As a doctor with cancer, I have opinions on opinions

The modern news cycle’s obsession with all things Trump has moved light years beyond dispiriting with cacophonous reams of vitriol shoveled endlessly back and forth.

One could opt out, I suppose, and simply take an elongated holiday from all things media-related. But like moths drawn to a flame, we can’t seem to help ourselves, and your humble scribe is no exception.

And so, I took note last week of Andrew Coyne’s ruminations in the National Post as to whether President Trump is certifiably nuts (it remains an open question, apparently, for some).

“We’re all entitled to our opinions,” wrote Mr. Coyne, “But even experts — especially experts — should not pretend that they are more than that.”


Opinions are like assholes, after all — everybody’s got one.

But, as Australian sage Tim Minchin rightly observed in a commencement address in Perth: “Opinions differ significantly from assholes, in that, yours should be constantly and thoroughly examined.”

Prejudice and bias distort our viewpoints no matter how robust our scholarship or how pure and uncluttered our thinking. Pontificate if you must is Mr. Minchin’s message, but afford your opinion serious analysis and then deliver it with humility and tolerance of criticism — and always prepare to be wrong.

Many of us — I’m holding a giant mirror up to members of my own profession — have a bothersome tendency to present our perspectives like a male turkey displaying his snood: arrogant, swaggering, self-important.

In the case of physicians, given our overstuffed educations, some propensity for hubris is perhaps understandable (albeit no less forgivable). Few people labor so hard, so intensively and for so long to acquire vast stores of specialized knowledge and experience.

Like most physicians, I employ that expertise daily to generate a stream of considered opinions in the process of plotting the best care for my patients.

In January of 2007, the discovery of a malignant tumor growing in the middle of my head left me scrambling for medical opinions to address my own illness.

The unwelcome news rudely upended my life and sucked all my energies into an immediate and fierce fight for survival (after the requisite period of staring, slack-jawed, at my MRI scan). “When a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully,” 18th-century British scribe Samuel Johnson noted astutely.

As I struggled to regain my equilibrium, this nugget coined by eminent scholar W. Edwards Deming caught my attention: “In God we trust, all others must bring data.”

I freely confess to a robust trust in God, but I’m reasonably sure that doesn’t preclude me from arming myself maximally with information — God helps those who help themselves — and so my wife and I set about to gather all the “data” we could.

We scoured the medical literature, consulted widely and internationally and obtained numerous medical and surgical opinions. It was a gargantuan effort, disproportionately driven by my tenacious and resourceful spouse.

And almost eleven years deep into battle with a cancer that, on average, extinguishes its victims in seven years, I’m beyond grateful to remain on the oxygen-rich side of this soil … and reasonably functional at that.

I’ve been the fortunate recipient of care by a world-class team of doctors, but in the context of this piece, one physician stands out.

On a Friday morning last fall with great trepidation, I sent the most difficult email I have ever crafted.

I was scheduled in three days to undergo a ten-hour craniotomy, an attempt to remove a recurrent tumor, at the hands of renowned Calgary neurosurgeon Dr. Garnette Sutherland. My email informed him that after much deliberation we had decided “at the eleventh hour” to go instead to Toronto for surgery.

This is the Dr. Sutherland, after all — the impeccably skilled surgeon famed for development of the neuroArm. That was the world’s first MRI-compatible surgical robot capable of microsurgery, an innovation inspired by the Canadarm of the International Space Station. This is the Dr. Sutherland who also pioneered a groundbreaking intraoperative MRI system based on a moveable magnet.

And this is the Dr. Sutherland to whom I said, “Thanks, but we’re going to go with someone else.”

The larger context surrounding this excruciating decision lies beyond the scope of this essay, but it goes almost without saying that when my tumor grew back yet again, I felt less than comfortable reaching out to Dr. Sutherland for advice. Bridges burned and all that.

But my options had become limited, and desperate times call for desperate measures. I decided to send him another email, recounting my clinical course over the past year and indicating my predicament.

Within hours I received a remarkable reply, empathetic and gracious, replete with possible strategies to consider. He concluded by an open invitation to meet to discuss options for treatment.

This from a surgeon who was invested with the Order of Canada for his contributions to neurosurgery, inducted into the Space Technology Hall of Fame and awarded the NASA Highest Technology Achievement Medal.

It is precisely this type of doctor in whom a towering ego in the face of colossal achievement would be expected and accepted even as well-deserved.

But Dr. Garnette Sutherland, doctor of doctors, sets his ego aside to focus squarely on his patients before attending to them with dedication, respect, intelligence and skill.

This is not a post designed to elicit sympathy for me — and certainly not pity its odious cousin. After all, I’ve become a bit of a graybeard, clocking in at 50-years-old this year (too old to die young); it’s worth remembering that only a century ago average, life expectancy was all of 48 years.

My scribbling serves instead as an admonition to all of us, doctors and non-doctors alike, to be circumspect in our opinions and to employ care in their delivery, to be perpetually open to correction and dissent and to be humble above all.

In sum: what the world needs now is a little more Garnette.

J. Edward Les is a physician.

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