For nearly two decades, I’ve been telling my oncology patients, with only a little irony, Welcome to your new normal. There’s no getting around the fact that a cancer diagnosis—for you or someone you love—is life-changing. Sometimes those changes are temporary (even though they can feel like they’re forever). Sometimes they’re indelible. Since roughly one in three of us will be diagnosed with an invasive cancer in our lifetime, and the other two will likely know someone who receives that diagnosis, it’s a menace that ultimately impacts nearly everyone.
The year 2020 will go down in history as the year the pandemic monster came and rattled the cage of the world, bringing all of us challenges we weren’t prepared to face. It created a new normal for everyone, redefining our peaks and valleys and relationships, what we are afraid of, and what matters most to us. It strained the medical community, and it frequently put cancer patients in the back seat, waiting for treatment, worrying about the virus, wearing masks and gloves and praying their weakened systems would be able to hold firm. Some immune systems did not, and so we had patients fighting the double whammy of COVID-19 and cancer. For me and my colleagues in oncology practice, and for medical personnel all over the world, it meant a new rhythm and intensity and higher stakes than ever.
The menace of a world pandemic also made telemedicine not just a theoretical possibility but the way things get done. Many patients in my oncology practice are immunocompromised, so if an individual doesn’t need chemo or lab work, we keep them home if we can. There’s been a surprising upside to this for me because it’s a new way to connect—just when I thought I’d learned them all. There’s nothing quite like getting a view inside each other’s homes to make us feel closer. Through telemedicine calls I’ve gotten to meet my patients’ pets, admire family photos, and peek at their potted plants. I’ve asked some to get closer so I can scan the books on the coffee table or to show me what’s for dinner (You’ve got LOTS of fresh veggies in that fridge, right?). We’ve laughed about unmade beds, half-done DIY projects, and family members who can’t seem to help getting in the frame. On my end, I’ve offered up introductions to my dogs and sometimes my family, tours of my “manctuary” home office with its shag carpet, carved Buddhas, lava lamp, religious and self-help books, my guitar, and the self-portrait I painted with my hands (no brushes!) for an assignment in college.
One patient asked about my most prized possession, and that gave me a chance to open the desk drawer that’s brimming with treasured mementos. It’s got thank-you notes and poems, postcards from remission vacations, candles and glass figurines, and memorial prayer cards from patients and families. And it has selfies—me with my tall shock of curly hair, usually making faces; my patients with even crazier faces, or sweet smiles, or shy grins. Sometimes we’re leaning into each other or holding hands; sometimes we’ve got our tongues sticking out or our thumbs up; sometimes one of us is bald and thin after going through the gantlet of chemotherapy and coming out the other side.
I like to think of each of those photos and gifts as a little love story. Each one commemorates a relationship that is more and deeper than doctor–patient to me. In medicine, doctors care for patients, sure, but if we’re doing it right, that care goes beyond diagnosis and treatment—into the territory of caring the way we do for our fathers and mothers, brothers and sisters, aunts, uncles, cousins, and friends.
Unfortunately, that’s not always the case and not always possible. We live in a world where the practice of medicine is conducted at arm’s length, through machines, across the Internet, and within models where an invisible moat divides us. It often feels like doctors are on one side of that moat and patients are on the other, and as complex matters of insurance, approvals, corporate policy, and even politics find their way into hospitals and exam rooms, the moat widens, sometimes until it feels like a chasm between people who should be relying on each other and working together. There may be no field where we need each other more, where that chasm does more damage, than in oncology. Cancer patients come to their doctors at their most vulnerable. They wonder how they’re going to get up each day. How they’re going to tell their families about their prognosis. Why they should subject themselves to brutal treatments or daunting odds. Whether they dare hope for a cure.
We know this is true in our hearts and minds, but we also know it to be true in documentable terms. Studies have proven that strong, empathic engagement between doctors and their patients increases patients’ willingness to report symptoms and concerns. That in turn improves diagnostic accuracy. Empathy increases patient engagement and compliance. Some studies suggest it even improves survival rates. Connection is a powerful intangible—like family, or love, or hope. So how can a doctor bring connection into the room in the small, often intense increments of time we have with our patients? Often, it’s through surprising secret tools—things like laughter, empathy, and music.
There’s notable science to each. Laughter has been shown to reduce stress and improve immune function. Empathy strengthens patients’ ability to cope with difficult treatments and eases suffering during end-of-life care. And music—wow—studies show music can lower patient anxiety levels during invasive procedures, ease the nausea caused by chemotherapy, decrease pain perception, and inspire feelings of peace and spirituality. And that’s just the medical stuff. On a personal level, listening to and making music together creates a sense of shared experience and kinship. It fires up emotional receptors that otherwise remain dormant. It is an honest, authentic shortcut to connection.
Steven Eisenberg is a hematologist-oncologist and author of Love Is the Strongest Medicine: Notes from a Cancer Doctor on Connection, Creativity, and Compassion.
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