Everyone in the room is quiet. I feel like the old man leaning forward looking through my glasses understanding the situation but not fully. As an observer I have seen it, can describe it but I am not experiencing it myself. No one in the room can appreciate that struggle. Three situations have made me think differently this week about cancer and what I do. So lets navigate the spheres of care. The psychological, the spiritual, and the physical realms that humans use to perceive their surroundings.
I walk into a room and pull up a chair. I feel separated from my patient because of a new unfortunate event. I start to talk. The power of words, trying to reconnect and asking politely to let me back into their struggle. My patient said to me “Mo I can handle the pain but not the emotions of this struggle”. I acknowledge this. I do not underestimate it. Anxiety and depression makes a patient alone as if orphaned by their diagnosis struggling at their core to make sense of things. The psychological scramble.
My patient sits across from me, my last one for the day I think to myself, going home soon, the day is done. Then out of the blue as I describe the cancer, I hear the words “Mo you talk about cancer very spiritually.” Revelation. Taboo, should not talk to this person about this right now, no religion allowed. That’s the training. My indoctrination. But honest that was one of the best conversations I have ever had with someone with this disease.
Challenged. My patient stares at me but does not understand. Waves at me and smiles. That innocent oblivious smile. Someone else is making this decision for them. They are in pain and the people around perceive the situation but are unable to communicate it truly and fully. How can this paradox exist you might think? In a challenged intellect perhaps where explaining the physical does not help, words are of no use and an orphan appears.
Three unique situations. Each one with no real guidance on how to approach them. Am I the pioneer then? Don’t want to be. But clearly we have to start thinking of this disease as different and evolve more holistic approaches to help those who it encompasses. Perhaps we have to explore it in places we dared not go before. Like orphans exploring parenthood for the first time.
Mo
This, in part, was the reason why i took Psychology as my major when I moved here from Russia. In medical school there I had a very good set of courses for the basic understanding of biology, but none (and no one) tought me the psychology of the person, how one hears words, interprets meanings and manifests the resultant understanding.
I occasionally stumble on the right things to say when i talk to my patients at the VAH and i see a bridge drawn between minds. I share a modiculum of their pain and confusion when i can. It scares me — the depth of another person is staggering and i feel small and insignificant with my mundane worries when their whole existence is questioned.
My mind, my words, my actions often seem inadequate. I fail to address the three components — the science, the spirit and the mind together as they form a human. I dissect and take on one at a time, often guided by nothing else but my mood at the time.
Mo, As you know I so look forward to this blog every Wednesday.. it gives me hope and courage to live with this beast.. I think you are right on when you say that the spiritual is so much of a part of the healing and getting through this ordeal in peoples lives.. I can say it has been the best thing for me and talking to your patients about is OK…I love it….so what if they say it’s taboo. Who says they are the gods of Medical ethics anyway… you are a person just like us.. and you have your own thoughts and opinions and if you feel this way, so be it.. it means you have compassion… Heaven to Betsy you are human! And thank you Lord for that…. someone is in the room with us feeling the compassion and totally trying to understand what we are going through…. My hat goes off to you Mo… for all the extra things you may do or are doing for your patients… It is My amazing doctor of science that is going to make a difference in the Melanoma world I just know it.. It shows in your actions…. Claire (your #1 fan)
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I SO love this blog Dr.Mo! Knowing where we stand, I’m sure you know that it makes my heart sing! Never be afraid to connect to what gives all of us something to hold on to and believe in. It’s where our strength comes from. As always: thank you for being you!
Why is it taboo to discuss spirituality, to open your heart, to be fully present with suffering, fear, sadness or joy? We can be agents of change. This blog is an invitation to break that taboo. Continue…