice to smokers who want to quit: Find a friend who smokes, and quit at the same time.

Read another smoking cessation story.

He liked what he saw between the binges: Recovery from addiction

In the darkest days of a 30-year drug addiction, Vera Crowl was homeless and living on the streets of southern California, getting by on odd jobs and sometimes operating outside the law. The college degree she had started decades earlier was all but gone, as was her ambition for a singing or theatre career.

"I got into the deepest, darkest addiction," she said. "I was doing all kinds of stuff for drugs and money." But today, after being clean and sober for more than seven years, Vera, 55, is taking her last class for a Bachelor's degree in psychology from the University of Dayton and is planning to begin a Master's in clinical counseling at UD in the fall. Because UD doesn't have a summer commencement, she was included in the spring ceremony this month.

She wants to become a substance abuse counselor, a call she says she received from God one evening during Blessed Adoration. By then, she had conquered her addiction and had become active in the Catholic community in Richmond, Indiana, where she now lives. "I haven't allowed myself to feel proud, because I'm so full of gratitude," she said. "Gratitude to God for calling me to His service and for His purpose. Gratitude to the recovery programs that have supported me, UD, my family, friends and the Richmond Catholic community."

Hers is a story of hope and commitment, and following God’s call. She grew up in St. Louis, graduated from a Catholic high school, and went to Southeast Missouri State, where she began "partying" too much. "I was mostly doing stimulant pills, and then I would take downer pills to sleep. It was crazy. I was young and strong," she said. "It just never occurred to me this was a problem. It was just something we did."

After four years at the school, she dropped out, a drug addict with no degree. She later moved to Berkley, Calif., to be with some friends who didn't abuse drugs and wanted to help her. She worked in a restaurant and did personal care in private homes.
"Not even these good, good friends could keep me or stop me in just progressing in my addiction," she said. "I tried to get help, but I kind of always fell prey to the need for drugs and alcohol." She ended up losing her jobs to drug use.

"It never occurred to me to stop," she said. "I kept thinking if I got it under control I would be OK. I just got worse." Eventually, another friend encouraged her to move to southern California, and he too, tried to help her. Her addiction did lessen, and she began working temporary jobs, but after several years she was back to being a full-blown addict, she said.

She moved again and ended up homeless and lived on the streets for five years. It was then she met Dick Crowl, the man she would eventually marry. He worked for the company where she did odd jobs. They began talking and spending time together. It didn't take him long to figure out she was an addict, but he told her he liked what he saw "between the binges," she said.

It was a step.

"That was my first glimmer of hope," she said. "My self-esteem was just crushed by that time. I didn't think there was anything in my life to appreciate or love, including God. I just felt so hopeless. I felt like I'd ruined my whole life."
The two decided to leave California and settled in Richmond. She was committed to getting clean, because "I didn’t want to live like that anymore," she said. It took a few tries, but recovery took hold. They married in 2000.

She became active in the church. "When I came back to the Catholic Church, all those (drug addict) memories flooded back. I was so ashamed."

It was then that she heard God's call to counseling. A few weeks later her father, an ordained deacon, received a letter informing him about a UD scholarship available to his family for his service to the church. She contacted the school, took some practice classes, and started at UD in January 2006.

She has taken a full course load of classes every semester — even summers — commuting to Dayton from Richmond several times a week. She also works part-time as a hostess in a Richmond restaurant.

"It's difficult to return to school after 30 years on the outside," she said. "It was a culture shock. But I've learned to accept success, I've learned to accept failure, and I've learned a lot about humility."

She takes inspiration from her father, who went back to school after he retired.
Vera won this year's Nora Duffy Award, presented each year to a UD adult learner who has overcome significant obstacles to achieve a baccalaureate degree and who reflects the spirit of the Marianist tradition.

Wiebke Diestelkamp, a mathematics professor at UD, nominated Vera for the award.
"Her church and her friends and her community are very, very important to her. She has a very strong sense for giving back and appreciates those gifts that she ahs been given," Diestelkamp said. "I'm very proud that she made it and that she didn't give up and that she did persevere."

Vera shares her story as a message of hope — that there is always hope — and faith.
"I wake up every morning, and I open my garage door, and I thank God. I thank Him for another opportunity to serve Him. I thank Him for my life," she said. "I have no doubt that God's hand is in everything. He allowed me to survive my own poor choices."

Advice: Help others through the problems you overcame.

Read another recovery story.

Thanks to David Eck for the source story in today's Catholic Telegraph.