Melanoma, Patient Care, Perspectives

Fabric


“Is it a myth?” My colleague standing next to me asked in the back room. “Treating cancer, are we really doing anything to help these patients?” I pulled up a scan of a patient diagnosed with melanoma that had spread to the lungs, who was receiving a novel agent and showed the questioner the response. He stared “wow, you are doing something!” As I looked at the end result, I thought it was a masterpiece. How did it come about? Was it just the permissive circumstances this time? Like a painting of a landscape that was itself beautiful, or the weaving of a magical fabric that falls beautifully regardless of the tailor’s skill… or a simple dish with overpowering spices that work every time? I smiled. I’d like to think I am all 3 of them.

I never walk into a room to deliver bad news smiling, and when I am clearly smiling as I enter the room that simple deduction is hard for my patients to make. I had a college student follow me in clinic today and we both walked into the room together. My patient stood up and amicably said hello, in his usual way, we were quickly chattering off, laughs, jokes and playing catch up.

In the midst of it, I tapped him on the shoulder and told him that his scans looked great, there was no evidence that the cancer had come back. He gave me a very solemn look, as he stared back wanting to believe me. “Really Mo?” he asked. “Wow, that is great.” We talked about his fears and where he was in his life. He shared, he no longer was scared the night before the scan, but he really became tense just right after the scan. I told him they needed to increase the medication they give him prior to the scan so he could come in all casual and relaxed. We all roared in laughter.

Then came the hugs. Everyone in the room gave me hugs. My patient startled me with what he said next. It was a truth best expressed from him, and it’s when I do my best listening. He did not talk directly to me but to the college student who was silently observing everything. He said, “Let me tell you something, this man, helped me make a difficult decision, he navigated all my options carefully, not omitting anything, he gave me choices and then showed me the way to go and that is why we chose the treatment, and it worked!”

Ah I thought; don’t dismiss the tailor who weaves a good fabric, the chef and how he adds his signature spice, or the painter who makes colors come alive. I realized I served him well and I still do. He brought alive his thoughts and expressed them to me helping me see through the fabric of his reality.

I listened intently to his thank you, taking it in whole heartedly. His words were heartfelt, and so was my joy.

Mo

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3 thoughts on “Fabric

  1. Claire Barnhouse says:

    Mo,
    Your #1 fan here and very good blog this week. You are such an awsome teacher and I love that when you talk to John and I you really explain things in different ways so we understand. I am glad I have you in my corner. Thank you for being my amazing doctor of science!
    Claire

  2. This ability to navigate, to clarify the murky substance that is oncological management for your patients, was one of the most valuable lessons I have learned from you. One of my first goals of independent practice is to master it.

  3. Gary Kaalberg says:

    Mo,
    The things that you explain to your patients and the clearness with which explain the bad news as well as the good news helps them deal with the issues. I have been on both ends, I have received good news with my melanoma and my daughter Jacquelyn unfortunately received bad news and the disease eventually took her life, but in both situations your honesty and knowledge made our decisions simpler. Your abilities are a Godsend and you cannot begin to know how much it is needed and appreciated.
    Thank you,
    Gary Kaalberg

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