Indexing Title: HTURINGAN's Medical Anecdotal Report [04-3]

MAR Title: Wholistic Surgeon

Date of Medical Observation: January, 2003

Narration:

Last 2003, I operated on a patient with breast cancer stage IIIA.

I learned that she has a strong family history of breast cancer, 2 siblings have the same disease and one already passed away.

She was for a long time in denial of her condition and refused to accept that she was also afflicted with breast cancer as her sisters, hence the late consult.

But unlike other patients, because of her exposure to her sisters, she was very knowledgeable about breast cancer.

When she decided to have her operation done, her resistance dissolved and she complied with utmost obedience to treatment.

She underwent chemotherapy for 6 months after the operation with diligent follow-up.

For a year, I was in touch with her and her grown daughters.

Three months ago, she came back with bone pains and a bony elevation on the head of her left clavicle. Chest x-ray and bone scan were both negative.

Two months later, she came back with persistence of bone pain, and this time with chronic cough.

Metastatic work-up this time revealed pulmonary and bone metastases, that were earlier undetected.

She was then referred to a surgical oncologist and was again on chemotherapy.

She and her daughters still came to visit me and update me regarding her condition.

Later, one of her daughters came back and told me of her deteriorating condition. I told her to get her mothers’ affairs in order as she may not have long to live and told her to give her mother the last best days of her life.

A few weeks ago, I received a message that she expired with her family by her side.

Again, her daughters came to visit me and expressed their gratitude for giving their mother the care and concern they felt I gave not just, as a doctor but also just like a real daughter to their mother as well.
 

Insights (Discovery, Stimulus, REINFORCEMENT):

Although we were taught in med school to only empathize with what the patient is going through, as a mere human being, sometimes when you have cared for a patient for so long, you develop more than a doctor-physician relationship and before you realize it, you have already formed a strong bond with your patients and their relatives that transcend the line of duty as a physician.

For terminal patients, as you guide them and their relatives through the process of acceptance of the course of the disease and its eventual outcome, one learns that as your role as a surgeon ends with the operation, your role as an oncologist, dietician, psychologist, friend, and daughter begins.