Speaker 1: I'm just a fool, wait, fearing stranger. Welcome to death,
Speaker 1: grief and other ship. We don't discuss. I'm Kyle McMahon,
Speaker 1: m hm. Hello. Okay, what does that mean? Should I
Speaker 1: come there now? Okay? Please please keep me updated? Okay,
Speaker 1: all right, love you bye. Dad had called me to
Speaker 1: tell me Mom was going into the emergency room. She
Speaker 1: hadn't eaten in seven days. She was in pain all
Speaker 1: the time. Through my mom's cancer journey. They had hired
Speaker 1: an oncology nurse, Kim, to come and check on Mom
Speaker 1: here and there, and it really helped to ease Mom's
Speaker 1: anxiety from growing through all of the various treatments and appointments,
Speaker 1: knowing that she had someone by her side at my
Speaker 1: parents house to help guide her through. Kim had been
Speaker 1: over the last few days since Mom had taken a
Speaker 1: turn for the worse. My mom. Mom's mother had passed
Speaker 1: away just a few weeks prior, and Mom had really
Speaker 1: gone downhill since then. All of us really were just
Speaker 1: trying to keep our heads above water. I was so
Speaker 1: close with my mom. I'd visit her weekly and we'd
Speaker 1: eat ice cream and watch horror movies or American Horror
Speaker 1: story how awesome is it to say you watch American
Speaker 1: horror Story with your eight year old grandmother. My mom's
Speaker 1: death was truly tough on all of us, and the
Speaker 1: aggressive chemo Mom had been getting had been taking its
Speaker 1: toll too. She was weaker than she usually was that
Speaker 1: mom Mom's funeral, Dad had pulled out a wheelchair for
Speaker 1: Mom to get in when she was getting out of
Speaker 1: the car. She had been having stomach problems and wasn't
Speaker 1: eating like she normally does, which really had never been
Speaker 1: much anyway. Seeing your mom in a wheelchair for the
Speaker 1: first time in your life just hits different. She was
Speaker 1: always superwoman to me, and now at my mom's funeral,
Speaker 1: here she was being wheeled in a wheelchair by my dad.
Speaker 1: Due to COVID, attendance at my mom's funeral was severely restricted.
Speaker 1: Mom's care team had said that Mom and Dad had
Speaker 1: to sit separately from everyone else because of her chemo
Speaker 1: and the cancer. And since I didn't live with my parents,
Speaker 1: I sat with my Aunt Kim and the rest of
Speaker 1: my family while Mom and Dad sat across the aisle
Speaker 1: from us. I had so many feelings just flowing through me.
Speaker 1: At that point, I was sad for my mom, and
Speaker 1: I was already missing her so much. I was worried
Speaker 1: about Mom, I was concerned about Dad, and here my
Speaker 1: parents were just ten feet away, and I couldn't even
Speaker 1: sit with them at a time I really really needed them.
Speaker 1: My family had asked me to give the eulogy for Mama,
Speaker 1: and I had worked on it for hours the day before.
Speaker 1: I looked over to Mom as I stood at the pulpit.
Speaker 1: She was crying, and although she was wearing a mask
Speaker 1: as we all were, I could see she was smiling
Speaker 1: at me, and that gave me comfort, just that look.
Speaker 1: And Mom always had that ability. She is safety, she
Speaker 1: is home, she is love. When I finished the eulogy,
Speaker 1: Mom motioned for me to come sit with them. I
Speaker 1: quietly asked Dad if that's what she meant, and he
Speaker 1: said yes. Mom kissed me on the head through her mask,
Speaker 1: and I knew she was in so much pain, not
Speaker 1: just physically from the cancer, but emotionally from losing her mom.
Speaker 1: And here she was cancer and horrible pain, grieving, and
Speaker 1: yet comforting me my safety, my home. Love. When we
Speaker 1: went to the cemetery from my mom, that's when Mom
Speaker 1: really broke down. She was sobbing, hysterically getting up from
Speaker 1: her wheelchair and nearly laying herself on my mom's casket.
Speaker 1: I could feel her pain. I missed Mom so much already,
Speaker 1: but now I'm hyper focused on Mom and her health.
