Wednesday, May 28, 2014
Just as “everyone knows Geico can save you 15 percent in 15 minutes,” that is, if you watch television, listen to radio, access the Internet or even sit on the beach at Ocean City and watch the single-engine planes flying by pulling banners; so too do people know that when your primary care physician tells you that you need to meet with an oncologist to discuss your recent medical results, you should bring along family, friends, advocates, doctors, lawyers, etc. (your presumptive “team”), because, well, you know why: your life may depend on it.
It’s also common, anecdotal knowledge that the patient receiving the diagnosis (in my case, a cancer diagnosis), is likely not hearing as many words as they think they are hearing. Moreover, as much as the patient is listening and concentrating on what the doctor is saying, the shock of the words, especially after the “c” word is uttered, does something to your cognitive functioning. It doesn’t exactly stop, but it’s no longer working as efficiently. Hours later (or even minutes later, outside of the doctor’s office), when you’re reviewing and discussing – and attempting to digest the words/diagnosis/prognosis you just heard, and perhaps even consider the treatment protocols recommended and the likely dramatic change in your life/future (heck, present), it all becomes a blur and your memory is hardly what you remember. It’s not a blank by any means, but neither is it as clear and concise as you expected it to be.
Having other/multiple sets of ears listening to the same advisory from your oncologist as you the patient hears returns some of the clarity that’s missing from your own recollection. Generally speaking, in this environment, there is a need for some dispassionate perspective, and often the patient is way too connected – obviously, to process the information and be the least bit objective. Aside from this need for a team, there is also a need to capture and maybe even synthesize the information presented for future consideration. We didn’t, but I’ve heard stories of patients who had team members with clipboard in hand taking notes and/or using recording devices for replays later. The collection and replay of information helps the patient be certain that what he thinks he heard (or what he’s already forgotten) is either correct and/or not lost in the extremely stressful moment. Having an agreed-to sense of what your new reality is, what your treatment options are going forward, what the likely consequences of those options are, and quite frankly, what the likely outcome is for all of it, is a tremendous amount of information to keep together and in some kind of order when your brain has just been split apart (figuratively speaking) by words you thought you’d never hear: “cancer, terminal, inoperable” said in your direction.
Unfortunately, there’s no real preparation or training for this kind of experience. As strong and as capable as you may think you are, a cancer diagnosis disrupts everything. At the initial meeting with your oncologist, what you hear and what you remember are not always the same. “Team” members can confirm what was said, and there’s lots of comfort in that at a time when, somehow, some way, you need to be comfortable.