I just finished reading page 28 of 42 in the book by Dr. Jerome Groopman's: The Anatomy of Hope, and felt that I needed to stop and read this piece of writing to share with you what I learned. For more than a decade, I meet a lot of cancer patients. Inside me, I hear all the time that many or most of the oncologists often mislead their patients about their treatment. Today, after reading the story written by no less than one of the world's leading oncologists and researchers, now I feel that I was righttogether. Let me tell you how Dr. Groopman wrote about what happened sometime in 1978-1979.
The actors of this story
1. Patient: 52-year-old Frances Walker, an African-American with a teenage daughter, Sharon.
2. Chief physician: 50-plus years, Dr. Richard Keyes on Russell Clinic, north of the city of Los Angeles, California.
3. Second physician: Dr. Jerome Groopman, 27 years to come, and the medical community has a blood disorder at the University of California,Los Angeles.
Frances has traces of blood in his stool in his annual physical exam. The research revealed a tumor in the lower intestine. He underwent surgery to remove the cancer but the surgeon found that the cancer has spread to lymph nodes and invaded the left lobe of her liver surgery. Doctors was seen as a stage 4 metastatic colon.
Frances and her daughter, Karen, went to Dr. Richard Keyes clinic. They were warmly received byThe doctor who went to look see Frances surgery. Everything was fine. They sat down to discuss follow-up treatment.
Richard Frances, all traces of cancer of the colon removed and the surrounding lymph nodes. A few small patches of the tumor was found on the left side of the liver. But we chemotherapy to help care for them.
Take Frances showed great relief.
Richard: Chemotherapy, I will make you very active against these patchesliver. I expect some side effects like mouth ulcers, diarrhea and anemia, but must be carefully monitored. All the side effects can be controlled and possibly reversed. Any questions?
Frances thought for a moment and understand what to do. Richard has written to the file of this patient, patient and family understand the risks and benefits of proposed treatment. "
Frances left the clinic.
Groopman Richard: When I met (patient) directlyproblems to come, I want to emphasize forgiveness, right?
Richard: Yes, certainly do not look at France, saying: "Madam, cancer of the liver kill you." What is the point of it? All it does is that the rest of the time even more unhappy. The reason for her to panic and refuse to palliation. Richard continued: "Every doctor has his own style, his way of doing things. Believe me, for patients in situations like this, too much informationoverwhelming.
After the first cycle of chemotherapy had little Frances' nausea and dry air. But he seemed in good spirits, despite them. He said: "I am a fighter." He later suffered a sore mouth, pain, and was the hospital and put in drops. After what was hospitalized again because of fever and abdominal cramps and diarrhea.
Three months of chemotherapy
Frances Richard at: Note that the TC. E 'delivery … it isDeposits treat us. Are about half the size of what we started with.
Frances: Do you mean that I have partially healed?
Richard: You're on your way to grace. Thank goodness. And goes.
The daughter of Frances, Sharon, closed his eyes and bowed his head in silent prayer.
Over time and was in January 1979
Dr. Groopman Frances shook my hand and felt shaking. France, liver function tests showed elevated values, which previously did not. DrRichard Keyes has examined his abdomen.
Richard: Your liver edge was soft and blood tests are a bit 'abnormal. Sometimes chemotherapy can flare up in the liver, as a side effect. They are due for a follow-up CT scan in a week. Until then I can give you a prescription for some painkillers. Do not be reluctant to use as you wish.
Frances left the clinic.
RICHARD A Groopman: You know, they really make a difference is not clinically as the cancernot chemo. There is not much we can do. Telling Sharon and Frances now we have only a couple of weeks of emergency requests. In this way, they have something to hold on for a little 'more. Richard Groopman looks friendly and drop: You're at the beginning of your career, Jerry … CONTINUE Ignorance is a kind of bliss. Maybe she will be happy, and appears as an adverse reaction.
