ONCOLOGY – “the Art and Science”

Asking my surgeon about changing oncologists was our last appointment. There was no need for more surgical follow up. His part was done. From the appointment, we marched up to the scheduling desk where he directed them to change my assigned oncologist. It took about ten seconds. Again it was potluck, but this time it was a good match. Oncologist B is a big thoughtful man who looked at what could be done positively without denying the seriousness of the cancer. It was a breath of fresh air. My immediate course of treatment didn’t change, but now I didn’t feel like I had a doctor holding me back and giving up on my survival. Rather, I had a doctor who was working with me and focusing on maximizing my chances for health and survival. The treatments were not without challenges. Towards the end of the initial course of chemotherapy, my body reacted with a severely obstructed bowel that put me in the hospital for a week. Then in September of 2001, after a year that included the surgery, radiation, the initial course of chemotherapy and a follow up reduced maintenance chemotherapy, I serendipitously developed shingles. Serendipitous because this took me off chemotherapy and for a good while I was not to need it again.

Yes, a big advantage of going from Oncologist A to Oncologist B was their attitude: Going from someone who was uncomfortable with my fighting for health to someone who was on “my team” and supporting and assisting my fight for health and survival.

Also more and more, I have come to understand that oncology is part art and part science. Especially in tough diagnosis, the willingness of oncologists and patients to have an open mind about treatment options and approaches is critical. Not to rashly rush into non standard protocols nor to rush off to Mexico for the latest “cure”, but to be able to think “outside the box” and not be straight-jacketed by protocols which are, after all, just general guidelines. The art part of medicine is harder to judge and unfortunately many oncologists, if not most, turn their back on its possibilities. What is the art of medicine? To me, it is taking the facts and “established” medical dogma of a situation and then asking if maybe other explanations or treatment courses might be appropriate. It’s knowing when not to take risks, but also being able to put the situation in context and knowing when to take calculated risks. The art of medicine is not the art of the Cubist, but neither is it the art of portrait painting. Maybe it is the art of Impressionists. Oncologists B and I undertook a couple then non-standard treatments: nothing rash and nothing that had no basis, but were outside the “standard” protocol. These add-ons helped and are still part of my medical regime. He was also open to the possibilities of Complimentary Alternative Medicine (or CAM) and dialogue with my primary care physician at the UIHC who is both an internist and a CAM practitioner (more on CAM later). Oncologist B’s willingness to employ art and science was like attitude, a needed change from Oncologist A.