The Doctor Factor Indeed

There is one more article from the June 23 issue of Newsweek that I have to write about, as it strikes a chord with me and I know it would strike a similar chord with many of the cancer survivors with whom I have worked as an advocate. The Doctor Factor is an important article that raises the issue of compassionate care.

I will say right now that I never met my stepdad John's oncologist. From the way John and my mom would describe this guy, he was big, gruff, and all business. I don’t think he was particularly offensive, but he did not exactly ooze bedside manner either. I'm sure he treated John as best he could, though the more I learn about chemo cocktails and New York's more prominent oncologists (who treated many of my colon cancer survivor friends), the more I feel like this guy was just not invested in John's treatment. Though, to give the oncologist the benefit of the doubt, John's cancer might have been so advanced there was really not much that could have been done beyond extending his life the 20 months that his generic chemo did. We never asked what stage he was - John made that choice and we had to support him in it. So, there's a lot I will never know.

What I do know is that many of my survivor friends went to the same handful of doctors, and have great relationships with them. I have never met a survivor who has heard of John’s oncologist. I have met some of these other doctors and they are absolutely wonderful people. Newsweek profiles a few more fabulous-sounding doctors, from D.C., New York and Boston. The article discusses the importance of genuine doctor-patient bonding, and how these relationships enrich the treatment experience for both parties. Compassionate doctors motivate patients to fight harder. Compassionate doctors don't spout pessimistic statistics. Being a compassionate doctor prevents burnout.

So why do so many doctors lack the very bedside manner that never fails to positively contribute to their patients' journey?

I can't imagine what being an oncologist is like, and I could never do it. But, trying to put myself in that position to answer my own questions, I suppose it's easier to not engage. I mean, how many patients do these doctors have, with how many different cancers, at how many stages? How can you possibly invest personally in everyone?

But how can you not? When I was the coordinator of the NYC chapter of the Colon Cancer Alliance, there were nights when I would come home from running a volunteer meeting and just cry my eyes out. The stories that came out of this one group of people were so surreal, so overwhelming. Stories of miracle responses to chemo, dozens of surgeries, fighting insurance companies. Stories of survival. Stories that bring goosebumps to my arms as I type - because I knew these people. I wanted to know them, wanted to befriend them, wanted to connect with them. And these connections have enriched my life more than anything.

This post is not a tsk tsk to oncologists who lack social skills or choose not to use them with their patients. Everyone handles tough life stuff differently, and the fact that there are people out there who choose to devote their lives to treating cancer patients is miraculous in itself. But I'm glad that Newsweek is making a point that compassionate care does make a difference. Because it does.

More Boobs! (A Book Review: Part II)

Now that I have slept on Bathsheba's Breast - or, well, on my thoughts about this book, I mean - I have come to the conclusion that, although it is not an easy read, this is a truly remarkable book. And I might be a little oversensitive because a) I am a woman with breasts, and b) I take my cancer reading very personally. So there. I admit it.

When I go back through the notes I took on each chapter of this book and attempt to digest everything I learned, I am almost overwhelmed with knowledge and awareness. I feel that now I have a solid knowledge of the history of this disease and also an awareness of the bigger picture: how breast cancer has evolved from being the original cancer, the only one known for generations because it could be seen without an x-ray or an autopsy, to setting the standard for cancer research, treatment, awareness, and advocacy. Olson covers this evolution in depth, and although he chronologically bounces around a bit, his efforts are fairly extraordinary.

In an attempt to be fairly concise... here are some very valuable things I learned from this book (with links to Wikipedia if you're interested):

• Breast cancer has taken the lives of countless notable women, from Theodora (wife of Justinian I) to Adolf Hitler's mom to Linda McCartney.
• Hippocrates named cancer for "karkinos" or "crab" because tumors seemed to have tentacles that resembled crabs' legs.
• Mastectomies were being performed in Germany as early as the 1600s! Yikes.
• And these surgeries were performed without anesthesia - that didn't come into the picture until 1846.
  
• William Steward Halsted invented the radical mastectomy (removal of breast, axillary bodes, both chest muscles in a single en bloc procedure - I didn't know what it was, either) in the 1880s. He was also a coke addict. Oops.
• By the mid-1950s, a variety of surgeries were being used on women, sometimes in succession, with each being more gruesome than the last. Needless to say, faith in doctors and science at this time was very, very high.
• Radiation also came into use in the 50s and 60s - but mortality rates for each of these treatments (radiation, radical surgery, lumpectomy, etc.) were similarly high.
• This is gross: due to the high mortality rates, every country except for the US opted for the less invasive treatments. American surgeons (most of whom were male) were the last to cling to the radical mastectomy.
• Luckily, the feminism movement gained momentum in the 60s, and empowered women were on a roll by the time Nixon announced the "War on Cancer" in 1971.
• Women like Shirley Temple Black, Happy Rockefeller, and Betty Ford started speaking out about their diagnoses in the 70s. Amazing and so brave.
• Rose Kushner was an incredible cancer advocate who took control of her diagnosis and treatment. Her courage paved the way for other women to have more control over their treatment options. Kushner was diagnosed in 1974 and died in 1990.
• Ruth Handler, the inventor of the Barbie doll, lost one breast to cancer in 1970, and the other in 1989. She started a breast prothesis company and was another incredible advocate.
• Breast cancer has been riddled with controversy for decades, but the disease has made its way into mainsteam consciousness, which ultimately bodes well for the cause.

Phew! And there is more where that came from. A highly recommended read indeed. I just hope that someday a book with this depth and detail will be written about colon cancer.