Two weeks later, Groopman had seen the report of the scan France wrote:"The liver metastases had more than doubled in size, and new fields have appeared in the spleen. The bodies looked as if they were full of large-caliber bullets, leaving holes. The scan also showed that the fluid was building in ' abdomen. I knew that patients like Frances rarely survive a few months. I had a slight tinge of yellow, looked in his eyes. It 'was jaundice, an indication that the cancer blocks the secretion of the liver of Gal. abdomen was thendistended with ascites, it frightened the navel outwards like a bubble. "
Frances came to the clinic.
Groopman: How are you?
French: very tired. I have no appetite. I had to force myself to eat because the food does not go down easily.
Groopman: It 'necessary to drain the ascites to relieve congestion. You'll feel better afterwards.
Sharon: So that means that spread rapidly, is not it?
Frances: I have the energy. I tried for a time that somethingwas wrong … But Dr. Keyes said he was from the chemo.
Sharon: I have your thoughts and Dr. Keyes said that chemotherapy might cure her.
Groopman: He did not – we did not – still think that. We said that there is a good chance of going into remission, what has happened. Groopman then explain what it means forgiveness and how it differs from healing.
Sharon: Why do you tell?
Groopman: The colon cancer behaves in this way. A decreaseDuring the reading will continue to oppose, and grows again. I'm sorry.
Groopman writes, "The last time I have (seen the patient) was in early March. Frances was able to eat anything more than a few bites of solid food. If spirits were too cold or too hot, are regurgitated. Each drainage of ascites, gives only a couple of days of testing before the liquid is being rebuilt. Frances declined further chemotherapy after hearing my recitation of truthful information about its chanceswork.
Sharon: I think (Dr. Richard Keyes) do not believe that people like us are wise enough or strong enough to complete the truth.
Groopman: It was not a case of not good enough. Dr. Keyes and I tried to save the concern. Well, we were both wrong.
Frances died shortly after. Groopman wrote: "A feeling of shame and guilt gripped me. Richard and I am not the patient (). It is an illusion, telling me that what Richard did, and I have embracedhow his students were the best for them. Ignorance was not luck, not when it is needed. Abandoning the truth, Richard and I had to leave France, deception and our Sharon left us alienated and bitter. "
Comment: It amazes me that this story was played over and over again by various doctors throughout the world. It seems that if it is in Malaysia, Indonesia, Singapore and the United States.
Groopman feel shame and guilt. I wonder how many others feelSimilarly, after having failed. How could they ever be confronted with their patients to know that in "trying to do their best" were actually deceived or misled their patients?
Groopman was right when he wrote that the episode had left Sharon alienated and bitter. Who would not feel disappointed, betrayed or deceived? In a decade of personal experience I have with patients and their relatives, who felt bitter and angry with the doctors who had taken them for a ride. Many have lost their belovedthose who have to stay out of debt with a great doctor. For a couple who are poor, are used to sell their property – land and house. E 'was the commitment they made to "buy" a cure "doctors who told them" false promise. Patients should understand that there is "an oncologist, so that" if we can do with cancer.
All the years I have always argued that patients should be told the truth, or enough to provide objectiveinformation to enable them to decide to do. There is no reason for anyone to "play God" and trying to be a hero. Groopman was right – he and Richard were wrong in trying to "protected" by Frances hide the truth. Or omitting the truth, they tried to protect Richard's "income"?
In writing this, I am 'anti-doctors "are not. I hope that patients, their families and the doctors learn what Dr. Groopman wrote. I have great admiration and respect for this author, Dr. Jerome Groopman. The initial phase of his career, has shown that he is an honest man full of love and compassion to be. I'm proud of him and congratulate him for his loyalty and integrity. It is the nature of the doctor that the world is necessary and patients should turn to for assistance. Unfortunately, I was skeptical and not sure that some oncologists. Patients and their families have told me that their doctors often are not, "I do not concern me> Cancer. "These doctors have no time for them or have compassion for all. When patients ask about the side effects of chemotherapy, the response was often overlooked or minimized," Well, it's nothing else – a bit 'of hair loss and nausea. "In fact, some patients have" hell ", while chemotherapy with no guarantee of cure. If patients more questions, the answer is often:" Why do so many. The doctor or my doctor. "There was an oncologist who said:I'm not cheap if you do not have the money go to other doctors do not. Otherwise, go home and sell your home and then come and see me. "