Speaker 1: I just lost one of my two rocks, my two people,
Speaker 1: so now I'm terrified of losing the other one. I
Speaker 1: looked up at the wall that my mom would be
Speaker 1: put in. She'd forever be with her husband Jim, my
Speaker 1: beloved pop up Aunt Kim would eventually be cremated and
Speaker 1: go in with them. Mom and Dad will be right
Speaker 1: above them, and I'll be cremated and go in with them.
Speaker 1: Aunt Kathie and Uncle Tom had their own place right
Speaker 1: next to them, and hopefully their son t J and
Speaker 1: his family would be there too, and my uncle Kevin
Speaker 1: and Aunt Michelle and their kids Brian and Megan. We
Speaker 1: could all be together forever. Mom collected herself and then
Speaker 1: apologized for losing it. But who could blame her. My
Speaker 1: mom was a special woman with a huge heart, and
Speaker 1: that's a big reason why Mom was too Mom told
Speaker 1: me later that day that she felt embarrassed about how
Speaker 1: she acted. I said, Mom, you lost her mother. Nobody
Speaker 1: is judging you at all for crying over losing your mom,
Speaker 1: And I could tell Mom was a bit spacey, a
Speaker 1: bit off. Ever, since my mom had passed the cracks
Speaker 1: and the foundation started showing up on Mom's cancer journey,
Speaker 1: it was almost like now that she was grieving momm
Speaker 1: she couldn't fight her cancer with energy too. I mean,
Speaker 1: it takes everything in you to fight a diagnosis like that.
Speaker 1: How could you possibly have the mental or physical energy
Speaker 1: to deal with the pain and grief and loss of
Speaker 1: losing your mother on top of fighting for your own life.
Speaker 1: And now here we are with Mom at the hospital
Speaker 1: and my anxiety sky high. Dad had said I couldn't
Speaker 1: go in because of the COVID restrictions at the hospital,
Speaker 1: but he would update me just as soon as she
Speaker 1: was seen. I retreated back to my bubble with blue
Speaker 1: binging more unsolved mysteries, with my phone in hand, just
Speaker 1: anxiously awaiting dad's call. He texted an update that they
Speaker 1: were taking her in for some tests, and I begged
Speaker 1: him please keep me updated. Then once again I began praying,
Speaker 1: now more angry and desperate than ever. God, you can
Speaker 1: change all this, so do it. Give us good news,
Speaker 1: Give her good news. I was no longer gracefully and
Speaker 1: humbly asking God to help Mom. That tactic clearly wasn't working.
Speaker 1: Now I was demanding it. I went over to watch
Speaker 1: a movie with my godson Aidan and his godmother, Michelle
Speaker 1: Shell had lost her father to cancer, and I was
Speaker 1: there with them through it all. She knew what I
Speaker 1: was going through, so I'd go over there a few
Speaker 1: times a week just to watch a movie and forget
Speaker 1: about everything as best as I could. Tonight, though, I
Speaker 1: was having a really difficult time, not concentrating on anything
Speaker 1: else but waiting for Mom's test results. Since my mom
Speaker 1: had passed, it had really become this vicious cycle of
Speaker 1: Mom taking medicine to help her stomach so she could eat,
Speaker 1: but then not being able to keep the medicine down,
Speaker 1: which only made her stomach work, which meant that she
Speaker 1: couldn't eat, and then the cycle would start over again.
Speaker 1: Dad called, and I immediately hopped up and answered, they're
Speaker 1: going to admit her. He said, They're gonna give her
Speaker 1: fluids through an ivy and put the medicine through that
Speaker 1: to help calm or stomach. Then they can work on
Speaker 1: getting real food in her and get her strength back
Speaker 1: up and get her home. Then Dad said something that
Speaker 1: made me wonder if maybe God did intervene. He said,
Speaker 1: I'm allowed to stay with her until the morning, and
Speaker 1: then they're kicking me out, and Kim is going to
Speaker 1: be working tomorrow and the section Mom will be in,
Speaker 1: so she'll be there with her all day. This was
Speaker 1: a lifeline in an otherwise shitty situation. Mom's own dear
Speaker 1: friend and oncology nurse would be working in Mom's section.
