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Andrew John Rynne, MD  
Male, 72
Dublin, Ireland

Specialties: sexual dysfunctions, reverse vasectomy

Interests: sexual medicine, Testosterone Therapy
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Cancer Doctors in Cloud Cuckoo Land.

May 24, 2014 - 2 comments
Tags:

cancer treatment

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oncology

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Chemotherapy

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radiation

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TERMINAL ILLNESSES

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Terminal Care

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allow to die



I do not wish to be unkind to my colleagues in Oncology, the specialist who manage the treatment of cancer suffers. Indeed I’m sure we all acknowledge the sterling work that they do and the lives they save or at least make much better. And besides, who knows when I may need their services myself some day. So I need to thread cautiously here. That said it seems to me that if Oncologists have one universal failing it is this: They never seem to know when to quit or to acknowledge that some cancers are beyond repair.

Watching a TV documentary on the life of a well known Irish journalist and author, Nuala O’Faolain, this thought struck me about Oncologists again. Nuala died from metastatic cancer in 2008 aged just 68 years. A heavy smoker all her life she developed lung cancer which was discovered by accident. A feature of her terrible plight was the suddenness of it all. One day she was seemingly healthy and enjoying life. The next day she was given just a few weeks to live.

She was in New York at the time when her left leg started to drag. Entering the nearest ER a brain scan showed that she had two braid tumours. Further study showed that these were secondary to lung cancer and that her liver was also involved. In short, Nuala was doomed and there was no coming back from this. The people in ER told her quite bluntly, that she had only a few weeks to live. Nonetheless, because she had private insurance, they referred her to their in-house Oncology Department.

So what did the Oncologists do? They did what Oncologists always do; they offered her Radiotherapy and Chemotherapy on the based that it might buy her some more time. She accepted the Radiotherapy and passed on the Chemo and returned to Ireland after 10 days treatment.

In a TV interview only days before her death Nuala put it very succinctly as only she could. She said that when her cancer was diagnosed and she was told it was terminal that “all the good went out of life”. Elaborating on this she explained the all the joy, the music, art, nature, laughs, enjoyment of good food, feelings, senses and all the things that you and I take for granted had suddenly vanished. Nuala made it very clear that she did not want any more time in a life out of which all pleasure, good and joy had just vanished.

In my view the Oncologists should have told Nuala that they were sorry, that there was nothing that they could do, given her a take-home pack containing lots of morphine and sent her home to die in peace. But did they do that? No, they did not. Unfortunately, it seems to be a trait of Oncology to never give up when clearly that is what is appropriate.



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by alltomuch, May 27, 2014
I agree with you that they seem to go beyond what is appropriate and I would like to add that they also seem to have an air about them that they are far above the little people. (in my experience anyway)  I feel that they should give the patient a clear picture and actual odds but they don't seem to want that.  I feel that they tell you just enough and give you false hope so that they can make their money.  

