When Sherryl met with her doctor last week to learn the results of the latest PET scan, he entered the exam room and, in a matter-of-fact I-do-this-every-day tone, delivered these words to her: "Well, we're running out of options." His follow-up remarks included information she'd not heard before, that cancer is and has always been present in the clavicle and in both arms.
The doctor proceeded to explain that he would be presenting her case the following evening, as he's done in the past, to the "tumor board," a group of medical professionals who review cases together to determine through consensus the best course of treatment from that point forward.
Sherryl was shocked and hissing mad at the words that she heard from her doctor. Actually, she was p***ed. But since this is a family blog, we won't use that word. First of all, for him to tell her he is "running out of options" is, short of medical errors that result in a sentinel event, the worst possible care a doctor could give to his or her patient. Speaking the truth is one thing, speaking it without a caring and empathic demeanor is quite another. Any seasoned physician knows better than to project a defeatist attitude to his or her patient. And in the case of cancer patients, the way these comments were delivered is unfathomable, shameful, and negligent. Secondly, in two and a half years of doctor visits, hospital stays, and numerous tests and treatments, Sherryl has never been told cancer is present in the clavicle and both arms. So, is the information correct or not? If it is correct, when did cancer appear in those locations and why didn't Sherryl know it was present before this visit?
We (Sherryl's sisters) have both worked with doctors for decades and some of them are very good friends of ours. We know the difference between a good doctor and a bad doctor. We've experienced high quality care and we've been down the thoughtless doctor-patient-relationship road before. For the latter, there was an unfortunate telephone conversation one oncologist had with our mother -- before she was diagnosed with cancer. "Do you have a history of cancer?" No, she replied. She had not had a history of cancer and, following a variety of symptoms and a battery of tests, this was the first time she was hearing the word "cancer" correlated in any way to her health. The doctor offered no more information, just asked more questions. She happened to be by herself at the time, hung up the phone, and fell apart. Her life was never quite the same again. "Do you have a history of cancer?" By phone! We blasted that oncologist for the poor judgment he used and for the impact it had on Mom.
Sherryl is a model of optimism and, in fact, several of the staff who are part of Sherryl's health care team have labeled her as their "poster child" because she is such a fighter. We all see her strength and determination on a daily basis and, because of her, every word that is typed onto this website reflects the cheerful joie-de-vivre she exudes while simultaneously waging an intense war against breast cancer. Even living with the disease, she continues to teach and inspire people of all ages. No one -- doctor, lawyer, or Indian chief -- will change Sherryl's mental well-being by saying aloud to her a string of 6 words that has the potential to dash all hope for the future. One of the roles of any health care professional is to champion their patient!
So Doctor, this as your written warning. Sherryl has choices. Choices in doctors, and choices in who communicates to her any and all medical prognoses. We know doctors are not gods. While they are human beings complete with gifts and faults, accuracies and errors, some of them are most certainly heroes walking among us. Individuals dedicated to the health and well-being of humanity. They save lives every day, they are dedicated to total health through prevention and early detection, and they work to better the health of the people who live on this planet. Individuals who spend their vacations in third world countries educating and vaccinating the populace, and bands of them who volunteer their time to triage and treat the weak and wounded when a natural disaster has occurred. Doctors we know left their families and jobs because critical medical attention was needed following the Indian Ocean tsunami of 2004 and Hurricane Katrina of 2005. Angels in stethoscopes, every one of them.
Based on a previous incident, it seems apologizing is not within the scope of your practice. You should consider learning that skill. If you, however, for one second forget how you should be delivering new information, good or bad, to your patients, you'd be wise to remember one thing. Legal checks and balances are in place, for you as a medical professional and for Sherryl as a patient. Sherryl can switch doctors in a heartbeat, pun intended. And do not for one moment underestimate the magnitude of the power that exists in Sherryl's support team, one that spans the globe. It's palpable.
So do your job. Be a medical doctor. And remember the words of the Hippocratic oath you took when you earned your credentials:
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I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. |
The Hippocratic Oath: Modern Version;
Source: NOVA
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