I just read pages 28 to 42 of the book by Dr. Jerome Groopman's The Anatomy of Hope, and I felt continue to read and write this piece to share with you what I've learned. For more than ten years ago, I met many cancer patients. Inside me I felt the whole time that many or most oncologists are often misled patients about their treatment. Today, after reading the story written by no less than one of the world's leading oncologists and researchers, I now feel I am quitealong. Let me tell you, what Dr. Groopman wrote about what sometime in 1978-1979.
The actors in this story
1. Patient: 52-year-old Frances Walker, an African-American with a teenage daughter, Sharon.
2. Main Doctor: 50-plus years, Dr. Richard Keyes at Russell Clinic, a city north of Los Angeles, California, USA.
3. Second Doctor: Dr. Jerome Groopman, a 27-year-old, up and coming doctor while a fellowship in blood disease at the University of California,Los Angeles.
Frances had traces of blood in the stool during their annual physical examination. A colonoscopy indicated a tumor in the lower intestine. She underwent a surgery to remove the tumor, but the doctor found that the cancer had spread to the lymph nodes and fell into the left lobe of her liver. This was seen as medically Level 4 metastatic colon cancer.
Frances and her daughter, Sharon, came to the clinic, Dr. Richard Keyes. They were greeted warmly byThe doctor who went to investigate the operation Frances wound. Everything seemed in order. They sat down to discuss himself, follow-up treatment.
Richard, Frances, all traces of cancer have been removed from your bowel and the surrounding lymph nodes. A few small areas of the tumor were found on the left side of the liver. But we have chemotherapy to take care of them.
Frances's face showed great relief.
Richard: The chemotherapy I will give you is very active against stainsin the liver. I expect that some side effects like mouth sores, diarrhea and anemia, but you will be closely monitored. All side effects can be managed and ultimately reverse it. Have questions?
Frances thought for a moment and understand what needed to be done. Richard wrote in his file of the patient: "Patient and family understand the risks and benefits of proposed therapy."
Frances left the clinic.
Groopman Richard: If I am the (patients) when a directQuestions come, I would be the adoption, correct intonation?
Richard: Yes, I do not want to look at Frances and say, "Madam, will kill the cancer in the liver you." What's the point of that? Because it does not make the remaining time more miserable. Or they lead to panic and refuse relief. Next Richard continues: Every doctor has his own style, his way of doing things. Believe me, for patients in situations like this, too much informationoverwhelming.
After the first rounds of chemotherapy Frances had some nausea and dry heaves. But she seemed in good spirit, despite the side effects. She said: "I am a fighter." Later she suffered from painful mouth ulcers and had to be admitted to hospital and put drips. Then they had to return to the hospital because of fever and cause abdominal cramps and diarrhea.
Three months after chemotherapy
Frances Richard: Look at the CAT scan. This is the Liver ... these are theDeposits, we are treated. They are about half the size of what we started.
Frances: Does this mean that I will be partially cured?
Richard: You are well on your way to a remission. Thank God. It will be removed.
Frances daughter Sharon, closed his eyes and bowed his head in a silent prayer.
Time passed and it was in January 1979
Dr. Frances Groopman shook his hand and held it trembling. In France, elevated levels of liver function tests, showed how they had never been before. Dr.Richard Keyes examined her stomach.
Richard: Your liver is tender and your blood tests are slightly abnormal. Sometimes the chemotherapy can inflame the liver as a side effect. They are due for a follow-up CAT scan in a week. Until then, I'll give you a prescription for some painkillers. Do not hesitate to use it when you need it.
Frances left the clinic.
Groopman to Richard: You know, it does not really make a difference if it is clinically cancerand not the chemo. There is little of what we do about it. By Sharon Frances and now we have only to add a few more weeks worries. In this way, they have something to cling to a little longer. Richard looked Groopman friendly and went on you began your career, Jerry ... PERSISTENT ignorance is a form of happiness. Can she get lucky and there will be a side effect of the drug.
