Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

4 Lessons From 12 Years as a Patient-Doctor


Our white coats are not shields; they could be traded in for a flimsy hospital gown at any moment. Keeping this in mind, we can think of how we want to be cared for when our time comes, and then give this level of care to others. We can honor our shared humanity and vulnerability in our practice.

My doctor rapped on the door just before he swung it open. His voice rang clearly, “your scan is clear!”


My cancer surgeon knew I had been sitting in anxious anticipation for my every-three-month scans looking for the recurrence of my tumor. And he knew to make the time until I heard them as brief as possible, minimizing any unnecessary suffering.


Waiting for test results is one of the most stressful aspects of being a patient – especially a cancer patient, where your life seems to hinge on the results of interval blood tests or CT scans.


In fact, in the cancer patient community, it’s developed its own term, “scanxiety.”


It’s just one of the aspects of life with cancer that causes suffering beyond the nausea of chemotherapy, the sting of radiation burns, the pain of surgeries.


Much of my suffering in more than a dozen years with recurrent cancer has not been a result of the many times my abdomen was cut sternum to pubic bone, the chest tube that seared with my every breath, the virulent nausea of my postoperative ileus. The worst suffering has been psychological and practical – loss, grief, disability, worry, financial drain, existential dread. The wondering of whether my life will be long or short. The fretful suspense of the time between scan and result. The worry my children will lose me soon.


In medical school we learn about therapies to combat the side effects of cancer treatment, but do we really consider how to treat all the aspects of suffering such illness brings?


I’ve worked to find my own ways of dealing with this – psychotherapy, meditation, writing, art, distraction – none of which I learned in medical school and few of which were offered by my doctors.


If we are to care for our patients fully, we must stop ignoring the breadth of suffering that stems from disease. We must better acknowledge the social, financial, psychological, and existential aspects of illness. When we are not mindful of them – we don’t give results promptly, we don’t offer patients counseling, we don’t consider the patient’s financial strain – unnecessary suffering results.


We may not be trained in therapies for all of these aspects of suffering, but in building teams and examining our systems, they can be addressed. Working together to acknowledge them explicitly, our patients will feel they are not suffering unnecessarily or alone.


Here are some tips I like to incorporate to address all aspects of suffering with my patients:


1.) Ask how your patient likes to receive test results – in person or over the phone, alone or with a family member or friend present; keep in mind this may change over time or based on the type of test.


2.) Find ways within your system to reduce wait time between patients’ tests and sharing results.


3.) Normalize the psychosocial aspects of all illness; make it routine to ask about stress, anxiety, and depression related to both acute and chronic conditions. Don’t wait for your patients to bring it up – they may feel too embarrassed or alone in their suffering to mention anything.


4.) Strengthen interdisciplinary teams, referral networks, and knowledge of outside resources to support patients as they deal with the financial, psychological, and existential suffering that comes with illness.