Empathy

I have spent years with cracking through mysterious diseases. Every time I solve a case - observing, gathering information, and asking questions - I relive the thrill of sleuthing at 221B Baker Street.

This Wednesday morning I received a call from my friend after her father suffered from recalcitrant attacks running amok all over the body. Crippled with dry cough, night sweats, weight loss, and leg swelling, he didn't get any better after staying in hospital for more than a week. Both the patient and his laboratory test results looked bad. So much so that his doctor wanted a costly scan called positron emission tomography.

After the phone conversation, it appeared to me as if this is an "immunological misfiring" instead of a solid organ cancer. Rather than pursuing a diagnostic tool with high dose of radiation, I asked my friend to bring her father to see me. An urine test and a kidney biopsy the next morning made a compelling diagnosis of immune system dysregulation kicking off relentless inflammation in the blood vessels.

The job of a doctor didn't stop here: we have to help the patient handle the bad news and tackle the disease. I have been lucky enough to be healthy most of the time. That being the case, I tend to have difficulty picturing myself in the patients' shoes. It's hard enough for a healthy doctor to imagine the patient's fear, not to mention the pain from a knife and creepiness under the drapes.

During my recent reading of a breast cancer surgeon's memoir, I learned about her own battle with depression, followed by finding a lump on her left breast (which turned out to be just a cyst), and then a large irregular mass on her left breast fiver years later (this time a six centimetre lobular cancer), chemotherapy, radiotherapy surgery and tamoxifen, and yet a locoregional chest wall recurrence. Her ordeal with tears, hair loss, radiotherapy skin burn, incessant night sweats from ovary shutdown, gets stuck in my head. Her story is more than a patient journey. It is a doctor’s reflection on what a patient’s life is like. I know more about patient's suffering, and have told myself to be a better listener.

As it turns out, I took better care of my patient's emotional health, and not just his immune bushfire.