Oncologists Are Mean?

8 Jan

I read this article in the New York Times which discusses a study that looked at the conversational strategies employed by oncologists with their patients.  Now I’m biased: the daughter of an oncologist and recently the daughter of a cancer patient?  Yeah, I have some opinions.

Cancer floors, at least to those who aren’t cancer patients, are like nowhere else in a hospital.  Cancer is a strange animal, a word that covers a multitude of sicknesses from the bad to the very bad to the “we can’t look you in the eye it is so bad.”  But hospitals have to treat a wide range of people.  The person in the first bed may want last rites, the person in the other bed may flip you off if you ask for them.

It is a place where you would think empathy should overrun procedure.  But if you take a step back, what you see is that in a way, oncologists and patients often look at cancer completely differently.  An oncologist sees a foreign agent, an interloper, something to be corralled and controlled, to be taken out with surgery or gamma knife or radiation.

But for the patient cancer may seem much more integrated.  It is in every step they take, every pain, every sleepless night every morning it is hard to wake up.  When a patient asks about a tumor they are asking about their whole body and when a doctor hears the question he answers the question about the tumor.  The article and study bring that up.

But is that empathy?  Empathy is feeling what the other person feels.  Feeling it, not mirroring it.  And I don’t think we want cancer doctors with cancer.  We don’t want them to humanize the enemy.  We want them emboldened against it.  I want the oncologists who are involved in my families’ life to be as mad and vicious as they possibly can be towards the cancer without hurting the person with the cancer.  A tough job.  And for a long time a nearly impossible job when the best we could do was put the patient so close to death that the cancer retreated and looked for sunnier climes, and then try to bring them back.  New novel agents are arresting cancer without the dangerous trip to the brink of goodbye.

So what is the point of the study?  To help oncologists be better?  Or maybe the best information is actually for patients?  I know its sounds mean that the cancer patients need to be better at something.  They have fucking cancer for fucks sake.  It sucks.  Seriously.  But maybe this study points to a basic problem with the way we look at medicine when we are in crisis.  We parcel our body parts, we lie about symptoms to our doctors, we don’t admit that we don’t floss, we don’t listen to good advice and we avoid the bad news if we can.  What if the study were turned around?  What if 500 patients said: I’m going to sit here and you are going to tell me everything you know about this tumor and how we treat it.  You and I are going to war together.

Would it actually make a difference?  I kind of doubt it.  In fact I’m doubting the thesis of this whole freaking blog post.  I dunno.  Say something in the comment section.  Who do you want?  Asshole who views cancer as a disease or nice doctor who helps you handle things emotionally as well?

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