You have cancer.
I am sure it is one of the toughest conversations you have to have with patients. As a nurse, having sat in on conversations with families when doctors have to share with them that their children will most likely not survive, I understand the gravity of these conversations.
Having been on the other side of this conversation, however, I am hoping to share what it means to patients to hear these words. Maybe give a few tips on how to make this conversation even a bit easier, for both the medical professionals as well as the patients and their families.
My Specific Story
In my specific story, there was a miscommunication between my family physician and my surgeon’s office. I had an appointment booked with my family physician in the afternoon to go over the results of my thyroid nodule biopsy. In the morning, while I was getting ready for the day, I received an unexpected phone call from a surgeon’s office who I had never heard of. The receptionist asked me why I was missing my appointment.
I didn’t even know I had this appointment. My primary physician’s office had somehow forgotten to inform me about it. It was one week after I had my biopsy done. The moment I hung up, I knew. It had to be cancer.
My husband and I had planned a full day of errands ending with the appointment at my doctor’s to find out the results. I guess in some ways we already had a feeling. This was going to be our ‘last normal’ day. All of that changed the moment that phone rang.
When I got to the surgeon’s office, I told the receptionist that I had no idea what the results of my biopsy were. I wanted to avoid someone just blurting it out to me.
The Moment Our Lives Changed
Once we were led into the examination room, the chairs were separated which meant my husband and I sat on opposite ends of the room. The doctor came in with another resident. I remember reminding him that I didn’t know my results yet. That’s when he said the 3 words that changed my life forever: ‘You have cancer.’
Bam. There it was. What do you do in that moment? Cry? Listen? Pray? I did all of it. ‘More specifically, you have medullary thyroid cancer’ he continued. That sentence just knocked the last little bit of air I had left out of me. From the moment I heard I had nodules on my thyroid, I started doing some research. In all of that time, I always skipped over medullary thyroid cancer since I figured it was so rare, I would not have THAT one.
I mouthed the words ‘It’s the worst one’ to my husband, before the tears started rolling down my cheeks. The rest of that appointment is basically a blur, besides that the doctor rearranged his examination room so my husband and I could sit next to each other and hold each other’s hand.
The next thing I remember was sitting back in his waiting room filling out paperwork for my upcoming surgery, which was supposed to be 15 days after the day we found out.
When The Patient Hears ‘You Have Cancer’
Now, I don’t know what would have been the ideal way to find out I have cancer, however, when I think back on this day, I wish there would have been a few changes.
I wish that the doctor who told me could have been my doctor. Someone I already knew. Someone I had a little bit of a relationship with. Although I have to say I really came to like my surgeon as well.
I wish I wouldn’t have gotten a phone call in the morning basically affirming my biggest fears without ever even saying a word.
I wish my husband and I would have been brought to a different room. Maybe not a brightly lit examination room, a room where it felt like being under a microscope when walking into it. Having been with parents when they received devastating news about their child, I found some of the most supportive conversations for parents happened in quiet rooms. Dimmed lights with comfortable chairs. Rooms that the parents could stay in a few minutes after receiving the news that would change their lives forever.
I wish it wouldn’t have felt so rushed. I understand that the doctor squeezed me into the schedule since I missed my original appointment, however the whole meeting felt quite rushed. This was the moment that turned my life upside down. Even though he did take time to talk to us, it felt very rushed and like another patient was waiting for him in the other room, which probably was true.
I wish we could have sat next to each other from the beginning. So that I could have fallen into him and had him next to me to steady me, instead of crying silently and then rearranging furniture.
I wish there would have been support available to deal with such a life-altering diagnosis. Especially at a young age of 25 when something like this news is the furthest from your mind. Someone like a psychologist. Someone who knows this disease to answer questions. I wish that a referral to talk to someone would be an automatic chain reaction after finding out.
Things could have changed by now, but I am not sure. I don’t know what the best way would be to change how patients receive the news. It is unclear to me if every cancer patient would even feel this way. These are the things I wish would have been different on the day my life changed forever.
Maybe there is a way that you as a health care provider are able to implement some of these things next time you have to give someone this news. Perhaps you can change a few things in your own practice. Maybe you can help be the change in your institution to help patients find some small comfort while life crumbles all around them. If possible, be the change.