Our relatives only want what is best for us but they do not always know what is best for us.
I have a patient who is in the food business primarily because she loves to cook. She gets up between 3 to 4 o’clock in the morning, starts cooking and does not stop until around 12-1 pm. I am amazed by her ability to get up so early because I don’t like waking up before sunrise.
When we were about to start chemotherapy, she asked me if she can still continue cooking during treatment. When she asked me, her daughter, who was seated next to her was giving me a signal to tell her that she will not be allowed to cook.
This has been a very common scenario in my clinic. I encounter patients and relatives who seem like little children telling their mother that the other has been bad hoping that the mother will take their side. Even for patients who are not actively undergoing treatment, relatives will automatically make the patient stop doing what they like to do. Relatives pay attention to everything that the patient does and forbid almost everything that the patient does. Some patients tell me that they feel like they are living in a cage in their homes.
I perfectly understand the well-meaning relatives. Our culture generally does not have a positive association with working. I remember that when I was in college, we felt pity towards those who were working students. Our society frowns upon making elderly people work whereas in Singapore, they encourage their elderly people to continue working.
However, in this matter, I always take the side of the patient, with some compromise. Firstly, because I find that most of the time, the relatives’ fears are irrational, extreme and unfounded. Take for example, the case of developing infections during chemotherapy. It is true that patients are very much at risk of developing infections because of treatment. I remind them to be more diligent in handwashing, to avoid unnecessary contact with people and animals and to avoid being in very crowded places or places with poor ventilation. These precautions, I believe, are general precautions that apply to all of us even if we are not undergoing cancer treatment.
Secondly, we all have billions of microorganisms in our body but we don’t get sick because our immune system is able to control these organisms from developing into disease. The immune system of a patient who is undergoing cancer treatment is weakened temporarily by the treatment, hence, they are at risk of being overwhelmed by their own body’s microbiological inhabitants. However, most of the infections that cancer patients develop are from organisms that are already residing in their body. Caution is important but need not be irrational.
Last but most important of all is that patients want some semblance of normalcy in their lives during those trying times. Being able to continue what one loves to do gives them a sense of meaning and hope. It validates who they are. It makes them feel good about themselves. It satisfies a psychological, emotional and sometimes spiritual need. It distracts their mind from going crazy thinking about what will happen. It does not make them feel useless and hopeless.
So let us allow them to continue BEING. I always encourage my patients to continue doing what they love to do with some precautions and compromises, of course. I am quick to defend them to their loved ones and assuage them that we will always be cautious and always be one step ahead of any problems. This kind of approach does not make the patient rebellious but makes them comply happily. I have never seen a patient fall into danger by continuing to do what they love to do. Instead, I see smiles, satisfaction, joy and a sense of hope.