My mother was a beautiful woman inside and out, at 68 years old she was strong and worked very hard at raising me and my 5 brothers.  My mom had started feeling poorly and went to the local doctor with her concerns, he dismissed them to having 6 children and a husband who was unable to work and told her to take maylox and "take a vacation" !!  She liked this doctor... he had a good sense of humor she said.  She was not getting better and on several occasions her blood pressure went up so high that he would sit her down in the office and put a pill under her tongue to bring it down, sent her home with BP meds. joking the time about life and kids....  She went back to him several times with complaints of stomach pains, bloating, feeling too tired and she had developed a bad cough.  The good doctor sent her home with some cough medicine and prilosec.  Well, she was getting sicker and sicker... there would be times when she would feel ok and then all of a sudden she would break out in a pouring sweat, feel sick to her stomach and have to lie down no matter where she was, in the middle of the store even!  Short of breath, panting and in pain I would help her to the car and then home.  I thought maybe it was her heart and asked if she could be tested, they agreed and she checked out ok.  Hummm... she wouldn't go back in because she knew that the doctor would tell her it was just stress and to relax etc.  
This went on for several months along with coughing fits that would leave her so weak that I would be scared.  She would just go take a nap and feel better when she got up.  
One day I went to pick her up to go shopping and noticed as she smiled her beautiful smile that her eyes were as yellow as they could be.  I told her that we needed to go to the ER now because there is something really worng, she wanted to go to her doctor... she wanted to see what he says... so I drove her many miles past the ER to her doctor and by the time we got there she was so sick to get out of the car.  I asked to speak with the doctor and after what seemed like forever he did finally talk to me, I explained that she was too ill to make it up the stairs to his office and that she trusts him so much would he please just take a look at her in the car and tell her she needs to go to the ER?  We had pulled up to the back door so he wouldn't have to but step out and take 2 steps..... would he?  NO... he said just take her the ER... I tried explaining that she didn't want to go unless he looked at her and said she needed to go... and that I would so appreciate if he would just take one minute to see her... (I knew something was really wrong with her, and she was scared)  I all but begged him to just take a peek and let her know that he cares and he would NOT.  I was so disappointed and felt so bad when I had to go out to my mom and tell her that the doctor she likes soo  much and trusts will not come out and see her... that was not an easy thing to do... he's a small town country doctor... a PA at that!!  Really??  She was really hurt by that, she thought they had become pretty good friends over the years.... so anyway, we go to the ER and they run some tests, and she is starting to feel better and we are sitting there joking and I got us some lucnh, waiting to go shopping.... ho hum...  waiting waiting.... then this girl comes in and scoops up my moms clothes and we are like "excuse me..what are you doing?"  she is wearing regular clothes.. looks like she might have the wrong room or something??  She says "Oh, I'm sorry, I am taking your belongings to your room, cancer floor, that is the 3rd floor... and both my mom and I stop cold... and the looks on our faces I can only imagine.. because then the girls face turned 3 shades of red and she starts stammering and stuttering and says... "Oh... I'm so sorry.... didn't the doctor come in yet???  and she just about runs out of the room...
My mom and I are looking at each other like there has got to be some sort of mistake, a misunderstanding.... cancer??  No way.... ha... that girl must be really new and got mixed up.... but at the same time we were both starting to get really scared and sick to our stomaches.... just the thought... and then ... no.... it can't be, that doesn't happen to us, it only happens to other people we hear about.... and in walks the doctor with a very grimm look on his face and proceeds to tell us that the tests show that she has lung cancer, liver cancer and pancreatic cancer.....
the room is totally silent for too long.... I felt numb.  I looked at my mom and she at me and neither one of us really could believe what we just heard... we looked back at him and he started talking about the results some more but neither my mom nor I heard a darn word!  I coulkd not hear any sounds at all... I took her hand and we started to walk out.... then all of a sudden the deafining silence was shattered by the busstling of nurses and what seemed like 50 people helping my mom sit down in a wheel chair and they were all looking at her and I with such sorry faces and telling us they were so sorry....    soooooooo.... this is real??  Now that fight or flight response kicks in and I take hold of that wheelchair and I smile, nod my head at the nurses and take FLIGHT.... I push her past everyone and right out the door into the bright sunlit parking lot!   Our conversation went like   "This just can't be.." " What did he say?"  "Did he say what I think he said?"  "Noooo... there is no way..."  "did he say Cancer??"  "Like liver, lung and pacreaatic cancer????"  Half a smile.. then a look of pure panic then tears and back to one of thos "You have to be joking" kind of looks with a crooked smile..Then some more tears and then a FLAT OUT     "NO I DON"T"    out of my moms mouth!!   That is when I knew that what we heard was real.  I saw in my mothers eyes fear and anger and pain, and all at once those feelings all hit me like a ton of bricks too.  
