To Find the Story Behind the Story…..

Cancer patients suffer due to physical, psychological, social, and spiritual issues. They battle for life till their last breath – suffering with the pain of cancer and insecurity of lives of their dear ones after their death, the burden of their unfulfilled responsibilities, and the fear of being a burden to their family and abandonment. This emotional suffering takes a toll more than the physical pain. We need to know and attend their emotions as well, which are no less than their symptoms.

Patient undergoes a war within – the relentless enemy ceasing to quit-shattered self-image, conflicts of altered expectations, and imbalance of mind, body, and soul. Our little gestures, which enhance self-image of the patient, can help them gain immense inner strength. Approach is not necessarily to be immersive, just realize vulnerability of the patient and that the impact of cancer novels other chronic illness due to its suffering of treatment in some, no treatment in some, and uncertainties in all. Truly said, “we need to respect this enemy so desperately surviving and replicating cannily, somehow teaching us to survive”.

Time is surely a constraint as we deal with a huge volume of patients. Yet, we can heal more, if we practice being holistic in our approach. We need to constantly remind ourselves that no illness is an isolated physical suffering. There is a lot more than the wrong habit of labeling patients as “carcinoma gall bladder on bed no. 6”, lot more to medical rounds than discussions with professional grandiosity. We need to instill faith; and contrary to popular thinking, faith does not contradict logic.

It is well said, “Battling the emperor of all maladies, the patient seeks immortality and, in a rather perverse sense, so does the cancer cells”. Ours is a crucial role in minimizing this psychological distress apart from alleviating the physical pain. The completeness of modern medicine is changing with the attitude of being a caring doctor. This can be achieved by adding curriculum of medical humanities, improving communication skills, learning cross cultural values, palliative care ward rotations, and courses for all oncologists for self reflection. Means are many but the purpose is single and simple – being humane while dealing humans. Agreed, some of the patients are cold and arrogant, but it requires only a little intent and skill to break the ice. So, let us:

• address the patient respectfully. Juniors learn attitudes mostly by role modeling, so, seniors own a greater responsibility.

• understand the patient with his/her own psychological and social context.

• recognize the ‘whole person’.

• motivate them to talk openly and honestly about their concerns, fears, expectations, perceptions, and beliefs.

• be empathetic and a good listener.

• instill faith and trust.

• develop skills to filter information for those who have an information overload.

• answer the majority, who still have inadequate information. Dying with unanswered questions is difficult for sure for all.

• self-denial is common but truth needs to be conveyed in a stepwise manner.

• use easy to understand language and help patients to take decisions suitable to them and their family.

• amenities, advancements, and technology are tools. Realize, our purpose is to heal.

• communicate on subtle, use words to complement.

Just try to find what's going on in a patient's mind to find the story behind the story.