Healthcare & Choices: Part 2

“The physician should not treat the disease but the patient who is suffering from it.”

—Moshe ben Maimon
 

My experience with cancer has given me a deeper understanding and appreciation for all that I have. I've also experienced what is both VERY RIGHT, and VERY WRONG with the healthcare industry, as well as the care it provides. Things could have been quite dire for me as a single woman without health insurance. Living alone in Brooklyn without dependents put me in the position of falling through the cracks, unable to obtain or afford affordable healthcare.  However, I am an example of how programs previously set up actually worked to provide an unexpected safety net of care that I could not have anticipated. (And, I'm only one of many who are grateful that someone thought to provide for those of us who would not have otherwise had access to healthcare.) That fact along with the dynamic, knowledgeable, empathetic and fierce cancer team that formed around me, made all the difference in the care and treatment that received.

Now settling into the phase where doctors’ visits are much less than they once were, I'm attempting to catch up and resume timely visits to everyday doctors, such as my dentist, optometrist, gynecologist, blood work/labs, and my primary care doctor. In doing so quite recently, I happened to be discussing my vitals with a nurse, when the doctor, who had just last year given me my cancer diagnosis, came in and looked at my chart. When he started to address me, everything in my body tensed up!  Before he could finish his sentence, I turned to the nurse and basically told her that I could not, WOULD NOT be seen by this doctor. We had a history that resulted in my inability to trust him. So, when he asked me to remind him of our past meeting, I explained to him how he had made me feel uncomfortable and uncared for when he stopped answering the questions I had regarding the cancer diagnosis and treatment options he had given.

The quick lumpectomy he wanted to set up for me would have been VERY wrong for me!  I further explained that last year, when I had informed him that I had not only secured my second opinion doctor, but that she was adamant that I receive an MRI before any final decision should be made. Her approach was to get more information before offering an opinion to do anything, especially cutting open a person, who was until that moment healthy, until then abruptly thrown into the dilemma of trying to understand to what extent cancer was going to affect her life. To that, my original doctor said, and I will NEVER forget it, "An MRI is not necessary."  Really? I found him, and his response to be arrogant!

Just one year later, during this second encounter with this arrogant doctor, my impression of him had not changed.  I made him aware that thankfully, it was the 3-D mammogram where my second opinion surgeon detected an extra legion which proved cancerous after a second biopsy, and that the MRI that he had deemed “unnecessary” had located 15 microscopic legions beginning to form in my body that we were able to address! To that, the arrogant doctor’s response was to inform me that he was a good surgeon who has been doing surgeries for years. I felt bad for his patients and wanted to ask how they felt about their surgeries and their experience with him?

Lucky for me, my second opinion team was committed to performing additional screenings that as far as
I am concerned, saved my life. I expressed this as well as my belief that if I had gone along with his lumpectomy and treatment plan, the additional legions would not have been caught until later. His response to this was, "How do you know that?" 

Well, this is what I do know:

1.  I know that the arrogant doctor had a “bedside manner” that sucked then, and still seems to be lacking. And let's just say that it is highly UNLIKELY that all of what was found by the additional screenings which he did not consider necessary, would have been caught in the few weeks’ time in which he was trying to schedule me for a lumpectomy. But, VERY LIKELY that if I had merely had the lumpectomy then, that the other legions which were already beginning to form would have continued to grow and behave badly as cancer cells do. That would have resulted in more cancer to be dealt with whenever it would have been finally detected. But here's the thing, whether this doctor was as arrogant as I had perceived him to be or not, apparently additional screenings like 3-D mammograms and MRIs are NOT standard procedures in many hospitals. Such attitudes and elitists procedures need to change. We already know that early detection is so important. And additional screenings could help us to increase the early detection of additional cancerous legions. Why isn't standard procedure to search for more in the early stages? Why isn't this aggressive step being taken toward helping a woman with cancer get her life back sooner rather than later or with less extremes? Why are we risking the possibility of missing cancerous cells in the early stages of cancer that could quite likely become a problem down the road?  Thankfully, my team was on it!
 

2.  A doctor's job and interest should be in treating people and not the disease. This initial doctor showed neither connection nor remorse for what I may have gone through, before or after my diagnosis. Based on my diagnosis, his impulse then was to push to surgery without further exploration or nurturing me in the process of such the huge event that cancer is. And one year later, this doctor demonstrated no concern for the fact that he had once made me feel so unsafe that I would not even let him near me for a minor matter one year after the fact. In the end though, I felt good and empowered knowing that once again I chose to take care of myself by saying “NO!” and deciding that that doctor is NEVER getting anywhere near me again. He paled immensely in comparison to every doctor on my chosen team.
It was clear to me that my team was intent on working for me, and WITH me, towards getting me
back to myself and to my life. They rocked it! 

It's been well over one year since the cancer was literally cut out of my body. People continue to ask me how I'm feeling and the answer to that question is rather complex. I've been working toward resuming living my life with as much normalcy as I can. With the ongoing support of my family and friends, I am beholding to my inner fight, sense of self, and choices that lead me to my diligent cancer team.