How does anyone deal with that kind of death sentance?  I think I will just deny the whole thing... let's go home.... if we say it's not so then it won't be so..... that is all I could think of because when I thought about the facts I felt panic and fear for my mom and myself too!  I cannot do this!  They cannot do this to my mom!  She looked so helpless all of a sudden and then the nurses were all coming out to pat her on the shoulder and say how sorry they are and that she should come back in and they have more tests they would like to run.....  
I'm like.... more tests??? Isn't liver, lung and pancreatic cancer enough??  
This was in October of 2007.  In november she went through many more tests to find out how far the cancer has spread and if it was in her bones etc.  Tests that were uncomfortable and hard to take... but she was doing it.  They found that she did not have lung cancer.. it was an infection and they gave her antibiotics.  They found that the spot on her liver was not cancer..... but they gave her pain meds and found that she had diabetes and gave her insulin... we were so happy and hoping they were wrong about the pancreas too...... I mean.. they were wrong about both of these... soooooo.....  went went for the rest of the testing with a lot of high hopes!!  
Unfortunatly.... she did have it.. and she was feeling worse because of the insulin and heavy antibiotics... and when the first oncologist came in to talk to her about the surgery he was so high and mighty and seemed so annoyed that we had so many questions and that we said we wanted to think about it... he stormed out of the room!  So, we decided that we were going home and not going to do anything.... just go home and let nature take it's course.
While we were on our way through the hospital, we both just broke down crying right in the middle of a ton of people... and the sobbing was uncontrollable.  As we were holding on to each other crying... this real nice doctor stopped and asked if there was anything he could do to help?
We gained as much compossure as we could and then he told us that he hoped we didn't mind, but he overheard the doctors talking about her situation.. and he didn't think it was as bad as they were saying.... and if we would like to come into his office tomorrow we could talk about her options... OK... here we go again..... HOPE!  It might not be as bad as they said!!!  We talked to him and he said that there was a 50/50 chance that she would have a better quality of life or maybe longer... but that there is also the chance that she won't.  The way he talked to us gave us so much hope and confidence that he could help her and we were so happy!!!
Now it's December.... she goes in for the surgery, we are scared but have not lost hope... we discussed some things like having regular stitches instead of staples to which he agreed, and that he would make the smallest incision that he could.... about a half an hour later he came into the waiting room and told me "I'm sorry, it was much worse than I thought.  There is notihng I can do."   Total disbelieff....
After they got her into her room I could not believe that she was in so much agonizing pain and that was one of the things he assured us that would be kept well under control.... he lied about everything!  She also had an incision that was as long as it could  possibly be and staples!  For the next three days she begged and cried in the worst pain I have ever whitnessd anyone have to endure, they kept telling me that she has had pain meds and they couldn't get ahold of the doctor to give her anymore... she swelled up so much that they had to put a pump in her belly that had to be emptied every 10 minutes and I was the one who had to do it because there were not enough aids on the floor to keep coming in on time.  
On the third day I had more than I could handle wathing her writhe in pain and not be taken care of properly that I told them to remove all IV's etc. I was taking her home!  Then I got some help.... they wanted me to let hospice come home with her and I said NO.. I will take care of her myself!
But I finally did allow them to send hospice with the understanding that I will be her caregiver and that I do not want anyone coming out except the initial intake worker.... and the doctor can come once a week to check on her..... they agreed and lo and behold.. they gave her enough pain medication for the ride home that she finally went sleep!!  My mom woke up 2 days later and she smiled and thanked me for bringging her home.  I was told that she only had two weeks.... I ordered a different med combo then they have in the hopsice kit and she was alert and not in pain.. I took care of her and she got to be with us for TWO WHOLE MONTHS!!  
I wish that they would have just sent us home and didn't do the surgery because she would have had longer..... but the doctor got his money and he was not available to answer any questions for me..... it's so sad..... If I have cancer... I will NOT go to the doctor.....

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by profjpr, May 27, 2014
And we wonder why doctor's get sued? I'm sorry but her first doctor shouldn't be practicing medicine. He should be selling shoes. When I was in Europe a few years ago, I broke out in a terrible rash. We were in the South of France and the innkeeper immediately called her doctor who drove over and examined me in my room. It turned out to be a reaction to something I had eaten (not at the Inn; by then I wasn't feeling good). For $60 this doctor drove over. No waiting in the ER, etc. And your mother's friendly, hometown doctor wouldn't walk outside? I hope to god you sued him for malpractice--for ignoring your mother's symptoms and possibly accelerating her death.

I've already decided that I would NEVER have chemotherapy. Not ever. Bombarding the body with toxins isn't what I want. No matter the outcome. When someone is so far gone, a fast, gentle death is so much more preferable to a long, lingering painful one.

I watched a good friend of mine spend months in bed on morphine. She had ovarian cancer and she was dying. She couldn't speak. She couldn't think. She was already gone and her family witnessed her pain, listening to her moans.

Why are we kinder to animals than we are to humans? It baffles me.

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