Speaker 1: That would help her mentally for sure, which is such
Speaker 1: a huge part of this battle. For the next few days,
Speaker 1: they did tests and determined that in addition to IBS,
Speaker 1: which is a completely common g I issue, the tumor
Speaker 1: had grown slightly and it was pushing up against part
Speaker 1: of her stomach. The plan was to put a stent
Speaker 1: in to push it away. That next day. The surgery
Speaker 1: was successful, but I could tell Mom was scared. She
Speaker 1: had texted me before that and said that she heard
Speaker 1: it was cold outside. I couldn't help but laugh of
Speaker 1: all the things going on with her, and she texted
Speaker 1: me my hair, it's cold outside. Eventually she texted that
Speaker 1: the situation wasn't good, but it's in God's hands now,
Speaker 1: And when she said that, it really really hit me.
Speaker 1: The same God I've been praying to for years, begging,
Speaker 1: pleading with to help Mom, and we're just leaving this
Speaker 1: in his hands now. I tried to steer the conversation elsewhere,
Speaker 1: but she wanted me to know how much she loved
Speaker 1: me and always has and always will. Of course I
Speaker 1: felt the same, and I let her know that. She
Speaker 1: said she had to go for an X ray and
Speaker 1: she texts me later. Once again, I just broke down
Speaker 1: in tears. Over the next few days, this roller coaster
Speaker 1: called cancer journey continued up and down and sideways and
Speaker 1: upside down. As it was getting closer to Christmas, it
Speaker 1: was becoming clear that the chances of her being home
Speaker 1: before then we're getting smaller. You wouldn't do that, right,
Speaker 1: God right, Mom needs to be home for Christmas. You
Speaker 1: wouldn't do that. God right. My entire life, I had
Speaker 1: been with my mom on Christmas. It didn't matter how
Speaker 1: old I was. Mom always made Christmas special. It didn't
Speaker 1: matter if I was eight or eight. She had a
Speaker 1: way of going overboard in the best way, always knowing
Speaker 1: what you'd love while also covering what you wanted. And
Speaker 1: probably most important, getting you what you needed to And
Speaker 1: it wasn't just like that with presents. She was like
Speaker 1: that with everything having to do with Christmas and all
Speaker 1: year really, but Christmas was just special with Mom. Mom
Speaker 1: and Dad always had Christmas at their house. It was tradition.
Speaker 1: The whole family would come over and we'd have dinner
Speaker 1: and laughing and presents and love. Christmas and Easter were
Speaker 1: Mom's holidays and it always showed. Now, with Christmas Eve
Speaker 1: being just a couple of days away, my heart sank
Speaker 1: realizing that she probably wasn't going to be home this year.
Speaker 1: She'd be in a hospital bed and none of us
Speaker 1: would even be able to go in and see her
Speaker 1: because of COVID. That thought scared me so much. Mom's
Speaker 1: favorite holiday, and she'd have to spend it alone in
Speaker 1: a hospital bed, with no visitors and in pain. This
Speaker 1: just wasn't fair. None of this was right, None of
Speaker 1: it is just I brainstormed with my family to see
Speaker 1: what we could do. We found out from her nurse Kim,
Speaker 1: that Mom could see out the window to the top
Speaker 1: floor of the hospital garage, so we planned a many
Speaker 1: surprise pop up party on the top floor of that garage.
Speaker 1: I would have sat out there all day if I
Speaker 1: was allowed. After all, what's Christmas without Mom? Christmas Eve
Speaker 1: came and I decided that I was going to do
Speaker 1: something with that energy, that anxiousness, that the nervousness and
Speaker 1: anxiety that I was having. I was going to use
Speaker 1: that energy and do something good for the situation. So
Speaker 1: I wanted to bring dinner to the staff working on
Speaker 1: Mom's floor at the hospital. I went to Costco and
Speaker 1: bought a bunch of desserts, and then went to Boston
Speaker 1: Market and got a big turkey in a bunch of sides.
