A Quote by Paul Kalanithi
I have sat with countless patients and families to discuss grim prognoses: It's one of the most important jobs physicians have. It's easier when the patient is 94, in the last stages of dementia, and has a severe brain bleed. For young people like me - I am 36 - given a diagnosis of cancer, there aren't many words.
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For me, I think that there's a lot missing from the recovery or the post-diagnosis side of treating patients. Once the diagnosis is made, I feel that care drops off tremendously, even though it is precisely the time that a patient needs help the most, even if they are not verbalizing it.
Part of my training was learning how to refer patients to cardiologists for heart problems, gastroenterologists for stomach issues, and rheumatologists for joint pain. Given that most physicians were trained this way, it's no wonder that the average Medicare patient has six doctors and is on five different medications.
What I quickly learned after my diagnosis is that the world of a cancer patient has many parts and a good deal of uncertainty.
It's unconscionable that cancer patients get the wrong diagnosis 30 percent of the time and that it takes so long to treat them with appropriate drugs for their cancer.
It's most useful to think about not jobs but tasks. And within any given job, there are lots of different tasks. If you're a radiologist maybe reading the images machines can be able to do that better, maybe making the broader diagnosis and communicating it to the patients.
Around a quarter of cancers eventually spread to the brain. As people live longer, their risk of developing cancer increases; as cancer survival rates improve, their risk of developing secondary tumours in the brain increases. We can therefore expect increasing numbers of brain-tumour patients.
The physicians of one class feel the patients and go away, merely prescribing medicine. As they leave the room they simply ask the patient to take the medicine. They are the poorest class of physicians.
I think the way we think about cancer, the way we treat cancer, has dramatically changed in the last century. There is an enormous amount of options that a physician can provide today, right down from curing patients, treating patients or providing patients with psychic solace or pain relief.
Parents, teachers, clergy and physicians change lives with their words. It is hypnotic for a child or patient to hear an authority figure's words. As I am always sharing, 'wordswordswords' can become 'swordswordswords,' and we can kill or cure with either words or swords.
Many medical students, like most American patients, confuse science and technology. They think that what it means to be a scientific doctor is to bring to bear the maximum amount of technology on any given patient. And this makes them dangerous.
I had gone through a mother having dementia in the last couple of years of her life. She was in a nursing facility in my little hometown area of northern Illinois, so I got to see a lot of other patients there in various stages of the disease. I had a firsthand exposure to it in a pretty big way.
It has oft been said that physicians make the worst patients, but it is the opinion of This Author that any man makes a terrible patient. One might say it takes patience to be a patient, and heaven knows, the males of our species lack an abundance of patience.
Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practi- cally insurmountable. It is no disparagement to the many skilled physicians who have put their cases upon record to say that, in fully one-half the diagnosis was made post mortem.
The most blatant forms of denialism are rarely malevolent; they combine decency, a fear of change, and the misguided desire to do good - for our health, our families, and the world. That is why so many physicians dismiss the idea that a patient's race can, and often should, be used as a tool for better diagnoses and treatment.
The health dollar is very precious. When someone has such a bad condition as brain cancer, we know they're going to die and they're usually going to die within 12 months of diagnosis. They cost a lot of money to keep the patient alive for that period of time. Is it really worth it?
Incredibly, nearly 70,000 Young Adults between 15-39 are diagnosed with cancer each year. 10,000 will not survive. This is a very important stat for me, because I fall in this category. I am one of these statistics. Unlike every other age group, there has been no improvement in the 5-year survival of young adults in 30 years. That means many young adults have the same chance of getting cancer and dying from it as they did in the 1970's. This is not OK.
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