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The Big C” Doctors bedside manners are non-malignant but aid The Big C

January 25, 2012

When I was sitting on the white piece of meat wrapping paper on the bench in the oncologist’s office at the Stanford Cancer Center, I’d hear the footsteps of the Indian oncologist in the hallway, who for the sake of my frustration I will only identify as Dr. Sri Lanka. I hear the hard flat heels obediebntly followed by her assistant and then a door open down the hallway and close. Then I hear the door open and the heels and the following footsteps and another door open. One after another, over and over until finally my door opens and there they are. It was like being in a jail cell and awaiting the rebels to take you out to be shot. Already, I was Camu-ed out in a Sartre two-step. No exit, stranger.

And there they are with the file and their monotone uninflected voice and rattling off all the procedures and results after looking at my file for what? Maybe an hour. Maybe? And after being battered with all the terms and descriptions and the type of tumor and the medications, I’m vaporized. Fred is gone. I’m just this person anchored to a body and sinking and watching my air bubbles rise to the surface as I descend to the bottom.

They are not sensitive to this situation. There is nothing close to compassion or a touch.And I stare at them in a a daze knowing that they have said these same comments about my “care” and my “treatment” around well-worn phrases they have said as they have made these rounds how many days a week after opening how many doors?

This is how your treatment begins? The tumor has more respect than you. It might as well be sitting on their shoulder.

I can’t help suspecting doctors are big on overkilling your treatment to cover themselves in the event of a malpractice suit. And they do this regardless of the pain and strain they inflict on the patient. I have these catheter attached to my kidneys and they are draining urine into bags strapped on my legs. The reason is to reduce creatinin levels in my kidney beans so  they will be healthy enough to process a stronger dose of chemo. All good, get that. And the reason the kdineys are this way, my tumor is blocking the ureters that lead to the bladder and backing up urine.

I talk to Dr. Sri Lanka and say,” How much does my tumor shrink on the average after each chemo treatment?”

SHe clips, “ABout 20 percent.”

“So I can get these bags removed after two treatments of chemo?”

“No, you will have to wear them for the entire three months of your cycles.”

“Well after two treatments that’s 40 percent wouldn’t that mean the ureters are free and the bags can be removed? After all it’s shrinking.”

“Well it could be shrinking in a way that still blocks the ureters.”

“So then why can’tyou at least do an ultrasound after my second round of chemo just to see if my ureters are free?”

She just stares at me. See, I have to ask for this!

How hard would it have been for Dr. Sri Lanka to say, “You know Fred, I understand it’s difficult to have those bags, and if you weren’t connected to them you might be able to feel better about yourself and have more energy to fight your cancer. SO I tell you what, after your second round, let’s do an ultrasound and if your ureters aren’t blocked we’ll remove the bags. But if they’re still blocked, we’ll unfortunately have to leave them in.”

But no, that would require becoming a caring physician.

Anyway, as I have advanced more of me has walked into the hospital, and I have learned to look at their personality the same way I see the tumor, something to overcome by the force of my personality. I can’t get mad. If they want to develop a callous in the world of pain instead of a warm embrace and a soft word and a gentle touch and eye contact–go right ahead, but I’m immune to it. Instead, when I am at the hospital I try to talk to other people going through chemo or waiting and discuss our cancers and treatment and ask them how they’re doing and diets and I reach out to them.

Before a person becomes a doctor, I think they should have an IV in their arm and wheeled around in a gurney through every hallway in the hospital and then brought to their office. Maybe they have to see the world they look down upon to see why some people don’t look up to them.

It’s a hard thing to forgive in a person, but easy to accept. Just don’t become like them.

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