This week I was privileged to spend two days shadowing a consultant oncologist in Derriford hospital. This was a brilliant opportunity to gain a more pertinent insight into medicine’s palliative endeavours. Oncology is often an avenue for the provision of end of life care; this was fully exemplified to me today when a middle aged man’s prognosis was estimated at three weeks. Previously healthy and in full possession of his mental faculties; within the space of a few weeks his malignant brain tumour had progressed from a stage 1 to a stage 4 tumour.
- grade I – cancer cells that resemble normal cells and aren’t growing rapidly.
- grade II – cancer cells that don’t look like normal cells and are growing faster than normal cells.
- grade III – cancer cells that look abnormal and may grow or spread more aggressively.
I was able to spend time observing various clinicians during their consultations with cancer patients. Prior to numerous consultations I spoke to patients in the absence of a doctor in order to gain privy into their perspective on cancer. One specific occasion elucidated the stark difference in doctor patient perspective. One patient, with a brain tumour, was offered one radiosurgery course around 6 months ago, however instead opted to have to tumour removed surgically. Having discharged herself on the day of surgery, this patient now required a course of 28 radiotherapy treatments. Having spoken to the patient about her situation, she said making a decision was difficult and thus causing her current, unfortunate situation.
However, when talking to the consultant about the very same situation, it was apparent that the patient was advised clearly to have to single radiosurgery treatment previously. Her self discharge was a major inconvenience to the surgeon and her subsequent requirement for the 28 treatments will be difficult to book. Both sides of the story seemed completely justified from each perspective consequently placing me in an uneasy state of confusion as to whose was more important. Perhaps both were as significant as each other.
To conclude, this experience has allowed me to gain better insight into patients receiving long term, life changing treatment. My mother’s current breast cancer treatment, coupled with my shadowing experience, has made me realise that the future is completely unpredictable. To quote the consultant I shadowed, “you wouldn’t get out of bed if you knew what was around the corner”. How very optimistic!