Monday, October 26, 2009

All in a Day's Work

By Marcia Prenguber ND, FABNO

Sunrise Today
Photo by via Flickr, under the Creative Commons license.

All in a day’s work – a day of repeated inspiration. The challenge is how to record the events of the day, to savor the beauty, to reflect on the challenges, and process the losses. Starting the day with an early morning meeting referred to as Breast Clinic, the team of providers (pathologists, radiologists, mind-body counselors, naturopathic residents, medical, surgical, radiation, and naturopathic oncologists) sit in a darkened room to view scans and path slides. The details of the diagnoses of patients with newly diagnosed or recurrent cancers of the breast are presented, reviewing the pathologic nature of cells projected more than 200-fold on the screen in some ways give us a more real view of the enormity that these cancer cells play on an individual’s life. The stains that color these larger than life cells cast them in a friendly hue, but the meaning that those stains convey is not so good natured. I’ll admit, at first glance, this environment may not appear very inspirational. However…

The intensity of thought and depth of care that is evident during the discussion of the PET/CT scans, the path slides, and the Breast Surgeon’s review of each patient’s story as told to her by the patient is inspirational. The focus on the significance of each assessment, the conflicting information, the challenge to weigh the details appropriately make it very interesting, but inspirational? The details of each patient’s efforts to cope with the circumstances of the changes in their lives since the diagnoses, their lifestyle habits and all the rest of the information gathered by each of us in the time spent with the patients contribute to our understanding of the patients and fuels the fires of inspiration. Knowing these details about their lives gives us pause to reflect on what we do with our own moments in time. These patients inspire us to pay attention, to focus on the details, to bring to them the best that we can be, in whatever discipline we represent.

As a naturopathic physician, all of those details that patients bring to the cancer center matter to me. I look at this as winning the big prize – I get to use all that information in developing my treatment plan. And then to put icing on the cake, I get to spend time exploring these pieces of information with the patient – and just getting to know the patient. The most significant source of inspiration comes from learning who each patient is and how each one of them is dealing with this new challenge. What strategies do they each use? When and why do they choose not to know more? How do they deal with pressure from family and friends to try everything under the sun to try to treat the cancer? That these patients share this is such a privilege. Their courage, their strength, and their vulnerability inspire me. And makes me look a little deeper.

So, as the sun starts to come up in a spectacular sunrise and the morning meeting comes to a close, I am reminded that it is the start of another gorgeous day that I have the good fortune to go spend time with those patients. And to do so as a naturopathic oncologist – what a fabulous profession.

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