As with all newly diagnosed patients, I would introduce myself and explain the role of a medical humanist on the cancer care team, emphasizing how I could help to facilitate communication with their doctor about what may not have been understood regarding their diagnosis, treatment plan, prognosis and supportive care needs.
On this particular day, the patient was a nurse who politely told me that she had a background in medicine and didn’t need my services. In fact, after an initial consultation with one of the oncologists, she told me that she wasn’t sure that a small community cancer center in Vermont could offer her the best care. So, she traveled throughout the northeast to talk with oncologists at well-known cancer hospitals.
Then, several months later, I received an email telling me of her disappointing experiences at these institutions. She asked me if I thought there was a doctor in the Bennington practice who would listen to her preferences for care and be willing to help her come up with a plan. I approached one of the oncologists and explained the request. A meeting was scheduled.
The patient asked if I would join her and her husband for ‘moral support,’ which made me wonder what she was asking. As a writer I’m interested in the meaning of words so I looked it up. The Oxford Dictionary offered a definition of “support or help, the effect of which is psychological rather than physical.” I told myself that I could do that.
I sat quietly during the meeting and understood that this patient was hoping to be seen and heard, which was not her experience at other cancer centers. She described how those doctors would talk about her prognosis and clinical trials with seemingly little interest in her concerns about quality of life and incorporating complementary therapies in her care plan. What I observed at this meeting was an open and respectful conversation between the patient, her husband and the oncologist.
The following day I received an email from the patient stating, “Our joint experience with the doctor resulted in that collective sigh because it was just right. There was connection, harmony and truth. To be honest with you, I can’t imagine that experience happening without your intervention. Thank you again.” She went on, “I feel such a comfort knowing she [the oncologist] offered to be with me along this very interesting journey.”
I replied to her email by confirming what was discussed at the meeting adding, “I’ve been thinking about your goal to ride your horse this summer and your Chinese doctor saying, ‘then that is my goal for you.’ I thought about what the horse represents in literature and discovered that it’s the symbol of surging potency and power of movement.”
In my medical humanist’s note, I documented this patient’s perspective, which was included in the medical record and important in developing a plan of care. I used the patient’s own words. “Horses to me are what help tie me to this world…they give me access to another multi-dimensional place where all things are possible.”
Soon thereafter she began chemotherapy. Although side effects were debilitating, her oncologist tapered the dosage so she could ride her beloved horse. This patient felt heard and understood.
Sometimes, being present and offering moral support is enough.