Speaker 1: They were away from their families at Christmas, making sure
Speaker 1: that mine was okay. It was the least I could
Speaker 1: do for them, and once again it was one of
Speaker 1: the things I was able to control and an otherwise
Speaker 1: uncontrollable situation. I drove to the hospital and and let
Speaker 1: the guard know that I had food for them on
Speaker 1: Mom's floor, and he looked so happy and thankful. He
Speaker 1: called somebody from the floor and they came down and
Speaker 1: got it and brought it all up. Of course, a
Speaker 1: few hours later, Christmas morning came and it was just
Speaker 1: another morning for me. There'd be no joyous Christmas morning
Speaker 1: with my parents, like there had been every year my
Speaker 1: entire life. I had bought presents for people, but couldn't
Speaker 1: even gather the emotional strength to wrap them. I retreated
Speaker 1: to my bubble with Blue, just counting down the hours
Speaker 1: until we could surprise Mom. And when that time finally came,
Speaker 1: I gathered up the poster boards I had decorated to
Speaker 1: make signs telling her how much we love her, and
Speaker 1: I met my family and some of her close friends
Speaker 1: on the top floor of the hospital garage. We called
Speaker 1: Mom's nurse, Kim, who was working that day, and she
Speaker 1: wheeled Mom over to the window and we all screamed
Speaker 1: and hooped and hollered and told her how much we
Speaker 1: love her. This was Christmas with pancreatic cancer. It was
Speaker 1: yet another thing that it was robbing us up. Shortly
Speaker 1: after that, Dad and I met at my parents house
Speaker 1: and went over to Aunt Cathy's. She was having Christmas
Speaker 1: dinner at her house in place of Mom's usual get together,
Speaker 1: and Dad and I really didn't feel in the Christmas mood,
Speaker 1: and with COVID it was probably just as well. We
Speaker 1: took our plates back to my parents house and just
Speaker 1: had a quiet meal together. Mom's presence was felt, but
Speaker 1: her absence was felt more. See that's the thing about cancer,
Speaker 1: or any kind of terminal diagnosis. It doesn't just eventually
Speaker 1: rob you of your loved ones. It robs you of
Speaker 1: those moments along the way. Can rob you of Christmas
Speaker 1: morning laughing and enjoying each other's company. Can rob you
Speaker 1: of your mom's cooking, which you never realized just how
Speaker 1: much you'd miss. It. Can rob you of that hug
Speaker 1: you look forward to every time you see your loved one,
Speaker 1: that shoulder when you need it. Pancreatic cancer was robbing
Speaker 1: Mom of her life, and it was robbing me of
Speaker 1: my mom, And it was robbing the world of a
Speaker 1: really damn good person. What cancer doesn't care. Cancer doesn't
Speaker 1: care that Mom had built her whole life around being
Speaker 1: a good person, doing for others, making people happy. But
Speaker 1: I do care, and I'm powerless as it steals her away.
Speaker 1: By New Year's Mom was well enough to go home.
Speaker 1: That had called me to tell me that hospice was
Speaker 1: going to come in, and immediately I began having a
Speaker 1: full blown anxiety attack. He explained that it was actually
Speaker 1: the palliative care part of hospice that was coming in
Speaker 1: and the plan was to help Mom regain her strength
Speaker 1: so she could begin chemo treatment again and then be
Speaker 1: back on the road that we were on. I heard
Speaker 1: what he was saying, and I held onto that hope.
Speaker 1: But something in the back of my mind just knew
Speaker 1: this was bad. This was really, really bad. The palliative
Speaker 1: nurses of hospice were amazing, and they'd come about twice
Speaker 1: a day to check Mom's fluids and make sure she
Speaker 1: was eating and moving around. Ultimately, they never did get
Speaker 1: to that rehabilitation stage, as Mom was simply fighting every
Speaker 1: every day to stay alive. Ever since she had gotten
Speaker 1: home from the hospital, she was simply existing. The good
Speaker 1: days had turned into good afternoons, and soon those turned
Speaker 1: into good moments, and eventually those good moments were less
Speaker 1: and less. I was watching the person I love the
Speaker 1: most in this world fade away before my eyes. I
Speaker 1: cherished every moment that I could with Mom. It was
Speaker 1: so hard to see her in pain, but it was
Speaker 1: apparent that time was running out, and I was numb.
