Clinical Faculty: Why You
Are SO Desperately Needed
By
Leonard Zwelling
Yet again, it happens. A call comes on a weekend. A friend
has a relative who is clearly ill. I am told a story.
The
mammogram was positive, but the doctors told her the shadow was benign and not
to worry. That was a year ago before the ache in her back would not go away.
The
chest x-ray showed a spot. Let’s give it a few months and see what happens, he
is told. Two months later, a seizure.
The
fevers were on and off. There was a slight cough and pain in the groin. The
patient lost a few pounds. He needed to lose them any way. Then the night
sweats began and someone did a physical exam. His spleen was enlarged and the
Mono Spot was negative. $1000 of blood tests later and a PET and CT scan finally
showed the nodes lighting up. Broad spectrum antibiotics were suggested to the
man because biopsy of the pulmonary nodes was “too risky.”
These
are just some of the patients about whom I have been called and asked the same
question: “should the patient be seen at MD Anderson?”
My
answer is always the same.
“Absolutely.
Send me an email with 5 lines about the patient with all the contact info and I
will find a doctor.”
Invariably,
I get the email with 10 pages of lab and x-ray data scanned in and attached.
Just as invariably, when I send the email to a few faculty members I trust the
most, I get the same answer.
“My
nurse will call the patient Monday morning and I will see him or her next week.”
There
is no hesitation. There is no reluctance. There is only the patient, another
person, in need and then an equally urgent need for an excellent physician and
the full knowledge on the part of the faculty member that he or she can make a
difference in someone else’s life.
About
half the time I also get a call from the patient or the family that the local
doctor who has been caring for the patient to date does not feel the consult at
Anderson is needed. He (usually) or she (rarely) can take care of it where the
patient lives. Fortunately, the patient has already decided the time for an
Anderson visit has arrived and will not be deterred.
I
have made these connections for family (one of my cousins died at Anderson in
the early 1990s, but not without bravura attempts to save him from the ravages
of disseminated renal cancer). I have made it for many friends and even for the
people closest to me. One of the Anderson surgeons spared my wife’s mother an
operation she would have gotten in Cleveland for the thyroid cancer she was
told she had that the Anderson surgeon knew was an enlarged lymph node and not
a thyroid mass on physical exam. The lymphoma was diagnosed with a fine needle
aspirate. Even when Genie had her seizure in July of 2012, I had no doubt where
to send the ambulance and when the meningioma was diagnosed in a few hours, our
friend Jeff Weinberg said he would do the surgery but that Franco DeMonte was
the best there was on this type of operation. Dr. DeMonte and Charles Conrad
took superb care of my wife as did every nurse and orderly we encountered at MD
Anderson.
I
recently wrote about finding a personal purpose after David Brooks eloquently
wrote of the answers he received from readers about their reasons for being.
The
clinicians at MD Anderson need never wonder about their purpose. They exercise their
purpose at the times of others’ most desperate need and they do it with grace,
insight, and skill.
God
willing, they always will because the likelihood of making cancer history is
still small despite the newspapers’ messages from Chicago this week.
I
know we are at a moment in time in oncology at which the superiority of the
laboratory investigator is on the rise as molecular and immunologic therapies
of a whole new type emerge from the bench to the bedside. Clinicians can feel
they are little more than conduits doing trials for the drug companies and maintaining
the electronic medical records for the billers, insurers and back room green
eyeshade crowd at the academic medical centers of America. Do not be fooled.
The surgeons, radiotherapists, pediatricians, medical oncologists, pathologists
and radiologists and all the support personnel that make cancer center-based
medical care unique and patient-centered still matter—especially if you or a
loved one is the patient.
Don’t
let those lab guys fool you (and I used to be one). They are critical, but they
are only the beginning not the end.
Back
in the ancient era of the 1960’s there was a famous bumper sticker that read:
“Next Time You Get in Trouble, Call a Hippie.” This was in response to the
police taking an awful beating to their reputations from the radical left.
Perhaps
we need to amend this slightly to “Next Time You Get Sick, Call a Molecular
Geneticist.”
As
a frequent patient, highly dependent for my survival on some fine physicians
who are also great people, just say for me, I am most grateful that they know
their purpose.
To
the clinicians of MD Anderson, if no one has told you lately, I, at least, am
grateful for your dedication to your purpose.
