A patient was brought to my clinic after having hopped from one doctor to another in search of the holy grail. When the patient was brought to me, he was so thin and frail and had difficulty speaking because of severe weakness.
I asked the relative what they wanted to achieve in bringing the patient to me. I picked up that the relative, at this point in the status of the patient, was hoping to cure the patient from the disease. Apparently, he was not yet ready to throw in the towel and was looking for all possible avenues, despite the patient’s very very deteriorated condition.
I felt the intense emotions of this relative for the patient. My heart bled almost non-stop and found it hard to look for the right words to discuss the situation with the patient and relative.
A Time To Know
As a physician, I consider it my responsibility to give hope whenever I can. However, I need to make sure that the kind of hope that I give is that which is just enough and not cross the line into malicious falsity.
At some point in our treatment, I need to let the patient and relatives know that science will no longer help in the cure. The role of science has to change from one of might and power to cure to one of compassion and provision of comfort.
Discerning the Boundaries
I think “hope” has been over used and abused by many entities in our society. There are businesses that take advantage of the patient’s desire for hope by offering treatments that claim unfounded effects of cure. Many are malicious and take advantage of the patient’s sensitivity and vulnerability. We must always be careful and watch out for them.
What is also important is for us to examine ourselves and our own motives as to the path we choose. I always tell my patients that no option in cancer management is incorrect as long as that option has been carefully thought out and discerned to most suitably fit the person, his beliefs, his values and all that the person is about.
Are we really doing what is good for the patient or what is good for us? Doctors and relatives have to be extra-cautious of our recommendations to the patient because there is an extremely thin line between what is good for the patient and what we think is good for the patient. We need to be certain that what we recommend or choose is not a projection of our own wishes in the guise of choosing the best for the patient. We need to ask ourselves the very painful question of whether we are really protecting the patient and not ourselves.
The boundaries are so blurry but the boundaries do exist. We just need to be diligent and extremely careful.