Meet The Professors: Pancreatic Cancer Edition, 2016 - Video 15Perspectives on the rewarding experience of being an oncologist
7:15 minutes.
TRANSCRIPTION:
DR BROOKS: This was a delightful 94-year-old guy who had this great joy of life and every visit was fun. We joked. We had a good time. And 4 months later when they died, back at home I got a letter saying, “Thank you for providing care and allowing him to still enjoy his time in Maine.” So yes, even though I really didn’t provide a lot of benefit for him, I certainly felt satisfied. DR LOVE: We’ve been talking a lot in some of programs about what we call the bond that heals and just the bond, which I think I can hear in your voice in terms of this patient. The other question we’re going to ask in the survey is, is there anything in particular you did for the patient that you found gratifying or that happened? Did the patient achieve any goal? Anything in this case? DR BROOKS: Yes, I think the biggest goal was to enjoy summer in Maine, and he did. He also wanted treatment. He wanted active treatment. He got active treatment. And he felt pretty good. DR LOVE: Mike, any thoughts about this concept? When the fellows come to you or med students about, “Why are you in oncology? Why,” do you get a satisfaction even in cases that have these rapid downhill courses? And what is it that’s giving you satisfaction? DR SCHWARTZ: The first thing we tell residents is that, “Don’t judge oncology by what you see in the hospital.” Because, basically, patients go in the hospital to get very toxic treatment or to die. And when they come and rotate through us, it tends to be a cheerful place. And the patients are appreciative. They most understand going in that they’re not going to be cured for most of the diseases. And if we can control their pain, that often is enough to feel good about it. DR GLYNN: Yes, I really echo what Mike said. I don’t think I’d be an oncologist if I had to work in the hospital as an oncologist. I think what we do in the outpatient setting, especially today, is so gratifying. And even if it’s people like you just talked about, Phil, to just help them die in peace, that no trauma at the end of life, it’s all about just having gratitude at the end of his life. That’s a great gift. DR LOVE: Margaret, I think I remember asking you this in an interview one time, the idea of specializing in pancreatic cancer and what it’s like to go to work every day. Any thoughts about this issue, particularly as you focus on pancreatic cancer? DR TEMPERO: I actually decided to focus on the disease because, at least at the time, no one else was. And I thought, “Who’s going to be there for these people? They have a serious illness. Somebody’s got to figure out how to make it better.” So then, obviously, I had to adjust my expectations in terms of what I was able to do. But 1 thing that I convinced myself very early on is, you can help everybody with something. You can find something that you can do for them. And when they leave your office, they feel a little bit better than when they came in. DR LOVE: And Tony, I’m curious about your thoughts about this and also the concept of if you’ve ever been through anything, any type of health issue or medical issue and you realize how important your caregiver is to you. Any thoughts about what you get out of taking care of patients with pancreatic cancer, Tony? DR BEKAII-SAAB: I think about it again and again. Would I ever do this, if I go back and think, (1), would I ever be a doctor? The answer is yes, (2), would I ever do what I’m doing in oncology? The answer is yes. And taking care of pancreatic cancer patients? Definitely. It’s very gratifying to take care of patients, including and mostly they are patients who end up dying, I mean, overwhelmingly 99% of them will die at some point and many of them prematurely. And I think the biggest problem in medicine is that, in medical school and in residency, you get taught that if the patient dies, you’ve failed. And when you’re talking about residents and students rotating on the floor and seeing patients going miserably into their destiny, they feel that this is a profession that ultimately leads to failure. The reality is, I think the biggest success that I feel and the biggest reward I feel is that when I’m able to give a patient a little quality time along with extra time to enjoy whatever they want to enjoy even if it’s a short amount of time, a summer in Maine, seeing the birth of a grandchild, achieving a certain milestone and then realize that at the transition point where they need to be transferred from active care to palliative care and comfort care and allow that transition eventually to death to be as peaceful and dignifying as possible, then I think I’ve done my job. And it’s very gratifying from that standpoint. And you get letters from patients. You get visits from patients. Patients volunteer. Patients’ families volunteer with us in clinic to help other patients or other spouses go or other partners go through the process. So every time I look at it, I continue to think this is one of the most rewarding jobs I would have ever done. DR LOVE: Phil? DR BROOKS: I agree with everything that was said. I mean, I find it a great joy. One of the things I do when I have medical students with me, I tell them that every one of my visits is going to have a laugh or a smile. And they should keep track and tell me if I’ve missed. DR LOVE: Wow! Is that something you consciously do? DR BROOKS: Yes, I do, especially in my later career. DR LOVE: Huh. Interesting. Do you, like, joke with your patients? DR BROOKS: Absolutely. DR LOVE: How about you, Mike? DR SCHWARTZ: I do. They joke as well. DR GLYNN: You have to have humor with this. Yes, absolutely. DR BEKAII-SAAB: No. I agree. Humor is the best medicine. DR LOVE: Humor. DR TEMPERO: Humor. DR BEKAII-SAAB: Humor is the best medicine even when we’re discussing — and I have the nurses telling me, I’m coming out of a patient’s room and I get to the nurse, and they said — we just had a discussion about hospice and the patient is willing. She said, “I would never be able to tell that, because there was laughter and people were laughing in there. And you would think that there was something joyful happening.” I’m like, “You have to be able to inject that humor.” Patients don’t want you to go and be Dr Gloom and Doom. They want you to be realistic, but also, they want to enjoy your presence. And they want to feel that you’re part of their care personally and professionally. They want to have that personal connection. And part of that personal connection is really to take off the mask and really be yourself and just be able to allow that humor backflows. DR LOVE: Margaret, any comments on that? And do you share things from your personal life with your patients? DR TEMPERO: Oh, we do. I think we all do. DR BEKAII-SAAB: Yes. DR TEMPERO: And we find things in common with our patients, and we tell stories and we ask them to tell us stories. So it’s a friendship. You’re walking a difficult path with a friend. DR LOVE: That’s where we kind of came up with the concept of the bond that heals, which is, even if you have a patient who your therapy — the tumor just goes right through, that bond that you’re giving to them is something they value. So the med student might not realize that you’re actually giving something very valuable to the patient. It’s just not the systemic therapy. |