Wednesday, March 12, 2014
Originally, this column was to be a discussion about the communication process between my doctor and this patient. Specifically, the time lag between when tests are performed/completed and when those results are communicated to the doctor who in turn – per this patient’s request, e-mails them to me. In the olden days, results were most likely offered up in person; in the post-olden days, more likely a phone call was made; presently, at least in my experience, results most likely will be e-mailed. I imagine an enduring problem for the patient – during all three "days," has been the time waiting for test results and hearing about them from your doctor. Excruciating is one of the most accurate characterizations of that delay, combined with an unhealthy dose of helplessness. Eventually, if you live long enough, you sort of become accustomed to the process and learn to roll with the punches, both figuratively and literally. Nevertheless, the patience and experience you learn can’t totally stop the rampant speculation that keeps you up at night and sleepy during the day.
All of this being said and mostly internalized and assimilated into my terminal-patient brain, unfortunately doesn’t prevent the process from negatively impacting your waiting-for-test-results-from-your-doctor compartment where you’ve (at least where I have) attempted to compartmentalize this process so that it doesn’t adversely impact every other psychological compartment I’ve previously constructed. But I may have learned my lesson this time. The reason being that even though I received an e-mail from my oncologist two days after my CT Scan was completed, it turned out to be sort of an incomplete/inaccurate assessment: "Some better, some worse. I’ll explain more on Friday," (the date of my next infusion and coincidentally, the date of our next face-to-face appointment, a week later). It seems the Radiologist had compared this recent scan to one I had taken nine months ago and consequently, made some incorrect assumptions – but of course, we didn’t know any of this until we saw my doctor; as such, we stressed about the content of the e-mail.
Friday arrived and we went to The Infusion Center where I was hooked up as usual. Within a few minutes, my oncologist walked over to my Barcalounger. Dina immediately whispers: "He’s not smiling." (Reading the facial expressions and body language of your doctor has no doubt become the bane of every patient’s existence, especially when dealing with oncologists.) Soon enough though, after my doctor began talking (and explaining the radiologist’s mistake), it became clear that my results were quite the opposite of what the original e-mail had indicated. It was not "some better, some worse," it was Tony-the-Tiger GREAT! news with which I could most definitely live – and for many years, too, he said. To say were pleasantly surprised might be the understatement of the universe. To say we were over the moon might be a bit more realistic, hyperbole notwithstanding.
So what did I learn? What did my oncologist advise me going forward? To not interpret the delay in the communication process as indicating anything other than the nature of the process; nothing to be taken personally or interpreted in any meaningful way. And even though the news we received was extremely encouraging this time, the process, such as it is, likely continues, and anticipating that news – good, bad or indifferent – is to be delivered in any other way is unrealistic. As difficult as it is for this patient to be patient, in some cases, as I learned this past week, your patience can sometimes be rewarded