by Mai Brooks, M.D., F.A.C.S.

Today, I diagnosed metastatic cancer in a new patient who just came to see me, and I had to tell her.  This young beautiful vibrant woman will not live long, perhaps a few months.  There was nothing I could do for her.  All I could do was to tell her that I care for her, and to show her my professional “love.”  My assistant then faxed my consultation report to the patient’s referring primary physician.  An hour later, the physician called me, in disbelief.  Together on the phone, we shared a sense of profound loss.

You may read this and think that “love” is useless in this case.  Love will not cure her cancer; love will not protect her from the pain and suffering that is imminent.  And you would be absolutely correct.  But what is the alternative to love?  Is it hate?  Is it apathy?  When I was younger, I used to think that only actions and accomplishments are truly useful.  You can list them, objectively and concretely.  You can measure its productivity, compare it to other people’s, etc.  But when there is no useful action, as in this case, is there nothing left but despair?  When somebody hurts you, is there nothing to do but retaliate?  Medically, it has been shown that hate hurts you physically just as much, if not more, than the person you hate.  Scientifically, it has been shown that despair pains you mentally just as much, if not more, than the actual bodily trauma.

So, should you choose “love”, because it is the lesser of two evils?  Well, I certainly do not think so.  As I get older and accumulate more knowledge and experience, I realize more how little control I have over life in general.  Maybe you did not have a good childhood, perhaps people have done horrible things to you, natural disasters occur, and you are now helpless. 

Please realize that the only thing you have under your control is how you feel and react to external happenings.  Unless you have a psychiatric illness, you can choose to “love” or you can choose to “hate.”  None of us lives forever.  Do you want to wait until you’re laying in your deathbed to think “maybe I should have been nicer to this person, or that person?”  Or do you want to evaluate every day of your life whether you have contributed somehow some love to the world that day? 

I offer you my humble opinion that “Love is THE answer – every day of the year!”

Patients come see me because their worst nightmare has come true.  They’ve been told that they have cancer. Cancer, they fear, means death.  Worse than death, they are sure that cancer means becoming maimed for life.  Chemo will make your hair fall out. Surgeons will cut you open.  If it’s skin cancer in a visible part of your body such as your face, the scar will be there for everybody to see every single day of the rest of your life.   If it’s breast cancer, although people won’t see your scar unless you go topless, you know it’s there.  And you probably will feel less attractive as a woman, even though your scar is not visible to the public.  That’s why I care a great deal about how I plan my operation to minimize the resulting deformity.  Of course, getting your body rid of that cancerous growth is first priority.  But my second priority is to help you move on with the rest of your life.  The less you are reminded daily of your traumatic encounter with cancer by looking at an ugly deformity, the more “normal” life will be.

When patients come see me, they can only think of the worst of the worst.  My job is to help them face their worst nightmare.  Usually in retrospect, having lived through your worst nightmare makes you realize that it was actually not as bad as your worst fear.  But when you’ve just been told you have cancer, you do not have the benefit of hindsight.  So, I try my best to put things in perspective.  Thanks to the excellent cancer screening we have in this country, most patients present to me with early cancer that can be removed by surgery.  I tell the patient where her or his cancer is in the spectrum of cancer stages.  No, your cancer is not like that of your relative/friend/neighbor who died from cancer a few months after he or she had been diagnosed.  Unless you’re in the medical field, your idea of cancer is likely defined by the worst case that you’ve seen, heard about or read on the Internet.  I’m no psychiatrist, and you may leave my office feeling just as scared as when you came in.  But at least, you will know in no uncertain terms that I, your surgeon, am not scared for you because I am confident that I can take care of your problem.  Not to minimize your problem, but I have dealt with worse cancer cases and I can handle yours.  And you and I will face this cancer together, and we will get through this nightmare together, and we will wake up to a fuller life ahead.

Patients come see me also because they’re afraid that their worst nightmare might come true.  Fear of cancer can be just as painful as the real thing.  I have seen patients in agony, who actually then found it more bearable once they know their diagnosis, even if that diagnosis is cancer.  Uncertainty is horrible; it keeps you up at night, it gnaws at you during the day.  So, I try my best to provide answers. And I try to do it as quickly as possible, because I understand the pain.

Dr. Mai Brooks

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