Forums » Off duty » News & media » Cancer and good manners
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Cancer and good manners
posted at 9/11/2010 12:50 PM GMT
on bmj.com
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*Moderator*
Posts: 682
First: 17/11/2008 Last: 19/5/2013 |
There is a good (in my humble opinion) article from an author about how people talk to him now that he has stage four oesphageal cancer. Some people are blunt eg "Well Yes I suppose a time comes when you have to consider lettting go." The author (Christopher Hitchins) says that he'll decide when to do the straight talking thank you very much and he really wants to hear inspiring stories of people who have got better against the odds. Ever since I was felled in mid-book tour this summer, I have adored and seized all chances to play catch-up and to keep as many engagements as I can. Debating and lecturing are part of the breath of life to me, and I take deep drafts whenever and wherever possible. I also truly enjoy the face time with you, dear reader, whether or not you bring a receipt for a shiny new copy of my memoirs. But here is what happened while I was waiting to sign copies at an event in Manhattan a few weeks ago. Picture, if you will, me sitting at my table, approached by a motherly-looking woman (a key constituent of my demographic): She: I was so sorry to hear you had been ill. Me: Thank you for saying so. She: A cousin of mine had cancer. Me: Oh, I am sorry to hear that. She: [As the line of customers lengthens behind her.] Yes, in his liver. Me: That’s never good. She: But it went away, after the doctors had told him it was incurable. Me: Well, that’s what we all want to hear. She: [With those farther back in line now showing signs of impatience.] Yes. But then it came back, much worse than before. Me: Oh, how dreadful. She: And then he died. It was agonizing. Agonizing. Seemed to take him forever. Me: [Beginning to search for words.] … She: Of course, he was a lifelong homosexual. Me: [Not quite finding the words, and not wishing to sound stupid by echoing “of course.”] … She: And his whole immediate family disowned him. He died virtually alone. Me: Well, I hardly know what to … She: Anyway, I just wanted you to know that I understand exactly what you are going through. |
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Re: Cancer and good manners
posted at 10/11/2010 11:58 AM GMT
on bmj.com
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Posts: 1178
First: 19/4/2010 Last: 21/5/2013 |
I suppose what I'd really like someone to say is "I'll just drift you off to sleep, and when you wake up, the surgeon will have removed the tumour, and it'll all be OK". I think whatever the illness, I just want people to be honest, non-sensationalist, and not pitying. A generally positive outlook would be nice too. I've had many medical problems, and most people seemed far more worried about them than me, I have just got on with it, so I suppose I just want the same back - JFDI. Not sure if I'm good with my cancer patients or not - I just try to be honest, generally on the positive side of things, and non-sensationalist about things. Difficult to get it right - which I suppose is why I'm not an oncologist, or a palliative care specialist.
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Re: Cancer and good manners
posted at 10/11/2010 5:24 PM GMT
on bmj.com
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Posts: 1784
First: 7/3/2009 Last: 18/5/2013 |
It is imperative to give patients encouragement. Don't tell them stories that are lies but give them strength and hope. One important thing is to let patients feel they are not alone. We will fight together and we will do the best. The element of "we" and not just "you" is important. Not less when you deal with a colleague that is sick. Don't give the dry statistics, don't be cynical and don't say how sorry you are for him or her. Say everything but be careful to adjust to the person in front of you. It doesn't help to say that situation is bad or hopeless or grave etc. These phrases will not help to deal with the disease and will make the patient miserable, depressed and anxious. Always try to leave a ray of hope.
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Re: Cancer and good manners
posted at 11/11/2010 6:58 PM GMT
on bmj.com
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Posts: 566
First: 9/10/2009 Last: 13/3/2013 |
Doctors have an important ongoing role in the aftermath of a cancer diagnosis, including monitoring the patient's progress, offering educational and emotional support, and providing continuity of care. Apart from the positive reinforcements discussed above, patients with cancer, including cancer-survivors, need to be encouraged to engage in preventive health practices, including immunizations and maintenance of a healthy body weight and balanced nutrition, as well as regular exercise. It’s important for the doctor to establish a trusting relationship. Issues related to intimacy, including sexuality, fertility, and developing and maintaining interpersonal relationships, deserve attention throughout follow-up care. Most importantly, doctors should remain alert to nonspecific symptoms or physical findings (e.g., mass, adenopathy) that can indicate cancer recurrence.
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Re: Cancer and good manners
posted at 12/11/2010 8:30 PM GMT
on bmj.com
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Posts: 1
First: 12/11/2010 Last: 12/11/2010 |
At present a close friend of mine have cancer with metastases to columna, and the pain is 'killing him softly'. Today he was readmitted to hs local hospital with worsening of his pain, and they found that his blood sugar level was quite high - after two weeks of steroids. He has never been told to monitor his blood sugar himself, nor used insuline, but today he was told by the specialist in a patronizing tone that 'You see, this involves knowledge'. When I studied medicine we were told to 'stay with your patient' - that is, give him the information he seeks. I try to use this sentence when I see my friend and his family, but when they are in hope of curing the cancer I find it hard to keep their spirit up. Even though a fighting spirit is correlated with longer living... |
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Re: Cancer and good manners
posted at 14/11/2010 3:28 PM GMT
on bmj.com
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Posts: 25
First: 3/6/2010 Last: 14/3/2012 |
I volunteer in a hospice offering palliative care, and I always see the nurses and doctors being very supportive of the patients. Staff always engage patients in conversations and share jokes. However, one thing to note is that they are NEVER patronizing. I always think that it is crucial to give patients that independence which can be taken away from them when they find out they are suffering from cancer. |
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