Speaker 1: It was almost as if my brain shut down everything
Speaker 1: and I was just going through the motions. Except when
Speaker 1: I went to see Mom. And when I got too
Speaker 1: emotional to see her in the states she was in,
Speaker 1: I tell her how much I love her, give her
Speaker 1: a big hug and kiss, and I'd run to my
Speaker 1: car to cry it out. Almost every night, I'd leave
Speaker 1: my parents house and drive around crying, screaming about how
Speaker 1: unfair this is. Somebody that may have seen me driving
Speaker 1: down the road probably think I'm some kind of whack job.
Speaker 1: Seeing this random dude driving down the road screaming and
Speaker 1: crying alone in his car with his hands waving everywhere.
Speaker 1: I'm sure it was a sight to see. And I
Speaker 1: did that every night that I would leave my parents
Speaker 1: house until one day it was different. One day I
Speaker 1: asked God to take her. Don't let her be in
Speaker 1: this pain anymore. Stop making her suffer. It's cruel, it's inhumane.
Speaker 1: How can you possibly allow her to live like this?
Speaker 1: Take her? God, take her. The guilt from saying that
Speaker 1: hit me immediately. I had uttered the most reprehensible words
Speaker 1: I could imagine, but that's how I felt. I couldn't
Speaker 1: see her suffer anymore. Since the day she was diagnosed,
Speaker 1: I was always so positive and optimistic, and I would
Speaker 1: get angry at her when she wasn't matching my good vibes.
Speaker 1: But now I was raising the white flag. It was
Speaker 1: selfish of me to want her to stay here, not
Speaker 1: like this. She didn't deserve this, She didn't deserve any
Speaker 1: of this. The right thing to do is to want
Speaker 1: her suffering to stop. Right right up next, I speak
Speaker 1: with a highly published oncology expert, Dr Gregory Masters, and
Speaker 1: we talked about the other side of a terminal diagnosis,
Speaker 1: which is the doctors who must give them when we
Speaker 1: come back. When we think of our own grief journey,
Speaker 1: do we really ever think of the people on the
Speaker 1: other side of it. On a cancer journey, were often
Speaker 1: intimately involved with an oncologist to help guide our loved
Speaker 1: one on the right course of treatment for them. I
Speaker 1: was interested in how a doctor is able to give
Speaker 1: such devastating news and all the time, regularly throughout their
Speaker 1: entire career. I sat down with lung cancer specialist Dr
Speaker 1: Gregory Masters, an oncologist at the Helen F. Graham Cancer
Speaker 1: Center and Research Institute who also serves as an associate
Speaker 1: professor at Thomas Jefferson University Medical School in Philadelphia. Dr
Speaker 1: Masters is one of the world's foremost experts on lung cancer,
Speaker 1: and he's published numerous papers on his studies. I wanted
Speaker 1: to know about that other side of the cancer journey.
Speaker 1: Mom's oncologists seemed to always be rooting for her, even
Speaker 1: when she disappointed him. Why is this do they give up? Dr?
Speaker 1: Masters lays it all out. I go into see a
Speaker 1: new patient with either suspected cancer or with cancer. I
Speaker 1: want to get all the information I can that's available
Speaker 1: at that time, and sometimes it's incomplete. Sometimes that's one
Speaker 1: of the hardest things, is going in and not having
Speaker 1: all the information, because people want to know everything that's
Speaker 1: going to happen right away and that that's totally understandable.
Speaker 1: They want to know what's next and you know what's
Speaker 1: happening now. So I try and gather as much information
Speaker 1: as is available before I go in to see a patient.
Speaker 1: I may look at other UH specialists records from their
Speaker 1: interviews and their encounters with the patient. I'll look at
Speaker 1: any radiology testing or X rays or CAT scans or
Speaker 1: m r I scans. I may look at any biopsies
Speaker 1: to see what the pathology is and if we know exactly,
Speaker 1: you know what the cancer is, where the cancer is.
