Archives of The Cheerful Oncologist, Volume 2

“God grant me the Serenity to accept the things I cannot change..”.

Last week I had one of those days when I felt not only popular but like a true celebrity. Everywhere I went people wanted to see me, to talk to me, to get me to sign my name for them. I almost wanted to put on a faded T-shirt, boots and a ratty old stocking cap and, like some overrated movie star, stroll down the boulevard, ready to deck any unfortunate papparazzo who dared to come within my reach.

That, ladies and gentlemen, is what is commonly called a pipe dream. In reality I was just another working stiff running around the office who happened to be an oncologist, and having identified myself as such, was now fair game for any and all nurses, patients, family members, colleagues, technicians and morticians who wished to exercise their right to demand satisfaction from me for a host of troubles.

Trouble…trouble…trouble - oh, we got trouble! Right here in River City! With a capital “T” and that rhymes with “C” and that stands for cancer!

Ahem…pardon the musical interlude. What I am trying to convey is the sense of angst doctors feel when they are bombarded with the suffering of the ill. Sometimes we get hit with such a missile barrage of problems we come to a stop in the middle of the hallway, listening to one tale of woe after another as we attempt to come up with solution that doesn’t immediately identify us as clueless or even worse, insensitive.

Unfortunately there are some complications of cancer that cannot be resolved no matter how hard we try. Not to be flippant, but death is a major complication of cancer. [No! Really? What a brilliant deduction, Sherlock! -Ed.] Even in this time of nascent hope as the promises from translational medicine become reality, death still finds its way into the sickbed as easily as the rays of the moon. Fatigue, although more readily tamed these days, continues to lurk around every corner, eager to weigh down the innocent. Blessed are the physicians therefore who follow our prayer and accept the limitations of medical care, and who possess the serenity to move on from the disquietude of futility toward more humble, but more readily attainable goals. To put it in the vernacular, docs are as worthless as teats on a boar if they ain’t at least tryin’ to help the patient.

“Courage to change the things I can…”

There are some adversities from cancer that can be alleviated, and when skillful physicians spot them they attack with as much force as St. Patrick did when he decided to collect snakeskin luggage. Of all the disgusting symptoms of cancer, none upsets both patient and doctor as much as pain. Pain is unacceptable at any level and in my opinion must be suppressed at all costs - even if the antidote leads to side effects such as sedation. I’d rather have my patient asleep and free from pain than wide awake screaming in agony. The same can be said for nausea, which can be successfully treated with modern antiemetics. All it takes is one tenacious caregiver to make a difference in someone’s misery.

I guess as long as we’re out hunting for things to change we might as well include the bete noire of ignorance. Oncologists have the power to slice through the irritating and humiliating haze of ignorance by performing one simple act: speaking honestly, yet kindly to patients and their families. Taking the time to analyze the medical record, carefully interview and examine the patient and construct a thoughtful plan of action isn’t enough - we must become adept at communicating with patients, otherwise they live with the awful fear that comes from not understanding what lies ahead.

“And Wisdom to know the difference.”

Here is where the prayer becomes the perfect inspiration for anyone besieged with a serious illness, or anyone who finds themselves, as I have, in a career spent trying to throw life preservers to the drowning. If only we could acquire such wisdom as to not waste our days worrying about things that frankly cannot be reversed. If only we knew how to unlock the gift contained with this peaceful saying.

Well, what are we waiting for? This isn’t a contest, or a quiz, or a lottery. Re-read the first line: “God grant me the Serenity…” This is a prayer, and prayers are how those with faith find relief from desperation. Therefore the next time we find ourselves wishing for strength to cope with adversity, we might try repeating this prayer and then believe that these gifts will appear when we need them the most. This is the secret weapon of the steadfast, incorruptible healer.