the good doctor

"The good doctor is smart, compassionate, dedicated, thoughtful, funny, and kind. He cares about all the right things - about love and honor and ethics and community. He has faith in himself, in his profession, and in those he serves."

- The Country Doctor, Life, June 1998

i first read this when i was still in undergrad and i was home, going to the doctor's office with my mom for her routine annual visit. we were in the waiting room and i was looking through the magazines. there was a Life magazine (it was still in print then) and it had an article on doctors. i remember reading this quote and i wrote it down. i've saved it for years now and i keep it written down in different places. reading it reminds me of what i aspire to be - a good doctor.

the part i've been thinking about recently is the last part - having faith in myself, in my profession, and in those i serve, my patients. in particular, i've been thinking about my patients. and people in general. being a heme/onc doctor has really taught me a lot about people.

i've been in school/training for most of my life. i work more than 12 hours every day. i don't get to sleep much. i don't get weekends off. and i hardly have any life outside the hospital. but, despite all these things, i still feel very lucky - and it's because every day, i get to meet wonderful people and i get to see the beauty of life, the depth of love, the strength of the human spirit. and so i am constantly inspired. and my faith in people is constantly challenged and constantly re-affirmed.

cancer patients are given the chance to see life differently, granted that this is not a gift that anyone would want or wish for - but it is still a gift. they are given the chance to appreciate life differently. it is true that, for many patients, cancer is an incurable disease. it is also true that treatments are getting better and the hope is that, if there is no cure, there are at least therapies that will allow cancer to become more of a chronic illness rather than a terminal illness.

still, there is a stigma associated with it and, ultimately, cancer patients feel that they are faced with their own mortality. they can fear this and they can deny this - or they can embrace the diagnosis and embrace their lives and continue to grow through this experience.

and that is my wish for my patients.

- that they embrace their diagnosis. in my initial visits (and subsequent visits) with patients, i always try to take as much time as possible to discuss the details of their diagnosis with them. i want them to understand it. i want them to ask questions. i want them to feel like they own it (and not the other way around). an interesting thing about cancer is that it only takes one bad cell (simplistically speaking) - and that the one bad cell is different from one cancer patient to another. when we diagnosis leukemia, we do flow cytometry and cytogenetic studies, looking for particular surface markers and genetic abnormalities. while some surface markers and genetic abnormalities are consistent in a particular leukemia and help to diagnosis it - there are a number of them that are unique to a patient. this is like a "fingerprint" of their leukemia. it's their "fingerprint" and it becomes their diagnosis, their cancer. they can take their time with this - but i want them to know it, own it, embrace it. we will go through their treatments together. they will find out what they're made of. and they will be surprised to find out how strong they are. and they will be surprised to discover how much love surrounds them. they just have to give themselves a chance. i believe this. i know this.

- that they embrace their lives. we often don't get a chance to see the longitudinal aspects of our lives, but when i take a medical history - i'm looking at everything that happened to a patient medically since their birth. in the same way, patients need to be able to take a longitudinal look at the other important events and relationships that they have had throughout their lives. this is the time to let go of all the fears that have kept them from looking into their past, in depth. we all have colorful histories. we all have our own crosses to carry. patients need to think about what is (and who is) important in their lives. they need to gently find their way, to not be afraid to face the sad things in their lives, the things that have caused them hurt in the past - so that they can think about what it will take to heal those wounds. they need to accept their own personal history and embrace who they are. it will give them appreciation for their own lives and help them to cherish all the people in their lives in this day.

- that they continue to grow. we are always growing. we are always becoming something greater. i hope for patients to realize that just because they are diagnosed with cancer - just because they think they are going to die - it doesn't mean that they have stopped growing. we never stop growing. their is always room for growth, and creativity, and introspection. and happiness. and peace.

this doesn't happen in one visit. it doesn't happen in a month. sometimes, it takes years.

but my wish is that it eventually happens.