I have a friend of mine who has spent a brilliant career doing innovative cancer research. He has been responsible for discoveries in genetics that are saving thousands of lives, but he has difficulty understanding how I have spent my life “doing the same thing, everyday.” He fails to see the excitement and the satisfaction in the practice of community oncology. While I can explain the complexity and the great variation of each day, I have difficulty describing the moments of fun, satisfaction, and challenge, which come from relationships with my patients.
Today was no different.
A patient’s wife stormed in with a “big complaint.” It seems that even though her husband is getting better, his cancer being in remission, she is disturbed, because he is not yet able to complete his various jobs around the house. The chores are piling up, and she believes he is slacking off. Apparently, I failed to adequately explain that chemotherapy has an anti- “honey-do list” side effect. Patience is a virtue and, with time, he will get back to the grindstone…if she does not kill him first.
Then Alice came in, three weeks into her chemotherapy, bald as a cue ball; to my astonishment, proud of it. She exclaimed loudly, halfway down the hall, “Don’t I look great! Losing my hair is such an adventure!” Trying to be sympathetic, and missing the point, I said, “Yes, losing your hair can be a real shock.” “I suppose you are right,” Alice said, “But, it is also a great time saver.” Speaking as one who is approaching naturally bald, I take that as encouraging advice.
Adam has cancer that, while slow growing, has spread to his bones. We have had a great deal of difficulty controlling his pain, while not being too sedating. Today, he announced that he had found the solution to pain. Encouraged, but baffled, I inquired how? “Atlantic City,” Adam said. “When I am in a casino, I feel no pain!” Morphine and blackjack, anyone?
Lois complained that her kids are dominating her life. She feels less and less her own person, and more and more the victim of her own “second childhood.” “You know the worse thing they do?” “No, Lois, what is that?” They make me eat right and exercise!” While sympathetic to her plight, I am without solution. Perhaps an occasional McFreedom Burger.
Vivian, who was treated last year for a cancer in her brain, is going on a cruise. She is very excited because the boat has a rock-climbing wall. Her husband is excited because the ship has a dozen bars. Therefore, she plans to repel up and he plans to repel down. I hope neither lands on their head.
June was beat up by her recent chemotherapy. Evidently, she was nauseas for a couple days. Was she able to drink enough fluids? Sure. Did she have any stomach pain? “No.” Did you take the nausea medicine I gave you? “You better believe it doc, I was popping those puppies like pez.”
I saw George just days before his 90th Birthday. He is doing well, so he should be in great shape to celebrate. “Do you have any plans? Are you going to do something special for your birthday? “Absolutely, doc. I am going to breath.” Enough said.
Every nurse and doctor knows that men make the worse patients. Today a nurse told me we should rate men on a scale of 0 to 10 for stubbornness and that will help predict their chance of survival. A “0” would be a man who is so compliant with medical recommendations that he changes the Band-Aid on a flu shot site for 3 weeks. A “10” is a man who refuses to go to the hospital even as they are doing CPR. She may have something there.
Finally, Joe, who I treat for bladder cancer. He is doing very well, but fights me when I send him back to the urologist for testing. Exacerbated, I asked, “Joe, what is the problem. Why won’t you go back to the Urologist?” “You’re kidding, doc. Every time I go to that office he shoves a camera up my winkie dink!” “Well, I guess that’s true, Joe, I’m sorry.” Blank look and pause. “Not as sorry as me.”