Diagnosis = Cancer (How Does It Feel?)

Recently, an old pal was diagnosed to have cancer as a direct result of routine screening.  It soon developed that, in his panic, my every word took over his usual decision process.  This probably had more to do with friendship and trust rather than my profession.  Whatever, it made me nervous that he wouldn't even entertain referrals to other oncologists.  Suboptimal!  In my mind, I may have defensively screened myself off for more than just a bit in order to retain maximal objectivity, so much so that, in hindsight, I'd become needlessly stern.  

For while the best approach may be clear as day, just how in the heck patients summon the will to stay the course is beyond me.  In the case of friends, I prefer the job of pure emotional support of that will.  One can become overburdened by this business in certain situations…

As usual, my friend taught me a few things, and the experience highlighted some truisms in clinical practice.

• Fostering acceptance of a dire diagnosis is a major job. 

• Primary physicians should be congratulated for all their patients who actually walked into an oncologist's clinic.

• I should pat myself in my back for all the times that I was entrusted with a stranger's care.  Why I accepted it as a routine aspect of this job before now is incomprehensible.

• Patients simply don't go for a tough fix until they've overcome their initial shock.  "Me, cancer!?"

• Success at making objective assessments does not imply that the patient has overcome his subjective assessment of you.

• Your recommendations, no matter how sound, become suspect when your foibles are hilariously familiar.

• In the absence of family, peer "sharing" by cancer survivors should not be expected to take up the entire slack.

• Support groups should have clear guidelines on how to approach individual patients.  Big sign on each forehead: Caution– vulnerable!

• For all our sakes, I should avoid my doctor-friends when I need personal medical advice and go see my non-favorite ex-profs instead.