Speaker 1: And then I have to, you know, prepare myself to
Speaker 1: go in and talk about something that's not really ever easy.
Speaker 1: My intent is to go in and learn as much
Speaker 1: as I can about the patient. Once I know as
Speaker 1: much as I can about the medical situation, and I
Speaker 1: try and get to know that patient. You know, it's
Speaker 1: in a short period of time. But I try and
Speaker 1: get as much as I can from the patient and
Speaker 1: from the family because almost always when someone comes with
Speaker 1: you know, a family member or a friend, that person
Speaker 1: is there to help provide as much support as possible.
Speaker 1: So I really think it's important to include that. But
Speaker 1: but I try and get as much as I can
Speaker 1: about you know, what the patient knows, what they fear, um,
Speaker 1: what they think is going to happen, and then to
Speaker 1: try and get to their questions about what might happen
Speaker 1: and what we're gonna do next. Is there ever resistance
Speaker 1: from the patient, and what I mean is culturally religiously,
Speaker 1: where there might you know, you might have to take
Speaker 1: those kinds of things into consideration. Is that a thing
Speaker 1: or oh it's totally a thing. Yeah, So there's there's
Speaker 1: I guess to me, that's all part of my job
Speaker 1: that makes it interesting and challenging. Sometimes it can be
Speaker 1: a barrier to getting you know, good communication, But again
Speaker 1: I sort of feel like that's part of my job
Speaker 1: is to understand the patient and their family and their circumstances.
Speaker 1: And it can go anywhere from some families who don't
Speaker 1: want the patient to even know the diagnosis um or
Speaker 1: don't want the patient to know that they're going to die,
Speaker 1: or don't want the patient to know that, you know,
Speaker 1: they may not be a candidate for some treatment that
Speaker 1: they're really depending on whether it's surgery or radiation. Sometimes
Speaker 1: it's there's a lot of fear to thinking about chemotherapy,
Speaker 1: maybe based on experiences they've had, or their friends or
Speaker 1: their family has had. Sometimes those experiences are you know,
Speaker 1: a long time ago where we weren't as good. But
Speaker 1: what I try and do is to help, you know,
Speaker 1: as to understand people and try and understand their situation.
Speaker 1: And I don't try and treat every situation the same
Speaker 1: because I don't think that fits. At the same time,
Speaker 1: I do have as part of my job the role
Speaker 1: of telling them what's going on and helping them understand
Speaker 1: as much as they're ready. For my mom, there were times,
Speaker 1: especially early on, she got better as it went on,
Speaker 1: but there were times where she was like, tell him
Speaker 1: to my dad and then he can he knows how
Speaker 1: to filter the information back because a big challenge for
Speaker 1: her doctor, which was my mom's and he was amazing.
Speaker 1: He had a handful to deal with with my mom
Speaker 1: because she had had anxiety and she was generally pretty
Speaker 1: good about dealing with it in normal day to day life,
Speaker 1: but when it came to this, it was like it
Speaker 1: just opened up the floodgates, and so he had that
Speaker 1: doctor had his ends full with my mom and how
Speaker 1: to handle this, you know, delicately, and I'm sure, um,
Speaker 1: it's got to be tough, you know, in your situation,
Speaker 1: how do you handle somebody like that where you're not
Speaker 1: just dealing with the physical part of it, you're dealing
Speaker 1: with the mental part of it as well well. I
Speaker 1: I think what you're describing as something that's common to
Speaker 1: all patients and all families in different levels. Um So,
Speaker 1: I do think it's important to to sort of get
Speaker 1: in there with the patient and their family and understand
Speaker 1: that and figure out where they're coming from. Sometimes that
Speaker 1: comes out right away, and sometimes people are very reserved
Speaker 1: in the beginning, and it takes a little bit of
Speaker 1: getting to know them, you know, maybe talking about what
Speaker 1: their outside interests are, talking more about their family, talking
Speaker 1: more about where they've lived and what they've done. That
Speaker 1: helps me to understand a little better when they tell
