Last week I received infusion number 13 of intrathecal methotrexate, administered over a period of two years. A local cancer clinic provides this service in partnership with my neurologist. As such, I’ve come to know my oncologist fairly well, and I’ve grown fond of him. I think the feeling is mutual.
Nine weeks ago, when I received infusion number 12, I informed him that the treatment was no longer working like it did during the first year. As a result, my neurologist and I decided I would get only three more treatments before giving up, unless it unexpectedly starts working again. My oncologist appeared to take this in stride, as I expected.
Keep in mind that every oncologist, especially one nearing the end of an accomplished career in medicine, has witnessed untold human misery. When you sign up to be a cancer doctor, you know that all of your cases are going to be of the life and death variety. As a matter of personal survival, you must develop the means to temper your natural grief response. Of course, oncology isn’t only about misery, it’s also about sometimes guiding your patients back to health, rescuing husbands for their wives and children for their parents.
When my oncologist greeted me last week, as usual, he asked how I was doing. I rather bluntly confirmed that the treatment was still no longer working, and that I would probably be back for only one more session. I continued to give him more specifics, in a clinical and dispassionate manner. “My legs are shot, and my hands are headed in the same direction” – that sort of thing.
I was taken aback by his reaction. His eyes betrayed the heartache that he felt. I hadn’t meant to elicit an emotional response. I guess I assumed that if there was anyone with whom I could speak so candidly, it would be my oncologist.
Am I to take from this interaction that, at least in his view, my condition is worse than that of a dying cancer patient? No, I don’t believe so. I think about it this way: when the evening news is blaring on my television set, and I am only half listening, if a story comes on about the death of a person in a tornado, I am desensitized enough to feel little or no sadness. But if there is a report of a puppy dog harmed in the same storm – an innocent, helpless creature – I stop what I’m doing, look up at the television screen, and experience a more tangible sadness. “Even the puppies?” I may lament. “Even the puppies?”
As I explained above, my oncologist is understandably conditioned to the suffering of cancer patients. But when his one and only MS patient is doing poorly, it’s more unbearable than it might otherwise be.“Even the MS patient?” He must wonder. “Even the MS patient?”