Wednesday, April 30, 2014


My first follow-up visit with the shoulder surgeon came about nine days after surgery. It was much, much too early for him to be able to tell anything about how the tendon was doing. Mostly, it was a chance for him to see how surgical wounds were healing.

It was a great visit, and not just because I was still double-dosing the Oxycodone he prescribed. When he removed the dressing, it was the first chance I got to see the "entry wounds" from the surgery. It was remarkable -- three tiny holes were all that was left from the arthroscopic surgery that repaired the "mess" that used to be my rotator cuff. I'm still amazed by it.

Removing the dressing also meant I didn't have to wrap my shoulder in plastic when I showered. (Showering, with my wife's assistance, was like a Three Stooges episode. Messy, but we laughed at the end.) That was great, too.

But the best part of that visit with the surgeon was when he took off the dressing. It was taped on pretty good, and his face was just inches from mine as he peeled it all away, very slowly. I was watching him. I flinched a little, and he winced. "Sorry," he said quietly. He winced and apologized two more times before he had it all off.

That, to me, if the sign of a good doctor. He feels my pain.

It made me think of my second appointment with Dr. R -- the one where he did the Bone Marrow Biopsy. As I've said before, Bone Marrow Biopsies are about as fun they sound. I'll skip the details. I know lots of people have a hard time with them. Mine wasn't as bad as some that I've heard of -- the local anesthetic helped. But I don't remember the pain of it as much as I remember Dr. R, and how he, too, was apologetic, and careful, and compassionate. He's fairly young, and I remember thinking I was glad about that, that maybe he was still young enough to not be too cynical and jaded.

I was reminded of both of these things when I read a short piece in the Journal of Clinical Oncology by Dr. Benjamin Corn called "Acquisition of Compassion Among Physicians: Why Is This Rite Different From All Other Rites?" (If the title brings up an echo of a key line from a Passover Seder, that's deliberate, as you will see if you read the piece -- and I recommend that you do.)

Dr. Corn tells the story of how he learned compassion. It came from experiencing a doctor's lack of compassion, and, in response to this, his older brother's own act of compassion. He's writing about the importance of training doctors to be compassionate, and thinks that their own personal experiences are a good place to start, thinking about their "initial exposure to kindheartedness—or possibly, their first collision with callousness—and then begin to do the emotional work that is
required to determine how those encounters left their mark."
I don't know whose job it is to teach a doctor to be compassionate. Or to re-teach it. I think it's probably easy for a medical professional to get jaded, to harden her heart a little. Working in a health system to sometimes treats people as less than people will probably do that to you. And for oncologists, who deal with dire circumstances so often, I have to think that putting up some kind of wall is necessary to just get through the day sometimes.

I had the fortune and misfortune recently to see some hospice workers in action -- nurses and volunteers. It was misfortunate because it meant I had to visit someone who was in hospice care. But it was fortunate because I got to see some examples of true, amazing compassion, of being with someone to try to share their burden.

When I first read Dr. Corn's article, it made me think about the importance of compassion for our doctors. But maybe it's even more important to see it in ourselves.

Every now and then, I'll see an article or a blog post about the good things that come from having cancer. I think as I get farther along this journey, and I have more and more distance from my initial diagnosis, I'm less apt to say, "There's really no good that comes from having cancer," and more apt to look for the good things.

And maybe one of those good things is that we as cancer patients can see others hurting, and understand where they are just a little more. Not just physical hurting, because that's only part of being a cancer patient. But emotional and mental and spiritual healing, too.

In a world that seems increasingly less compassionate, and more interested in looking at a screen than looking into someone else's eyes, maybe our own compassion can be an example for others.


Anonymous said...

Interesting that you had a bone marrow biopsy. I was diagnosed almost 3 years ago with nodes all over my body (at least stage III). My doctor (from Sloan-Kettering) said that the watch-and-wait would be the same, regardless of the bone marrow biopsy results... So I haven't had one yet; even though I suspect that I am at stage IV.

Lymphomaniac said...

Just more proof that there's really no standard protocol when it comes to Follicular Lymphoma. From diagnosis to treatment, it seems like very few of us have the exact same experience. I choose to look at this positively -- it means we have lots of choices. That's a good thing.