Breaking The Bad News-You Have Cancer
It is cancer-says the doctor.
What do you think is the first reaction of such patients? Shock? Disbelief? Numbness?
I have no statistics on this. But whatever, I have spoken and shared with many such friends, acquaintances, and fellow travelers, most either do not remember that precise moment or remember having asked a simple question like, 'OK, then, what next?'
Trust me, it is not because they were brave, but because the import of the words does not register immediately. In many cases, they and their family members might have seen it coming, yet when it does, there actually is no initial first reaction.
Cancer Cannot Happen To Me
A dear school friend of mine mentioned how, when she gets to know of someone having cancer, her heart goes out to the person. A pep-talk call, words of encouragement is all that she has offered. But last week, when her own father got a cancer scare, is as she confesses when it hit her. No one fathoms, that it could happen to them or their near and dear ones. And when it does, it is implausible.
It was during the course of our chat, that we realized how, from the time of breaking of the news to the entire course of treatment, everyone speaks about the radiation, the dreaded chemo-therapies, and the heavy medication that the 'poor' person has to undergo. Strangely, no one speaks about the mental state.
Breaking the news is as difficult as it is to receive. Sadly, the majority of the doctors neither have the sensitivity nor the skill for the job. I remember, during my time, while my neurologist tried to prepare me for the biopsy result and mentioned it could be a 'tumour', the oncologist during his rounds, minced no words.
59 doctors who treated cancer patients were included in a study at General Hospital of Komotini, Greece. Of this 66.10 % had not heard about techniques and guidelines on breaking bad news and 61.02% had not tried to find out information about it. And 96.61% considered that training in breaking bad news is essential for their clinical practice.
When I was told I had Thymoma
I vividly remember the day, when I was in the hospital bed, with a bandaged chest, waiting for the evening round of the doctors. A new doctor introduced himself. I asked, which doctor he was? 'I am the oncologist', said he, while I wondered, what work he had on my bed.
He touched and felt me all over!! Ha! Nodules, back, front, neck. You know, even as I write this, I can feel that plastic rexine under the white bed sheet and his big strong fingers touching my skin. The pregnant pause. And him eventually, saying, "You go home and rest for 2 weeks-then we shall begin the chemos!"
But why? I gaped at him. The neurologist had said, it was only a benign something. He cut me short and said, "What benign something? It is cancer-Thymoma"
My memory is as vivid as it can be. I nodded and asked, "What next?' He then explained the roadmap for the next 6 months of my life.
No. Let me clarify. I was not brave. I was not-not scared. I was simply numb. It had not hit me yet. I waited for that evening to pass and my husband, Rahul to come. For I wanted to break the news to him personally. His first reaction? "Ok, don't worry, shall cross this bridge too!" I have often wondered if this meant he was a super mighty hero, who took charge of things as they came or was he too deep insight in a state of numbness?
What is Bad News?
By definition “any information which adversely and seriously affects an individual's view of his or her future”
According to me, breaking a bad news like “you have cancer”, is like dropping the atomic bomb on Hiroshima and Nagasaki. The understanding, acceptance is like that mushroom cloud that grows slowly and steadily engulfing the center and all those around it. It's dreadful side and after-effects lasting forever and ever.
I have Cancer. But I am Fine
I mean, what else do you reply, when people constantly ask, how you are doing? I am fine. Or, I am OK. Wham! Soon you are labelled strong, brave and inspirational.
I am sure many people with cancer and other chronic health issues would agree that, in order to make your immediate family feel better, we put up an act of well being. Truth is that we need a place where we can just be. Without pretensions. Without the drama. Remember that cancer patients are dealing with both pain and suffering. Which of the two is worse if you wonder, then read about it here.
Cancer-Medication plus Counseling
The first-hand experience says, if medication and immediate treatment is essential to destroy the unhealthy cancerous cells, then equally important is professional assistance by way of a psychologist or counselor. In fact, I have always wondered, why it is not stressed upon, offered or a part of the treatment.
Neither doctors nor family can do this particular job justice. Doctors, because, it never was an important aspect or chapter of their syllabus I suppose and added to that their hands being full with lines of patients to attend. Which doctor would then have the time to simply touch the patient's hand across the table or put a hand on their shoulder while giving the dreaded news?
Family. The immediate family means the best. They are the ones having sleepless nights. Praying to the almighty with every breath of theirs. If only they understood that many a time, to make them feel better, we put up an act. Yes! That act of bravery. And it gets tiring after a while. Especially, if you happen to be the head of the house or an epitome of strength.
Counselors are the best.
Trained for the job
The perfect sounding board
I went for a trained psychoanalyst and am so glad I did. It helps when
Your confidence is low
Your self-esteem is super low
You wonder each minute if this was the end
You fear you will lose your job
You are coping with physical, mental, emotional and financial stress
You are tired of putting up the brave act
You want to simply cry and feel better
You are feeling confused, depressed, fatigued and helpless
How to Break a Bad News?
Frankly, there is no good way of breaking a bad news. Besides, when a strict, boring, busy, bordering on emotionless doctor breaks it, it is worse. Having said that, it would be nicer and more appreciated if the news is thrown at the already scared patient when, firstly, when it is done in privacy. Secondly, when there is a family member or close friend around. Thirdly, with some time on hand to extend a comforting touch. Believe me, it can do a world of wonder to the patient. And last but not the least, pay attention to the patient's emotional feelings, rather than simply vomit the next course of action.
A medical counselor not just for the patient but for the entire family is imperative.
May no one have to go through such a situation. And if some do, may the medical fraternity and the demonic hospitals, charge a little more but provide professional help from the time they break the dreaded news-You have cancer.
Leaving you today with my favourite flowers-the bougainvillea-because that's what life is like-thorny, delicate, colourful and beautiful.
PS: As always, a small little very big prayer to the medical fraternity to find a sure shot cure to cancer, and Myasthenia Gravis, not just for me, but for all fellow travelers around the globe. May health be with all.