title: Exceptional patients: narratives of connections.
abstract: OBJECTIVE
  This study sought to better understand the patient s perspective of the experience of recovery from cancer that appeared to defy medical prognoses.
  
  
  METHODS
  Fourteen cases of medically verified exceptional outcomes were identified. A qualitative approach, employing long narrative interviews was used. Data was analyzed using a cross case thematic analytic approach.
  
  
  RESULTS
  The major overarching theme was connections, both internal and external. Internal included connections with God or a higher power and with oneself. The external connections, the focus of this paper, included 1) personal connections with friends and family, 2) connections with the medical system: the physician, nurses and other staff, and 3) connections with other patients. They described the nature of these relationships and the importance of frequent contact with family and friends as providing significant emotional and instrumental support. They expressed confidence in receiving care from a reputable clinic, and with very little probing illustrated the importance of the relationship with their providers. They articulated the significance of the compassionate qualities of the physician and identified communication attributes of their physician that were important in establishing this connection. These attributes were demeanor, availability, honesty, sensitivity in the decision making process. They provided examples of positive connections with nurses and other staff as well as with other patients through their illness process.
  
  
  CONCLUSIONS
  The importance of connections in these illness narratives was richly illustrated. These issues often are overlooked in clinical settings; yet they are of crucial importance to the health and well-being of the patients.
authors.affiliation: University of Texas Health Science Center-Houston, School of Nursing, University of Texas M. D. Anderson Cancer Center,Houston,Texas.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Engebretson
authors.affiliation: University of Texas Health Science Center-Houston, School of Nursing, University of Texas M. D. Anderson Cancer Center,Houston,Texas.
authors.forename: Noemi E
authors.initials: NE
authors.lastname: Peterson
authors.affiliation: University of Texas Health Science Center-Houston, School of Nursing, University of Texas M. D. Anderson Cancer Center,Houston,Texas.
authors.forename: Moshe
authors.initials: M
authors.lastname: Frenkel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D009369:Neoplasms / Q000523:psychology*; D036301:Qualitative Research; D012944:Social Support; D029181:Spirituality; D017741:Survivors / Q000523:psychology*