It’s Treatable But Not Curable – REVISITED

I was thinking about the subject of my next blog when I was alerted that a new comment was awaiting approval. Mike H, who had just shared his thoughts on one of my recent blogs, was now posting a comment on one of my blogs from time passed titled -“It’s Treatable But Not Curable.” His disbelief that this particular blog had not been commented upon moved him to “step up” and respond to my question: What do patients understand these words to mean?  And, I had also asked readers whether the order of the words impacts a patient’s understanding of their illness.

Mike H stated, “I understood (at the time of diagnosis) the word ‘treatable’ to mean a very prolonged, uncomfortable and complicated future. I understood ‘not curable’ to mean I very well may not see my then young children leave the nest.” He went on to note, “The order in which those phrases came is, and was at the time, irrelevant.”

A couple of years ago, when I asked the same question of Dr. John Hearst and the late Dr. Carol Tunney on their Bennington, VT radio show Natural Instincts, they offered insight into the difficult task doctors’ face in reconciling patients to incurable illness.  “We give the good news first, it’s treatable,” Hearst said. Tunney, then a patient herself, explained, “All I heard was ‘not curable.’ Tell me it’s treatable and I’m open to hear more.”

We seem to be circling back – to the theme of hope and reality for which there is no standard dose. Who was it that said if you find yourself going full circle you know you are going in the right direction. Doctors often say they do not want to take away hope. Perhaps, asking patients what they understand the words treatable – not curable to mean can help define what they hope for – sooner rather than later.

So, who opens this conversation and when?


(4) Comments

  1. Anne Gatling

    Love the cartoon! Tip: click on it to make it larger and more readable.

    “Treatable/Curable” . Maybe all “speak sooner” conversations hinge on these terms and our very individual understanding of their meaning. All human communication is based on mutual understanding, never easy to achieve at best. I think it is everyone’s responsibility to speak sooner, with the ultimate goal of coming to understanding. And, in dealing with serious illness, the treatable/curable dichotomy is key. Thanks, Celia, for bringing this up again.


  2. Anonymous

    It is at Jackie’s request that I am posting her comment on my blog, which I am pleased to do. It also offers me the opportunity to alert others who – like Jackie – may have found Anna Moriarity Lev’s powerful image “too small to read.” If so, just one click will bring it to the fore.

    What did Jackie say? “Thanks for this blog. I want you to know I appreciate you bringing up these tough subjects. Keep up the good work.”

    While my blog may not be able to make these difficult conversations easier—I hope it will invite a dialogue that will…

    Celia Engel Bandman

  3. I’m a veterinary practitioner-generalist.When discussing,presenting “bad” news I’m extremely conscious of my body language,my facial expressions, eye contact,where i position myself in the room,how i might place a gentle reassuring hand on the client(owner of the pet),how i stoke the pet while at times crying too.Tears are real and too communicate empathy. Words are important but there are other forms of communication we need to be aware of and utilize to compliment our verbal message. Steve Zeide

  4. Mary Andersen

    Now that many of us have had the opportunity to watch, THE EMPEROR OF ALL MALADIES, produced by Ken Burns, we could see a physician and patient dealing with this issue. I liked the physician’s, approach of asking the question: ” Do you want the straight answer?” This gave the patient the moment to consider how much she wanted to know. I think it also speaks to Hope. A physician cannot give this. It is the patient who chooses to have this, in the face of all odds. Perhaps it is the initial acknowledgement that both are dealing with an unknown, and that these are the things that could happen, and that there are choices to be made along the way, one being no treatment.

    This talking about cancer is so important. I thank you for continuing the conversation, and helping us all to meet and greet these issues. My husband died in 2013 of prostate cancer and I am still processing all of this. Mary Andersen

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