DR. SUNSHINE

Today, I got a little bit of a wake-up call from a patient, Mr. F. I generally pride myself on being a positive doctor (though not necessarily a positive person when the white coat is off), and I try to speak honestly with patients while still giving them a sense that they are not alone and that there is still the possibility of multiple, small victories in life. I like to tell them that if prostate cancer were a race, it would be a marathon and not a 5K race and that many of them are at the starting line. Most seem to emerge from their visits hopeful and thankful.

Mr. F, on the other hand, said I always sounded like Dr. Doom. This was based upon the fact that whenever he asked about the possibility of a cure or making his metastatic cancer go away, I quickly seemed to redirect the conversation to the reality of the situation: his cancer, while possibly controllable for several years, was likely to eventually progress. He said he did not feel as though I was overly negative, just not as positive as I could be. I listened carefully and said that I thought he was right.

In the course of talking to patients about their disease and outcomes, I do err on the side of honesty and shy away from "sugar-coating." It is what I would want if I were the patient, but I now realize that I must do a better job of individualizing my delivery, rather than sticking to my "script." Mind you, I do try to tailor the conversation to the individual patient and family and their needs, but what I say and how that is perceived varies from person to person, depending upon the page on which he/she finds him/herself.

Dana Jennings, a prostate cancer "survivor" and writer for the New York Times writes today about how cheap and inadequate words are to describe what a cancer patient experiences in his piece entitled, "With Cancer, Let’s Face It: Words Are Inadequate." He closes with this line:

"So, no, cancer isn’t a battle, a fight. It’s simply life — life raised to a higher power."

Words by which to live...