Tips for Oncologists: Excerpt from upcoming book, Today Cancer, Tomorrow The World

Here are some tips for oncologist I sent to the Stanford Cancer Center. They responded and thanked me and are distributing this list to the oncologists. I have this list at the end of my upcoming book on my battler with The Big C.My main goal is to alleviate the suffering of others and improve care.

Tips for Oncologists.

(from Today Cancer, Tomorrow The World by Fred Reiss)

• Don’t do these things with the patient’s file: 1.) Never address a patient while holding up their file. 2.) Don’t look down at a file when you tell the patient the results of their tests. 3.) When you go over a patient’s file, put it down between you and the patient like you’re both sharing homework—you know, working together?.
• Before a patient goes through chemo, conduct a hearing test. So after they finish chemo, you can discover if they suffered hearing loss.
• Instead of weighing people in kilograms and explaining tumor size in centimeters, is it too much to ask to use pounds and inches? I mean you bill the in dollars and cents.
• Sure it’s difficult seeing cancer patients, but instead of getting worn down by this, always remember this upbeat note: we have come to be healed by you. You’re a healer and that’s a wondrous gift that you’re sharing. And healing requires creating a caring relationship with the patient.
• Don’t ask chemo patients, “How are you feeling?” Try these questions: 1.) “Have you been able to eat?” 2.) “Are you able to sleep?” 3.) “What fluids besides water have you been able to drink?” 4,) “What activities have you been able to do, or miss?” 5.) “When do you experience the most pain after you leave here?” 6.) “Is there any term I used or said something you don’t understand?”
• Tell your patient they have the option to take preventive medicines before they suffer from anticipated side effects from chemo, such as mouthwash rinses to prevent or alleviate mouth sores.
• If a patient requires long lengths of chemotherapy or don’t like needles—and who does?—inform them about a medical port. Show them what it looks like, and explain how simple the surgery is to implant it. (Yes, it’s possible to have infections from a port, but you can also get infections from IVs and nurses can be off some days finding a vein.). And, why not have a brochure on medical ports handed out to patients when they arrive for their first appointment at oncology? Muy Importante: Some patients don’t speak English, have someone who speaks their language explain a port—I saw too many people who couldn’t speak English with bruised veins and didn’t know how easy it was to get a port.
• Ask a patient about their personal and professional life so they remember who they are, instead of what they have been reduced to. Or where they’re from. It reminds the patient they’re alive.
• Explain why you became an oncologist.
• Call the patient at home if: 1.) There is a change in their medication. 2.) They’ve completed their first cycle. 3.) In the middle of their recovery week to see how they’re doing.
• Visit them in Infusion to show support: 1.) See patients on their first day of chemo. 2.) See patients on their last day of chemo. 3.) Or, maybe just go there to remind yourself of their suffering so you can improve your care.
• Acknowledge the high medical costs and tell the patient they might get calls from collection agencies but that the hospital offers financial assistance for them.
• Talk and listen to the oncology nurses more often, and go out of your way to acknowledge and appreciate their views—plus, reach into your pocket and buy them some doughnuts or chocolate once in awhile. Remember they have better people skills than you—you have things to learn from them.
• Call patient’s quickly with the results of their tests.
• Remember just because you were “out of clinic” that day the patient was “in clinic.” If you can’t be there for the patient, make sure someone else has the authority to do it—or, surprise tell the patient in advance who they can call and obtain test results,
• Inform them that chemo also goes after their nervous system too. And perhaps, add minerals to their chemo hydration that helps reduce the effects of neuropathy.
• Imagine the patient is your son or daughter, or father or mother. If none of those four choices works, pick someone in your life you care for the most.
• Don’t expect the patient to ask the right questions. They’re in shock, you’re not. Create a list of symptoms and concerns and go through them with the patient.

And know your place. You chose to be a doctor. The patient didn’t choose to have cancer. They outrank you.