“How was this last cycle of chemotherapy?” I asked my patient in the exam room. She was there for a routine follow-up visit before her next cycle of chemotherapy, which was scheduled for later that morning. She sat on the examining table, wearing a wig that was irritating her newly bald head, and a paper-thin gown that didn’t cover much.
“It went okay. I had some nausea and constipation but I am managing.”
“How has your mood been these past few weeks?”
“It’s fine. I’m doing okay.”
At this, I tried to probe more.
“How are your children coping with everything?
Her eyes welled up with tears. I waited patiently, silently giving her the space and permission to open up more. A few minutes later, she shared that she was in too much pain and discomfort to take her four year old son to the playground and that her eight year old daughter was struggling with her mom being bald. She told me about the increased stress chemotherapy was placing on her husband and their financial situation at home.
In that moment, all I wanted and all she needed was for me to sit and hold her hand and just listen to her story. In that moment, every cliché cancer quote about her strength and bravery was wrong. There was nothing I could say. I could not make it better. I could only listen.
However, that wasn’t possible. I didn’t have the time. There were other side effects to address, other patients to see, labs to review, appointments to schedule, notes to write… and the list goes on. But, I was unsettled. I wasn’t truly understanding how cancer treatment really affected my patients. I then realized that if I, as an oncologist, didn’t completely get it, how could others?
This led me to start the INTERLUDE: Women’s Cancer Stories with Dr. Teplinsky Podcast, so aptly named as cancer creates an interlude in life. I initially wanted to have a space for women to share their experiences in an effort to provide support, encouragement, inspiration and hope to other women also navigating through their own cancer journey. But now, 20 episodes later, it has become much more than that.
It has made me a better doctor.
I’ve learned that the emotional repercussions of a cancer diagnosis and treatment go far beyond what I ever imagined. I had no idea about the extent of the shaming, guilt and blame that some patients experience during this time. I now understand how important it is to use the right words — i.e. the patient did not fail treatment — the treatment failed the patient.
I’ve learned the importance of setting expectations. I now ask my patient every time how the results of scans, biopsies, tumor markers, etc should be delivered. I ask if they want me to call them or wait until the visit. I stress that the nurse calling does not always mean the results are good and that if they hear my voice on the phone, it does not always mean the results are bad. I now say “Is this a good time for me to give you the results?”
I’ve learned the importance of patient advocacy and that every single patient is an advocate for their own health. I now take the extra five minutes to review the rationale behind treatment one more time and to answer a patient’s question about a new drug or study that they saw in the news, even though it doesn’t pertain to their treatment. Cancer results in a complete loss of control. Advocating for one’s own health is a meaningful way to gain back some of that control.
20 episodes later, I cannot stress how honored and humbled I am to have this opportunity to speak with women every week about their cancer experience and to have the privilege of sharing it with others. This podcast has truly changed my perspective. It reminds me of why I became an oncologist. It has been well-established that doctors today are overburdened, overwhelmed and burned-out. This has been my game changer. This is how I am reconciling medicine.
Eleonora Teplinsky, MD
Dr. Teplinsky is a guest blogger for InCrowd this month. You can learn more about her and her podcast here: INTERLUDE: Women’s Cancer Stories with Dr. Teplinsky Podcast. This is a part of a series of women in medicine sharing their experiences in the medical field. Check our blog for upcoming pieces and you can find our previous pieces here: Women in Medicine Series