The following essay by Richard M. Levine, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which is coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and the bigcasino.org.
I’m a cancer survivor. I’m fortunate to have been in remission since 2000. I remember desperately waiting for the results of my biopsy. When informed that I had cancer, I went into emotional shock for several days. As a physician and oncologist, I was familiar with the health-care system and was able to navigate through its complexities with success.
Today, I remain acutely aware of how dependent individuals are when seeking medical care. Just waiting for a phone call to be returned, waiting for an appointment to be scheduled, or waiting to receive state-of- the-art medical recommendations in a technically correct but easily understood manner can be very stressful.
Being a cancer survivor has made me a better physician. Prior to my diagnosis, I remember having 10 to 20 phone calls to return at the end of the day. I was emotionally and physically exhausted and sometimes resentful of the additional time I’d have to spend after the hospital rounds and a full office schedule.
Today, I recognize the importance of each and every encounter that I have with patients and their caregivers. I make a determined effort to return every phone call, review every diagnostic report, and follow up with patients on a daily basis. I feel it is a privilege to have an individual place his or her trust and life in my hands—particularly a patient with a serious and potentially life-threatening condition. This is a responsibility that each physician (and everyone working in health care) should understand.
Keeping Patients in My Mind and Heart
Over the years, certain patients and their stories have stayed in my mind and heart because of the powerful examples and lessons they’ve provided. Virgil was the first cancer patient I cared for as a physician. He was diagnosed with acute myelogenous leukemia (AML) and was an inpatient when I started my first week of internship in internal medicine in July 1977.
To this day, I remember the dignity and respect that Virgil always conveyed for himself and others. Every day when the medical team visited him during our hospital rounds, he was showered, shaved, dressed in clean pajamas, and sitting upright in bed. His room was clean, and his bed was always straightened. He answered our questions thoughtfully, shared how he was feeling, and always had a positive disposition. He treated everyone with the utmost courtesy and consideration.
When the hematology fellow explained to Virgil that his leukemia was refractory to treatment and terminal, he responded in a calm and understanding manner. Family and friends truly admired this man and shared stories of his kindness and leadership in the community. It was a privilege to know him and to have the opportunity to participate in his medical care. I still feel a sense of loss that we could not have done more for him in his fight against leukemia.
Christina was a patient of mine diagnosed with recurrent Hodgkin lymphoma. During my fellowship in medical oncology, I helped supervise her treatment and follow-up. Her husband and parents were very supportive and friendly. Christina responded well to therapy, and I continued to monitor her in the outpatient clinic. She and her husband invited my fiancée and me to a Bruce Springsteen concert. We enjoyed the evening, and I had the privilege of getting to know her better as a person, not just as a patient.
She accepted the challenges and toxicity of her medical care, always following my recommendations with grace and a positive attitude. Christina did well throughout the remainder of my fellowship, and we remained in touch after I started my private practice in Florida. Unfortunately, she subsequently relapsed and passed away.
Cancer Dictates Patients’ Fate
Christina’s parents sent me a very kind note thanking me for the professional and personal care that I’d provided, expressing their feelings that she had remained in remission for so long because she had such a strong belief and confidence that I could cure her.
Of course, I know better. The disease decides what the future will hold. Nonetheless, I felt very fortunate to have a patient place such trust in me, even when I was a fellow in training. Christina reinforced in me the importance of having an open and honest relationship with each and every patient.
A few years ago, Dawn, a patient recently diagnosed with breast cancer, called our office requesting to be seen as soon as possible. We scheduled her appointment for the next day. Fortunately, she had a potentially curable breast cancer and completed treatment while working full time. Her personal life was very challenging in that Dawn was in a difficult marriage and had initiated divorce proceedings. She’d recently changed employment and was in a job she did not enjoy. She had no insurance and had additional stressful personal and economic issues.
Each time Dawn came into the cancer center, she was pleasant and professional. She wished to be informed and participate as best she could in getting better. After completing therapy, she changed careers and found enjoyable and fulfilling employment. She finalized her divorce and has since remarried a man who is very supportive and loving.
New Insight Into Life
One day Dawn informed me that “cancer cured my life.” I’d never heard that expression before, but I thought it was true for Dawn and possibly many others. If you survive cancer, or any major challenge or life-threatening event, it can provide insight and open a new window in life. I know that firsthand.
After 30 years as a practicing oncologist, I continue to enjoy my career immensely. I look forward to the next generation of physicians continuing to improve and advance the medical care patients receive, and helping provide them with the best care possible. ■
Dr. Levine is a medical oncologist at Space Coast Cancer Center in Merritt Island, Florida.