September 2008 Archives
My exam rooms in my office are pretty typical for a physician's office. They are small, 9 x 9 rooms. They have an exam table, two chairs, a rolling stool, a sink, some shelves, a literature holder, otoscope and ophthalmoscope, cabinets, few pictures of my family. They are pretty plain.
I have always wondered what the walls would say if they could speak. So much happens within these rooms; so much of life is examined and changed within these 9 x 9 rooms. Over the past 12 years, 1000s of conversations have occurred within those rooms. Some of them have been light-hearted and some of them have been some of the most serious discussions in a person's life.
Within this 9 x 9 room, I have sat and I have told people about their newly diagnosed cancer, talked about the fact that I believe that the patient with cancer now has recurrence by something that I found on physical exam. I have examined the patients and found abnormalities that, I know, mean their disease is progressing and no longer curable. This week a young lung cancer patient came in for a routine visit. While doing a physical exam I was able to feel a small lymph node in his arm pit. This turned out to be the “tip of the ice berg”. CT scans quickly confirmed wide spread disease. Hope for a cure and a long life evaporated in that room.
Within this 9 x 9 room, I have talked about patient's hopes, dreams, and their faith. Patients have taught me so much about faith and God. I have seen patients’ faith awaken as they have faced the challenges of their diagnosis. I have heard stories about their triumphs, tragedies, and their disappointments. I have talked about their children and families. Counseled young 20 year old women about positive genetic test and how these genes will dramatically change their health and threaten their future. How they now must consider removing both their breast and ovaries. These are some of the most difficult discussions I have ever had.
Within this 9 x 9 room, I have heard about love and hate, divorce and marriage, sex and inability to have sex. I have seen couples grieve over the lost of ever being able to have a child. I have reassured mothers that their unborn child will be safe as they receive chemotherapy for breast cancer and lymphoma.
In this 9 x 9 room, I have had discussions that would be appropriate at a kitchen table; I have had discussions that would likely be more appropriate in a confessional. Some discussions have made me blush and some have made me cry. I think that one of the most important things that a practicing physician can earn is the confidence that his patients are able to talk to him, talk to them about pretty much anything. In some ways, I suspect that I know some of my patients better than some of the people that I call my friends. In our day-today lives, our friendships are so guarded, what we relate to people who are close to us are so guarded, but a good physician makes sure that the patient understands that they can really talk and tell him anything. It is amazing what happens in the 9 x 9 room.
September 11th is a day of difficult memories when we would like to remember the great sacrifices of the people who died on that awful day. There are a lot of emotions that must go through all of us when we think back to that awful day and think about our country as it is today. One of the things that I am proudest of being an American is the passion for volunteerism in this country. This is evident is so many aspects of our lives.
The fact that our armed forces are a completely volunteer force is amazing. That young men and women would have the courage, the patriotism and confidence in themselves to join the military in this time of war and terror is something that we all can be absolutely proud of.
The volunteerism that we see when a natural disaster strikes our country is another example that I think shows the true character of our country. We have witnessed over the last three years, a continual flow of volunteers going down to the
The volunteerism also occurs on a much smaller scale in every community across this country. On September 12, Kansas City had the American Leukemia & Lymphoma Society's Light the Night Walk. This walk is a major fund raiser for this charitable organization. There were hundreds of people who volunteered their time, the staff, the registration booth, the VIP tents and all other games and activities that are part of this wonderful event. On top of this, thousands of people will have volunteered their time to raise money and in this one event will raise over $700,000 for the American Leukemia Society. It is a great thrill for a physician to go to an event like this and be surrounded by patient's who have survived cancer, their families and even loved ones of patient's who have died. I would encourage everyone, if they have the opportunity in the future, to participate in this kind of event.
Lastly, I want to give some special recognition to the dedicated men and women of the Jennifer Ireland Foundation. Last week we had a golf tournament to raise money for our foundation. A small group of people have spent countless hours organizing, recruiting golf teams, getting donations of prizes in order to make this fund raiser a success not only financially, but also as a wonderful testament to the wonderful person that Jennifer was. My love and admiration goes out to these people and my ultimate gratitude goes to them for helping us raise money in order to continue the work of this foundation.
It has been said that crisis brings out the best in people; in the practice of oncology I’m not sure that’s always true. For many families the diagnosis of cancer for a loved one is one of the greatest crises that a family can go through. Sometimes families step up to the challenge and sometimes the opposite is true. This blog entry is a tribute to those men who really have stepped it up & come through in the clutch.
Recently I lost a patient with ovarian cancer. She had battled her cancer over the last two years, and with every bit of strength that she could muster. Her husband was always by her side. I truly believe that she lived far longer than she should have because of the caring, the love & support that he gave her. It was very obvious that the two of them were very much in love. His dedication to her went beyond what we have become accustomed to see in everyday life. He never missed a doctor’s appointment; he never missed a chemotherapy treatment. When she was in the hospital, he spent every hospital possible moment with her, racing between the obligations of his job and his family to get back with her to support her. As a final act of this dedication to her, he came to the office several days after she had died and thanked every single person that was involved in her care. It was like he knew that we had all done our best to trying to support his wife.
One of the worst things that can happen to a man is to have is wife diagnosed with cancer. Unfortunately, it is something that will likely happen to many of us men during our lifetime. By our nature, men want to be able to fix things, to be protectors, to be able to shield our families and our wives from the outside world. Usually over a very short few days when the diagnosis of cancer is made men are thrust into a world that many of them find foreign. They are faced with terminology that they don’t understand such as; white blood cell counts, nater counts, body surface area, toxicity & mucositis. They watch their wives go through the side effects of chemotherapy feeling that there’s not much they can do. A husband of one of my patients with AML has taken on this challenge with a great deal of courage and passion. This is in despite the fact that his wife’s illness has taken her away & put her in the hospital for many weeks at a time. Her illness has challenged both of them emotionally, physically & financially. He too has always been by her side. There can be nothing more taxing or boring than spending weeks in the hospital receiving chemotherapy for acute myelogenous leukemia. Being in the same room, seeing the same nurses, going through the endless number of vital signs, blood draws, and eating the same hospital food is so hard. But this man has done everything he can to make his wife’s many stays in the hospital as enjoyable as possible. He has played card games, read to her, rubbed her back, but most of all has just been there. He has been her friend with confident and unwavering presence in her life, supporting her through this fight against this awful disease.
The diagnosis of breast cancer in a young woman can be devastating. It affects women in so many ways. It affects their sense of youthful inspired and invincibility. It affects the ability to potentially have children. Breast surgery or mastectomy alters their looks and their physical image. Then the treatments put women into menopause, depleting their bodies of estrogen and decreasing their sex drive. All these changes can’t help but affect the relationship between a man & a woman & a husband & a wife. Here again I know many stories of many incredible men who have stood up & accepted the challenge, supported their wives, loved their wives, stood by their wives & as a couple overcome the challenges caused by this disease.
It is not always like the way I describe above. Sometime crises in families can bring out the dysfunction; can bring out the underlying problems in marriages, but more often than not I see husbands rise to the occasion. In a world where you hear so much about infidelity, divorce, abuse & abandonment it gives me great hope and a great sense of optimism for our future by knowing these men.
