My professional and personal paths have brought me to exactly where I’m supposed to be.
When I began practice as a new family physician, I was surprised that many of my patients were suffering from symptoms that no pill could fix. They were exhausted, but their thyroid and blood counts were normal. Their bodies ached but I couldn’t find a lesion. Their life felt flat even though everything was fine and they weren't depressed. I desperately wanted to relieve their suffering, but the skills that I learned in medical school weren’t exactly what these patients needed.
Out of desperation I began sharing my own wellbeing practices with my patients, and to my utter surprise they started to get better. As I taught them about the stress response and how their automatic negative thoughts made them feel worse, their symptoms started to lift. I taught them to use breathing to activate their parasympathetic nervous system, how to meditate even if they never had tried it before, and how easy it was to try guided imagery with an app on their phone. We explored therapeutic arts, positive psychology, manual medicine, the importance of sleep and movement, and much more, and their pain, fatigue, sleep, anxiety, mood, and stress improved. Wow! This sparked my interest in integrative medicine and I eventually spent more than a decade as the Associate Director and Director of Education of the University of Maryland School of Medicine’s Center for Integrative Medicine.
The integrative approach to care spoke to me. It honored the whole person and highlighted the importance of stress management, sleep, healthy movement and nutritious food. It brought other healing systems to the party, such as traditional Chinese medicine, Ayurveda, and naturopathy, and encouraged community, creativity and positive coping skills. Integrative medicine seemed like the right approach.
Then my 12-year-old daughter fell off a horse and our world turned upside down.
There were months of disabling headaches. Brutal neck pain that kept her in bed all day. She could no longer read and had to leave school. Light was unbearable. Sound was too loud and language was confusing. Her world got smaller and darker until she could barely imagine her way out. Her doctors kept saying “brain rest” even when that clearly wasn’t working. She started down the path of steroids, injections and neck surgery and I took her to a very well-respected integrative physician to help support her healing. To my surprise, things didn’t go quite as I expected. The integrative physician told her not to take the steroids or pursue injections or surgery. He told her that if she stopped eating sugar and fixed the mold in our basement her pain would go away. She thought that sounded like BS and I couldn’t say that I disagreed.
That experience was an eye opener.
It made me realize that the subtle preference for non-medical approaches found in some integrative medicine practices might not be right for everyone. Patients with serious or complex conditions benefit from a truly integrated approach that uses the best of conventional medicine alongside evidence-supported complementary approaches focused on supporting coping and symptom management.
Ultimately, after adopting a truly integrative approach, my daughter began to improve. She took oral steroids and got them injected into her neck. She had occipital nerve release surgery and listened to guided imageries. She learned about central sensitization, did neurofeedback and vision therapy, took antidepressants and pursued psychotherapy and EMDR. She used yoga, photography, massage and music, and over time she found her way back.
Enhancing wellbeing in people facing serious or complex illness is the medical care that I find most meaningful. I pursued a Master's Degree and Board certification in Palliative Medicine because I wanted to be better at helping people heal their lives even when curing their disease was not an option. I loved the deep conversations and saw transformation in my patients’ lives even as their disease progressed unabated.
I started an integrative palliative medicine outpatient program designed to serve families facing serious illness. Our approach used the best of symptom-focused conventional medicine combined with evidence-supported complementary modalities, and every patient received a personalized treatment plan targeted to their unique needs. Most patients received both conventional approaches such as anti-nausea medications, antidepressants and pain medications, as well as modalities such as guided imagery, relaxation techniques, meditation, reiki, massage, and acupuncture. We used advanced counseling techniques such as cognitive behavioral therapy, positive psychology and motivational interviewing and we referred patients for spiritual support when needed. We talked about fears of death and designed legacy projects. My team was honored to be invited to weddings and funerals.
It was beautiful.
Some in the integrative world feel uncomfortable with progressive illness and end of life care, and many in the palliative medicine world doesn’t fully embrace complementary modalities. There aren’t many physicians or clinicians who are comfortable with both domains, and I realized that the world needs more integrative palliative clinicians. Additionally, these clinicians need the skills to attend to their own wellbeing so they can care effectively for their patients without becoming depleted. Integrative palliative care requires deep empathy and compassion, so preventing compassion fatigue is critical.
Thus, the Integrative Palliative Institute (IPI) was born!
My experience with medical education, physician wellbeing, integrative medicine, and palliative medicine has emerged from its chrysalis as IPI.
IPI will train physicians and other healthcare professionals in the art and science of integrative palliative medicine, so they can more effectively relieve their patients’ suffering, support their own wellbeing and deepen the meaning that they feel from their medical practice. My mission is to train 1,000 clinicians in integrative symptom management by 2030.
Design and Lead Your Team Retreat
Motivational & Wellbeing Seminars
Integrative Palliative Care Panels & Thought Leadership
Group Coaching for Leadership and Clinical Teams
Dr. Delia Chiaramonte is the most caring, experienced, and knowledgeable integrative and palliative medicine providers that I have been fortunate enough to work beside. Not only does she have an amazing impact on her patients, but she is one of the top educators in her field.
- Elyse Demers, MD
Dr. Chiaramonte is a gifted teacher. She engages learners through masterful storytelling to help illustrate concepts. She delivers the light bulb moment and a gem in her sessions consistently. Dr. Chiaramonte makes learning fun!
- Terry Nguyễn, MD
From speaking to leadership coaching, Dr Chiaramonte provides your palliative care or illness support organization with inspiration, expanded clinical skills, authentic wellbeing, and enhanced productivity
This honest, raw, and deeply meaningful book will guide families to confidently care for their loved one, improve communication about tough topics, and find growth in the challenging experience of illness.
When patients ask "How can I live now that I know I'm going to die?" do you know how to answer them? Do you feel confident talking to patients about tough topics such as advancing illness and death? Do you find yourself exhausted from witnessing the suffering of others? Through the stories of Dr. Chiaramonte's patients, Coping Courageously provides clinicians with a blueprint for being fully present for their seriously ill patients, while also taking care of themselves.
Hospice, palliative care, and illness support organizations are dedicated to improving the wellbeing of seriously ill patients and their families. Yet you can't be with your families 24/7. Providing resources, such as Coping Courageously, to the families that you serve extends your reach and multiplies your support.