I just finished reading page 28 to 42, the book by Dr. Jerome Groopman, The Anatomy of Hope, and I feel I should stop reading and write this piece to share with you what I learned. For more than a decade, I have many cancer patients. Inside me I felt all the time that many oncologists or more often deceive their patients for their treatment. Today, after reading the story written by at least one of the world's leading oncologists and researchers, I feel that I was right alltogether. Let what Dr. Groopman wrote about what happened sometime in 1978-1979.
The players in this story
1st Patient: 52 years Frances Walker, an African-American with a teenage daughter, Sharon.
2nd doctor manager: 50-plus years, Dr. Richard Keyes on Russell Clinic, a city north of Los Angeles, California.
3rd The doctor: Dr. Jerome Groopman, the 27 years, and was doing a medical society blood disease at the University of California, LosAngeles.
Frances had traces of blood in her stools during his annual medical examination. The study showed a tumor in the lower intestine. She underwent surgery to remove the tumor, but the surgeon found that the cancer has spread to lymph nodes and invaded the left lobe of the liver. Medicine is considered a Stage 4 metastatic colon.
Frances and her daughter, Sharon, went to the clinic of Dr. Richard Keyes. They were warmly received bydoctor that the operation went wounds Frances investigate. Everything was good. They began to discuss follow-up.
Richard Frances, all traces of cancer had been removed from your gut and surrounding lymph nodes. A few small spots of cancer was found on the left side of the liver. But we have to help take care of their chemotherapy.
Frances bright face.
RW: Chemotherapy I are very active against them in the villagesliver. I expect side effects such as mouth sores, diarrhea and anemia, but now will be monitored. All events can be controlled and possibly reversed. Any questions?
Frances thinks a moment and understand what needs to be done. Richard wrote in the medical record, "patient and family understand the risks and benefits of proposed treatment."
Frances was the clinic.
Groopman Richard: When I met (patient), and direct questions to comeI want to emphasize forgiveness, right?
Richard: Yes, definitely not Frances said: "Madam, liver cancer will kill you." What is this? All it does is that the rest of the time even more miserable. Too late for his refusal to panic and mitigation. Richard went further: Each doctor has his style, his way of doing things. Believe me, for patients in situations like this information is too overwhelming.
After the first screening ofFrances some chemotherapy nausea and vomiting. But she must be in good spirit, despite the side effects. He said: "I am a fighter." Later, he suffered from painful mouth ulcers and was hospitalized and on a drip. After she was again hospitalized due to fever and abdominal cramps and diarrhea.
Three months after chemotherapy
Frances Richard: Look at the TAC. Delivery … These deposits are treated. They are about halfwe started.
Frances: That means I had partially healed?
Richard: You are on track for an exemption. Thank God 'on the road.
daughter Frances, Sharon, closed his eyes and bowed his head in silent prayer.
Time passed and it was in January 1979
Dr. Groopman Frances shook his hand and felt it tremble. France had increased liver enzyme values, as they were before. Dr. Richard Keyes examines her abdomen.
Richard: Your liver edgesupply and blood tests were slightly abnormal. Sometimes chemotherapy can inflame the liver as a side effect. You must pay for a follow-up CAT scan in a week. Until then I will give you a prescription for some painkillers. Do not be reluctant to use it as you want.
Frances was the clinic.
Richard on Groopman: You know, not really make a difference if the cancer is clinically and not chemo. There is much we can do about it. By Frances and tellSharon now we just add a couple of weeks concern. This will stick to anything for a while '. Richard Groopman looks friendly and drop: You are beginning your career, Jerry … Continued ignorance is a form of happiness. Maybe she'll be happy and ultimately an adverse reaction.