Two weeks later, Groopman saw the report of the scan and Frances wrote:"The liver metastases were doubled over, and new deposits had appeared in the spleen. The bodies looked as though they had been infiltrated by large-caliber bullets, allowing huge holes. The scan also showed was the fluid build-up in the abdomen . I knew that patients like Frances rarely survive more than a few months. I noticed a faint tinge of yellow in her eyes. There was jaundice, an indication that the cancer of the liver, the excretion of bile is blocked. Her stomach was sodistended from the ascites that she pressed her navel outward like a soap bubble. "
Frances came to the clinic.
Groopman: How are you?
Frances: Very tired. I have no appetite. I have to force myself to eat, not to go because the food good.
Groopman: We have to drain the ascites to relieve the pressure. They should be better afterwards.
Sharon: "And that means it is fast spreading, is not it?
Frances: I have no energy. I felt for awhile that somethingwas wrong ... But Dr. Keyes said it was from the chemotherapy treatments.
Sharon: I thought you and Dr. Keyes said that chemotherapy might cure.
Groopman: He has not - say quietly -. We have said that it is a good chance to go into remission, what has happened. Groopman then explained what that meant, and how it differs from response to recovery.
Sharon: Why did we do?
Groopman: cancer behaves in this way. Shrinking aduring the treatment then becomes resistant to it and is growing again. I'm sorry.
Groopman said: "The last time I saw the (patient) was in early March. Frances was nothing more than a few bites of solid food to eat. When drinks were too cold or too hot, they broke them. Any drainage of ascites when only one few days of relief before the fluid re-accumulated. Frances declined further chemotherapy after hearing my frank recitation of data on their chance. work
Sharon: I think he (Dr. Richard Keyes) did not believe that people like us are smart enough or strong enough to handle the truth.
Groopman: It was not a question of clever enough. Dr. Keyes and I wanted to spare you the worry. Well, we were both wrong.
Frances died soon afterwards. Groopman said: "A feeling of shame and guilt gripped me. Richard and I did not have the () patients. It is illusory to tell me that it had done what Richard and I were adoptedas an apprentice was the best thing for them. Ignorance was not luck, not when it arrived it. With the abandonment of the truth, Richard and I left Frances, and our illusion we left Sharon alienated and bitter. "
Comments: It amazes me that the same story has been played over and over again by different doctors. It seems no matter whether it was in Malaysia, Indonesia, Singapore or the United States.
Groopman was ashamed and guilty. I wonder how many others were of the opinionthe same way with after unsuccessful. How could she ever know the face of their patients that, in trying "to do their best," they misled or deceived in fact their patients?
Groopman was right when he wrote that the episode had left Sharon alienated and bitter. Who would not be disappointed deceived, deluded? In a decade of my own experience I have met patients and their family members who are bitter and angry at the doctors she had taken for a ride. Many have lost their loved onesalongside those with a hefty pay medical debts face. For some who are poor, they resorted to the sale of their property - land or a house. The fact that the bet that it was buying "cure" that misrepresented "to" say the doctors, she took, was promising. Patients do not understand that it is "so much you can do every oncologist," when they are confronted with cancer.
All these years I have always held the view that the patient was telling the truth or make available, must provide sufficient and unbiasedInformation to enable them to make a decision for themselves. There is no need for anyone to play the "God" and try to be a hero. Groopman was right - he and Richard were to be protected in an attempt to "false Frances by concealing the truth. Or concealment of the truth, they tried to "protect Richard's income?
By writing this, I am not "anti-doctors". I hope that patients, their relatives and even the doctors to learn from what had written to Dr. Groopman. I have great admiration and respect for this author, Dr. Jerome Groopman. From the early stage of his career, he had shown himself a man of integrity with love and compassion. I'm proud of him and greet him on his righteousness and integrity. This is the kind of doctor that the world needs, and patients should go for help. Unfortunately, I'm skeptical or not too sure of some oncologists. Patients or their family members told me that the doctors were not rare, "for my money is not in myCancer. "The oncologist had no time for her, and showed no sympathy at all. If the patient was asked about the side effects of chemotherapy, the answer is often trivialized or downplayed," Oh, it's not much - a bit of hair loss and nausea. "In Indeed, some patients went through hell "during chemotherapy without any assurance of a cure. Patients who are more questions, the answer was often: "Why ask so many questions. Check with your doctor or physician, I was." It is an oncologist, who said:"I'm not cheap, if you do not have the money to other doctors. Otherwise, go home and sell your house and then come to me."
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