Parting Gift...

Dr. Stinson

I have a love-hate relationship with medicine which I will explain in an upcoming post… Till then a true story from one of my patients…                                                     

The gentle voice on the phone was that of Dr. Stinson.

"I have a gift certificate for a massage that will expire soon, but I am undergoing chemotherapy and I just don't feel up for it at this time."

I could hear the pain and weariness in his voice.

"I'll tell you what, Doctor. Your certificate will never expire. Don't worry...just come in when you're ready. I wish you well until then."

Nearly a year went by before I heard from him. We scheduled his Thai massage.

On seeing him for the first time, I was struck by his appearance. Youthful for his 50+ years, tall and trim...not your typical cancer survivor.

He looked like he had done everything right in his life. And, indeed he had. Good diet, exercise, moderation.

What a great example he must have been for his patients.

He came from a family of physicians…well-respected in the community.

It seemed a shame that someone like him would suffer cancer and have to undergo the debilitating treatments.

He imparted a valuable education as he related his experiences and how they had impacted his life, his practice and future plans.

Despite having completed the rehab that was needed after chemo, he was still struggling to get his strength back.

He explained how chemo poisons the muscles, doing permanent damage.

He had closed his practice for a time, but hoped to open again...part time, if need be. He was determined to do his best as he moved forward under his changed circumstances. But he found that, despite his best efforts, he was never able to work more than half a day.

Given the economics of paying staff and malpractice insurance, he might be forced to retire for good...several years earlier than planned.

He told me that he and his wife had originally planned to travel the world in their golden years, but in the aftermath of cancer treatment, they were now hoping to take a couple of bus trips around America instead. It was sad to see their diminished dreams at the end of a long career..

But, on the positive side, he had achieved his main goals in life...to see his sons to maturity and to serve people in his career as a doctor.

He was grateful for that.

He made some mention of seeking treatment along less conventional lines and how that had made all the difference.

It was a hard-won victory, but he made it through.

This is the story he related to me...

Dr. Stinson had been diagnosed with non-Hodgkin's lymphoma in his late 20s.

As is typical, he was urged to begin treatment immediately. But his first thought was that if he followed that advice, that he would not live to see his 3 young boys grow up. He tried (unsuccessfully) to negotiate with his doctors. “Not every cancer is the same. Hodgkin's does not call for aggressive treatment," etc., but he was met with considerable resistance.

He was told "There's no time to waste. We need to begin treatment immediately!"

He remained uneasy. When he sought a 2nd opinion in the nearest big city, his local doctor friends were unreasonably offended and several friendships went by the wayside. It was a cruel awakening. Wherever he turned he was given the same advice, but it still didn't sit well with him.

Venturing farther afield in search of answers, he wound up at the Mayo and Cleveland clinics, where he had the beginning of some real conversations...

“True...Hodgkin's could be handled somewhat differently.” He did not need to rush into treatment, but neither should he delay too long. Weighing his options against his personal and professional judgment, he continued to search for answers. Eventually, he found a professor at a medical university who was freer to voice his opinion.

"Mark, if it was MY body and if I had 3 youngsters, I would do nothing. Let's monitor things at 6 month intervals. If and when we see substantial changes, we can begin conservative treatment. But, until such time, I would do nothing."

This was the voice of reason that he sought. So that was the path he chose. He lived, he enjoyed his family and he cared for his patients.

Some 16 years passed before they saw those changes. By this time his boys were in college! He had made it!

Treatment options had improved in the meantime, as well. He and his doctor opted for a conservative course of treatment but it still knocked him pretty hard. In the end, he was vindicated in his choices and he enjoyed a full and fruitful life.

It was a memorable afternoon with him... I appreciated his honest and sensitive portrayal. I would not forget him.

A year or so went by before I heard from him again. He was retired now. He looked a little thinner now, a bit more weary. Gentle and wise as before.

As we worked, we caught up on things.

There was a slight shift in his voice... a kind of earnest and serious tone.

He began to lay out a picture for me, something I sensed he was not free to do before. He began to show me the inner workings of his profession...the reason things had proceeded as they had.

"Do you remember how I was urged to begin treatment immediately? Do you remember how I tried to reason with the other doctors about different cancers being handled differently? Every physician insisted I begin treatment without delay. How I had to go outside the community to find someone I could work with more intelligently?"

"Yes, I remember!"

"Well, this is how it works behind the scenes... In medical school, it is constantly drilled into us to 'Diagnose and rush to treatment!’ It doesn't matter what the condition is. 'Identify and rush to treatment!' We are so heavily programmed along those lines that there seems to be no other possibility. Not for the doctor...not for the patient. There is no discussion, no middle ground, no common sense.

It was not always like this…

Practicing medicine was an art in my father's day.. You factored in the age, overall health and attitude of the patient. You would weigh the various options and come to a mutually agreed-upon course of treatment. Now, everything is all cut and dried. We are not acting in the best interest of the patient. The doctors all acted out of their conditioning. But it is wrong! We bully the patients...and their families. If I had followed their orders, my life would have been cut short, I would not have lived long enough to raise my kids and I would not have been able to fulfill my dream to practice medicine. In fact, not every cancer is the same and not every patient is the same. But no one would listen to me or to the science, because they were all duped into that irrational approach. 'Identify and rush to treatment,' no matter what it is!"

There was a change in his tone as he continued. It was clear and it was urgent. "TELL your people to hold the reins over their own bodies. They need to be in charge. No matter how hard you are pushed and rushed toward treatment, resist. Do not, under any circumstances, let yourself be bullied or rushed into any kind of treatment. Just know that this is how we were trained and we all act out of that relentless training. Take the time to do your own research and then...Do More. Above all, trust your gut! Listen to your instincts. You decide what's best for you."

That was the last time I would see the good doctor...  

Two weeks later, I read his obituary in the paper. It was in retrospect that I realized the importance of his visit and the message he entrusted me with. It was his parting gift...