Two weeks later, the report Groopman scanning and Frances writes: "The liver metastases have more than doubled in size, and new deposits had helped inspleen. The bodies appear to be punctuated by large-caliber bullets, leaving holes. The scan also showed that the liquid was built in the stomach. I knew that patients who survive Frances rarely more than a few months. I noticed a slight tinge of yellow eyes. It 'was jaundice, an indication that the blocks of liver cancer, bile excretion. His belly was so swollen that her navel from ascites printed as a bell. "
Francesin clinic.
Groopman, How are you?
Frances, very tired. I have no appetite. I had to force myself to eat because food is not easy to draw.
Groopman: We need to drain the ascites to alleviate. You'll feel better later.
Sharon: And that means that spreads rapidly, is not it?
Francesca: I have no energy. I did a little 'something is wrong … But Dr. Keyes said it was the chemo.
Sharon: "I thoughtand Dr. Keyes said that chemotherapy might cure her.
Groopman, no – we do not – ask says. We said that there was a good chance to go into remission, what had happened. Groopman then explain what is meant by forgiveness and how it differs from healing.
Sharon: Why did not you say so before?
Groopman: Colon cancer in this way. Falling for a while 'on treatment, which remains stable and growing. I'm sorry.
Groopman wrote:"The last time I saw the (patient) was in early March. Frances could not be more than a few pieces of solid food. If the drink was too cold or too hot, they regurgitated. Each drainage of ascites, which only few days of relief before the liquid is rebuilt. Frances refused further chemotherapy after my honest presentation of data on work capacity.
Sharon: I think he (Dr. Richard Keyes) I do not think that people like us are smart enough or strong enough to handletruth.
Groopman: it was not smart enough about. Dr. Keyes and I try to save, you worry. Well, we were both wrong.
Frances died shortly after. Groopman wrote: "A sense of shame and guilt my grip. Richard and I left out (patient). It 's a fantasy for me to say that Richard and I have not been embraced his pupil was the best for them. ignorance is not good, not when it was necessary. The truth abandoned, Richard and IFrances left, and our deception we have Sharon alienated and bitter. "
Comment: I am surprised that this story is played over and over again by various doctors throughout the world. No matter if it is in Malaysia, Indonesia, Singapore or the United States.
Groopman feel shame and guilt. I wonder how many others feel the same way after having failed. How could never live up to their patients know that in "doing their best" to do what reallydeceive or mislead their patients?
Groopman was right when he wrote that the episode had left Sharon alienated and bitter. Who will not be disappointed, cheated or deceived? In a decade of my experience I have with patients and their families who feel bitter and angry at doctors who had taken for a ride. Many have lost their loved ones with a heavy debt burden without a doctor-to-face. For people who are poor, they used to sell their property – land orhome. This was the commitment that went to "buy" the "wrong medicine" that doctors said was really promising. Patients may not realize that there is a "great doctor" to cope with cancer.
In all these years I always said that patients should be informed about the truth, or provide adequate and unbiased information to make a decision for themselves. There is no reason for everyone to play "God" and try to make a hero. Groopman was right – heand Richard was wrong to "protect" Frances hiding the truth. Or by withholding the truth, seek to Richard "income" to protect?
Writing this, I'm not anti-doctor. "I hope that patients, their families and the doctors know that Dr. Groopman wrote. I have great admiration and respect for this author, Dr. Jerome Groopman. From the early stage of his career, has shown that he is a man just full of love and compassion are. Theproud of him and salute him for his honesty and integrity. It 's the nature of the medical world and patients should turn for help. Sorry, I'm skeptical or are not sure of a few oncologists. Patients and their families have told me that their doctors more often than not, was "my money for my cancer." These doctors have no time for them or has no compassion. When patients ask about the side effects of chemotherapy, the response is oftentrivialized and undervalued, "Oh, not much – a little 'hair loss and nausea." Indeed, some patients in a "hell", while chemotherapy with no guarantee of a cure. If patients more questions, the answer is often: "Why, she asks so many doctors. If I am a doctor." There is an oncologist who said: "I'm not cheap, if not the money to another doctor differently. Go home and sell your home and then come see me."