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Contributors to cure


Tom Galli

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From February 2004 to March 2021 I was a lung cancer patient. That is 17 years to reach the pinnacle outcome for our disease--cure! When I think of the people who did the heavy lifting but three rise to the top: wife Martha, oncology nurse Heather Belle, and oncologist Victor Horadam. Only these 3 were with me through every twist of my wild treatment ride. These are my contributors to cure.

Long suffering wife is a wholly inadequate term for describing Martha's burden. I'm not an easy going guy; quite the opposite I can be intense, dictatorial, and completely convinced that my opinion is the only right one. To say that Martha tamed the raging bull is an understatement, in the extreme. Some suggest that spousal support comes with the "for better or worse" territory. But, consider Martha married me during my failed third-line treatment. Where was spousal duty at diagnosis, first, and second line? No, Martha's role cannot be explained by anything other than love. Our relationship was strained by treatment but love is unrestrained and unconditional. So are belief and conviction. Martha's strength of conviction that I would prevail was a mighty bolster against my slim odds. Her conviction saw me through long after I'd given up hope.

Why is it that nurses seldom get the star billing for their important role in medicine? Physicians get all the glory but only diagnose and prescribe; nurses treat. In medical oncology we see our nurse every treatment. By contrast, in 18 weeks of a typical chemo cycle, we might see our physician at the midpoint and end of treatment. Nurses also answer the phone or return emails and text and portal messages telling us how to deal with a side effect or in my case to "calm my raging sea of anguish." While my oncologist retired from practice just after pronouncing me cured, Heather soldiers on, day-in and day-out, dealing with a score of patients each day in active treatment. Heather Belle and thousands like her are the bedrock component of our medical oncology system. Do we understand that? Do we appreciate it? Do we thank them? Thank you Heather!

By virtue of modern medicine and recent advances cancer treatment, including lung cancer, is largely a "cook book" affair. Presenting with a stage and type, a physician will turn to the national standard of care for first and second-line treatments. When these fail and for many of us with lung cancer, they do; the physician needs to create a treatment strategy. The best physicians are applied scientists. They are current with science, understand theory, and use both along with insight to devise a treatment when the cook book runs dry. Insight is Victor Horadam's discriminating trait that produced my cure after 5 lines of treatment. If insight so important, how do we recognize it in our physicians? What are the indicators? What can we look for?

Let's examine Victor's methods to understand how he acquired insight. Before seeing us, Victor spent time in his office reviewing my medical file, scan, blood work, and current treatment. He had perhaps a hundred active patients and as a general oncologist, he treated most forms of cancer. I believe, he used this period of quiet contemplation to focus on my disease.  Then at the beginning of each session was the pro forma question "how are you doing?" He listened to our answer and took notes on points we made. Then he examined me, using a stethoscope to listen to my breathing and heart. He checked my pulse at my feet. He felt lymph nodes in my neck, lower throat and arm pit. Next he consulted the latest scan or test result. He explained what the scan meant avoiding jargon. Finely, he described possible next steps explaining the benefits and risks of each. This examination process never varied during my 17 years of consultations! Process discipline, I believe, allowed Victor to form insight into what might work. Consider that insight defined is "the capacity to gain an accurate and deep intuitive understanding of a person or thing." I was the person and my lung cancer was the thing. What are physician behaviors that allowed Victor to acquire insight?

Taking time to reacquaint, listen, examine, explain test results, and delineate possible next steps along with upside and downside of each all combined to generate insight. I believe insight comes from Victor's unique consultation process discipline. 

This forum is a special place where people with lung cancer can share their experience. When people learn of my treatment history, they ask me how did it happen. Here is how. I have a wife who loves me and whose conviction never waned. I had an oncology nurse who had the endurance of Job, was diligent in administering treatment, and was responsive to my needs. I had an intuitive physician whose process discipline yielded time and opportunity to find a way to eliminate my lung cancer. These are my contributors to cure.

Stay the course.

 

 

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What wonderful people you've had in your life.  It's hard to call someone who went through what you went through "blessed", but if you were going through something this existential and frightening you couldn't have asked for more blessings around you.  What an inspiring essay!

Lou

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