Indexing Title: JMDEGUZMAN’s Medical Anecdotal Report [04-5]

 MAR Title: Of Acceptance and Denials.

 Date of Medical Observation: July, 2004

 Narration:

            Being a Surgical Resident of Ospital ng Maynila Medical Center in-charge of the on-going Operasyon Pinoy: Operasyon Kanser sa Suso I get to meet patients afflicted with Breast Cancer from different walks of life. It is quite taxing for a while but looking from the other side I had learned a lot.

            Mrs. GE is diagnosed with Breast Cancer, Left; Stage III-B. She is currently undergoing neoadjuvant chemotherapy. The plan was to put her on 3 cycles of neoadjvant chemotherapy followed by surgery then another bout of adjuvant chemotherapy. This was fully explained to the patient after referring her to our service consultant. She accepted it with some apprehensions. On follow-up after two cycles of chemotherapy, the mass on her left breast already shrunk in size. Although the adverse effects of chemotherapy are being felt, her spirit is high.

            On that same day, I was advising another patient, Mrs. FP, also diagnosed with Breast Cancer, Right; Stage III-B. She was previously referred to our service consultant and the plan is the same as that of Mrs. GE. She needs to undergo neoadjuvant chemotherapy. The mere mention of “chemotherapy” put her in tears. When Mrs. GE came, I already spent thirty minutes explaining her condition and convincing to follow the plan of treatment. Frankly, I had a hard time. In my point of view, the patient was confused and I have lost the touch and can not find the right words to convince and make her understand.  Out of exasperation, I introduced her to Mrs. GE and let them talk for a while. Mrs. GE gladly answered all her queries and shared her experiences. I observed that Mrs. FP became at ease. For that short talk I saw smiles on their faces at the end.

Insights (Discovery, Stimulus, Reinforcements)

            Breast Cancer is common worldwide. Every female is at risk even males. As a physician, managing patients afflicted with this disease entails a lot of attention. Patients with Breast cancer suffer not only from the disease itself but they are also affected emotionally and psychologically even spiritually. In these aspects, we, as physician fail to recognize in wholistic way. No one is more difficult to manage than a patient who is in denial. I do not expect that all my patients will accept my method of explaining, educating them of their illness. Some really do not understand, either they fail to listen or they do not listen at all. Is it the lack of knowledge to impart or the lack of power to empathize? Patients too have their stories to tell, experiences to share apart from the advices of doctors. Acceptance of one’s condition is easy if someone can relate to you more, someone to listen and someone to unload your burdens.