I had a patient who had an advanced form of cancer. When she was diagnosed, her disease had already metastasized to her lungs and liver although at a glance, she did not manifest any trace of cancer at all.
After repeatedly explaining to her the situation, it became very apparent that she was not able to grasp the extent of her disease. Her relatives, however, understood very clearly and made a decision for her not to pursue active treatment of the tumor.
The patient gradually deteriorated and came to a point where she started realizing that her course was going downhill. At this point, she decided that she wanted to undergo active treatment. Her relatives, however, decided against this because of previous misconceptions about the toxicity of chemotherapy and because of financial constraints.
Addressing the NEEDS of Patients
There is a time to treat and a time not to treat. A patient is composed of a physical, psychological, social and spiritual self. Many of us tend to see and address only the physical and tend to ignore the psychosocial and spiritual aspects of a patient.
This patient was craving for treatment not necessarily to address the tumor but to address a more profound psycho-spiritual need of being able to say that she did what she had to do. She did not want to quit without giving a fight. She needed to be treated physically in order to heal. She needed to undergo treatment to facilitate acceptance of her condition and provide closure in her mind. Unfortunately, her family could not grasp these needs and wielded power over her.
I hope that she still finds the path to healing.