Isolation, loneliness, feeling of being all alone in the difficult journey are emotions that patients go through upon being diagnosed with cancer. Yet, the patient is not alone in the pain, suffering and sadness. His entire family is afflicted with the disease perhaps not literally but figuratively.
When a patient is stricken with any kind of severe illness, it is never his journey alone. The entire family is afflicted as well. When a family member undergoes surgery, his entire family also feels like they are undergoing the treatment too. When a family member undergoes chemotherapy and experiences its effects, the entire family suffers with him.
Dealing With The Family
I recently delivered a lecture about “Breaking the Bad News” to medical students. I told them that when delivering the bad news, I almost always discuss first with the family before going directly to the patient. I do this not with the intent of hiding the truth from the patient but to educate the family and facilitate their understanding and approval of the necessity of letting the patient know and have him participate in decision-making. It is very comforting for the family to understand and know that they are being considered important too. There are some who might consider this unethical since we are not supposed to discuss the diagnosis with anybody except the patient. They claim that doing so will undermine the patient’s rights.
I am strongly opposed to withholding the diagnosis from the patient. Let that be very clear. However, my experience has taught me that in order to be a good doctor, I have other things to take care of aside from the physical well-being of the patient. I cannot separate that from his emotional, social, psychological and spiritual well-being and a significant part of this well-being is in relation to his family. Part of managing patients is not only dealing with what the patient is going through but also taking care of the well-being of the relatives. The doctor not only facilitates understanding and acceptance by the patient but the family as well. Taking care of the family too makes the patient happy and gives him a sense of peace and security.
As a doctor, I deal with patients. But I must always remind myself that I also need to deal with relatives and need to see everybody as human beings who have raw emotions. Theory is very nice, very interesting, very exciting but being strictly adherent to theory is not what doctors should do. Strictly adhering to theory puts us in danger of being unable to deal with the real world, real people and human emotions. Strictly adhering to theory puts us in danger of being devoid of compassion and makes us no different from machines. We can debate about theory for as long as we want but when it comes to patients, we need to be a little bit more respectful, compassionate and understanding. At the end of the day, the patient and relatives may not necessarily remember how long they survived or whether we were excellent in following the rules but in how they were dealt with as human beings. Expressing their sincere gratitude in the face of terrible loss lets me know that I am doing the right thing.