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Reflections in a Head Mirror

Reflections - Archive

9/15/2009

The Save

A woman has the age she deserves.
-Coco Chanel
    

She sweeps into the office with a flourish, filling the place with her commanding personality. Because she can be curt, some of the staff members avoid her. She usually refuses to step on the scale to have her weight checked and reveals her septagenarian status only with reluctance.  

Long ago, I recognized her as being “old school” since I have known other women of a certain vintage who were outspoken and uncommonly crusty. She reminds me of a few of my parents’ friends who engaged confidently and forcefully in every social interaction. She remains stylish, if a bit dated, and is fond of expensive perfume.   

Her office visits have never been complicated. Her cancer was successfully removed with a surgical procedure over five years before and, except for some scar tissue and dryness, she has no other problems. She has no difficulty talking and she remains cancer free. Everything, from my point of view, is perfect. She is one of my “saves,” someone who had been cured of cancer with one of my surgical procedures.  

“Everything looks fine, Mrs. Anderson,” I told her at one of her visits. “You are doing great! No sign of the cancer. There is nothing worrisome.”  

She glares at me. “Nothing, eh? I would NEVER have another surgery! Never!” She continues. “This life is terrible! Why can’t you do something about the dryness? Why does my tongue feel so tight all of the time?”  

“Oh,” I think.  

“And another thing! Why does my tongue burn so much when I eat Mexican food? I used to love spicy foods, but I can barely tolerate them anymore! Oh, this is terrible!”  

So it goes. I try to explain the mucosal changes. Scar tissue is less flexible. The linings are thin and sensitive. Things are never the same.

She is not satisfied.  

As she gets up to leave, I find myself apologizing. “I wish things were different,” I say. "See you next year?"  

“I'll call when I'm ready to come back," She turns as she reaches the door and tosses me a patronizing look. “Oh, it’s OK, I suppose,” she decides. "I know you did your best.” Then she gathers herself up and heads down the hall.



   The following is feedback received for this blog:

I love older people; one day I want to be one ... in fact, one day I want to be one just like this!

- Jabulani


Congrats on the save. That must feel so good.

sounds like she enjoys complaining... but underneath it all appreciates that you saved her life.

It must be frustrating to have some of her concerns.

I'm the polar opposite of that. My Mother spoke what she thought and could come across hard. when she really was not that way inside.

years a go when my firstborn was a baby, I decided to sell cosmetics for Mary Kay so I could make my own hours, have an income but choose the time I could be with my baby.

They had a saying in reference to having a skin care program... that I still abide by today..although now with a different company.

At 20...you have the skin you've inherited.

At 40... you have the skin you've made.

And at 60... you have the skin you deserve.

- SeaSpray
seaspray-itsawonderfullife.blogspot.com
Posted 10:15 AM
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Could a greater miracle take place than for us to look through each other’s eyes for an instant?
-Henry David Thoreau    

It is almost 7:00 a.m. and I carry my briefcase and lunch bag from the car to my office. I nod to some of the night shift employees heading home. Another day has begun.  

I type my password and check the computer, reminding myself of the twenty patients I am scheduled to see today in the cancer clinic. A few new consults with untreated or recurrent cancers occupy the longer appointment slots. Follow-up and post-operative patients will be seen more quickly. It will be a full day but, hopefully, I will grab a few minutes around noon to eat my sandwich.  

I print out some office notes and carry them with me to our weekly 7:15 a.m. Tumor Conference. Several physicians present cases for discussion. We review the scans and the pathology, making recommendations for treatment. We determine who is eligible for a clinical trial. We look at recent research results. Usually, a brief discussion will mean better news for the patient; we have something to offer. A longer discussion can reflect the lack of good options.  

Clinic gets going. First is a 64-year-old man with a tongue cancer. Symptoms have been present for about six months. The scans are helpful. The cancer has not caused much damage. Only one lymph node is involved. Everything else looks fine. I run through the surgical risks, benefits, and alternatives. I prepare the consent form and look at the schedule. Any questions?  

He drops his head, hands gripping his knees. “My wife would have known what to ask,” he tells me. “She died six weeks ago. That’s why I waited to come in. I was caring for her.”  

I pause. There is a story pressing in on us from all sides. It floods the room.  

“I am so sorry,” I reply. “I am glad you are here. Your cancer is still very curable. Tell me about her.”  

We spend some time. I am soon behind on my schedule. There will be more stories that need to be shared before the day is through.  

A recent You-Tube video from the Cleveland Clinic is a spot-on rendering of what happens every day in a hospital. See what you think. No matter where we are, stories surround us, but they are closest to the surface when we are most vulnerable. Recognizing this reality should be part of the repertoire of every physician. We teach this to our students and residents. Even still, how easily we all forget.  

The day in clinic draws to an end and everyone has gone home. At 6:00 p.m., my charts are half-complete. I pick up my briefcase and lunch bag. I find my car and head home.

Tomorrow will be here soon enough.

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The following is feedback received for this blog:


   Dr Campbell, Your Reflections are always so moving including this one. The You-Tube Video from the Cleveland Clinic was excellent.

- Mary Ann, an RN
 
 
 
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Bruce Campbell, MD, grew up in the Chicago area, graduating from Purdue University and Rush Medical College. He completed an otolaryngology residency at the Medical College of Wisconsin and a head and neck surgery fellowship at M.D. Anderson Cancer Center. He has been on the faculty at Froedtert & the Medical College of Wisconsin since 1987.

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Dr. Bruce Campbell
Bruce Campbell, MD
Medical College of Wisconsin Otolaryngologist
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