For support partners > Doctor's Fear of Letting Go
Susan,
Thank you for your post.
Doctors and other health care providers are not always well versed in dealing with end of life issues. I know this might not make sense, but when you stop and realize that medical providers are all human, with their own life experiences and personal stories, it might help.
Medical schools are starting to teach students to talk about death and dying, but given its delicate nature, it sometimes takes years of experience for providers to know the compassionate words needed to discuss this subject. Instead, it gets avoided.
A group of providers who work in the field of symptom management and whose main focus is on quallity of life are providers who specialize in palliative care. Its a relatively new specialty, devoted to helping patients and their families work through this complex area of incurable disease.
One way to faciliatate a conversation about your husband's prognosis and treatment options is to ask for a palliative care consult. A palliative care team is integrative and can consist of a physician, nurse practitioner or physician assistant, or a registered nurse who can come and talk with you and your husband.
These providers are specially trained to talk with people about end of life issues, but also can treat troublesome symptoms such as pain. They facilitate conversations with your oncologist or other referring physician and many times include them in a conference where all the information can be discussed openly and safely and work closely with social workers and spiritual care also, so all your needs hopefully can be addressed.
Hopefully, this information helps you and your husband. I know from my experience working with people that many ill people want to talk about when treatment fails. But as you said, don't know how to bring the subject up. Palliative care providers can help gently begin that discussion.
Cheryl Waitkevich, ARNP
My husband had a check up last week at Seattle Cancer Care Alliance. The news was pretty darn good as she has put him in a "fairly stable" category. But the interesting thing I came away with was her continuance of talking more treatments when his cancer gets too big again ( and it will) even though his last surgery was the last best option for him. She still was talking chemotherapy, or more surgery down the road when it has been proven his previous chemo treatments did nothing for his type and more surgery is not a viable option. It made me think later that when would a doctor let go and help one discuss the painful topic of death. I appreciate that doctors continue to look at new treatments, but when there really is nothing will they tell you? Will they help you talk about it? We certainly hope my husband at least gets another year or two, but I am curious and want to seek information regarding how and when a doctor will tell you the truth.