Letters to the Editor
Just Surviving Is Not the Point
I was disappointed with your all-cancer issue (October 2010). I was hoping for something about living with cancer for those patients who choose not to undergo chemotherapy or surgery, who do not opt for a few more months of life at whatever price. I would like to know about their bravery, their loneliness, how their discomfort is managed. I hoped that I would find something about the doctors who believe that quality of life does matter more than longer life, doctors who care for cancer patients despite the frustration and pain of not “saving” them, despite fear of lawsuits from distressed family members, doctors who manage to find hopefulness in life, not just in staving off death.
Getting society to look at its dread of death is an overwhelming task. That dread interferes with enjoyment of the very life we cling to as long as we can. Patients come to us for help and hope. They are afraid to not take what we offer because they do not want to be rejected or abandoned by us.
It is painful for us to keep awareness of the patient’s dread of death in focus. Furthermore, we can easily be distracted from it by pressure from distraught families, from critical colleagues, from organizational politics, from corporations eager to offer new products, from researchers who need data to publish.
We physicians have the opportunity to take the leadership. We need to be ready to help our patients make choices that address productivity, satisfaction, self-image, pleasure, and legacy—not just survival. Our unwieldy and prohibitively expensive system has boxed us in: It is time to think more critically, practically, humanely about treatment, relief, and cure.
Deborah Pollak Boughton, M.D.
Psychiatrist and psychoanalyst, Minneapolis