May 24, 2014
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.