Speaker 1: me something, you know, if there's maybe some other hidden
Speaker 1: meaning behind that. So it's a really important part of
Speaker 1: my job, and I don't think I could do it
Speaker 1: well if I didn't listen carefully to what they're saying
Speaker 1: and figure out what their family dynamics are. It is
Speaker 1: hard having these conversations, but it's also a tremendous privilege
Speaker 1: to be part of that. We have a job as
Speaker 1: medical oncologist that's a combination of giving bad news, helping
Speaker 1: people understand bad news and deal with bad news, and
Speaker 1: also giving hope about what we might be able to
Speaker 1: do to help them through it. So I try not
Speaker 1: to focus on, you know, how it's affecting me, But
Speaker 1: I can tell you in reality, each patient is affecting me,
Speaker 1: and each encounter is affecting me. And if I can
Speaker 1: learn from that and be a little bit better the
Speaker 1: next time, or the next time I'm surprised by a
Speaker 1: discussion or surprised by an emotion. You know. Then then
Speaker 1: that allows me to enjoy my job more and be
Speaker 1: a better doctor. So it's an ongoing experience, like anything
Speaker 1: in life. I think we all learn that over time
Speaker 1: we're better at our job and never perfect. How do
Speaker 1: you give a diagnosis that I would think nobody wants
Speaker 1: to hear? Is that something you have to prepare yourself for. Yeah,
Speaker 1: it's totally something you have to prepare for. It's interesting.
Speaker 1: There's a lot of discussion about how we should give
Speaker 1: bad news, you know, and sort of academic discussions about that.
Speaker 1: And yet when you get down to it and you're
Speaker 1: getting ready to go into see a new patient and
Speaker 1: their family and you may have bad news, you're not
Speaker 1: fully prepared because you don't know exactly how that's going
Speaker 1: to play out. So again, what I try and do
Speaker 1: is to help he's into it by getting to know
Speaker 1: the patient a little bit, by getting to know the
Speaker 1: family a little bit, by being ready for what might
Speaker 1: come in that conversation, by knowing everything I can about
Speaker 1: you know, what we're going to discuss that day, So
Speaker 1: knowing their medical history, you know that sort of at
Speaker 1: a minimum, and then you know, trying to figure out
Speaker 1: how are they going to be able to hear this
Speaker 1: news and continue on. So usually I'll talk about the
Speaker 1: medical facts of the diagnosis and figure out if they
Speaker 1: understand that part of it, and then talk a little
Speaker 1: bit about what that means, because for each patient, with
Speaker 1: each diagnosis, there's uncertainty. And even if I'm completely prepared,
Speaker 1: it's not like TV where they say there's three months
Speaker 1: to live or six months to live, and that's how
Speaker 1: it is, and I think people sometimes are surprised by that,
Speaker 1: even though in all trually we know that everyone's different.
Speaker 1: So I try and help them understand that there's a
Speaker 1: range of things that might happen, and then try and
Speaker 1: think through how we're gonna get prepared to deal with
Speaker 1: that and what are the best tools we have to
Speaker 1: try and fight that um And many people come in
Speaker 1: ready to fight, but some people aren't ready to fight,
Speaker 1: and I have to figure that out and figure out
Speaker 1: where they are in terms of their goals. Some people
Speaker 1: haven't even thought about it at all because they might
Speaker 1: be too scared to think about it, or maybe you know,
Speaker 1: in their culture it's not something you talk about. Maybe
Speaker 1: your podcast will change that, I hope, so, but I
Speaker 1: try and figure out where I can go and how
Speaker 1: far I can go in that conversation, but at the
Speaker 1: same time and hopefully all the time being truthful and
Speaker 1: being honest with what I know, because I don't think
Speaker 1: it's my job to hold back information that I know,
Speaker 1: but I think there are different ways to deliver it,
Speaker 1: and sometimes is easing into it helping them understand, you know,
Speaker 1: what the tools are we have available, and that can
Speaker 1: help prepare for a discussion about a limited survival or
Speaker 1: a limited time to live, even if I don't know
Speaker 1: exactly what that is. Wow, it's got to be important
Speaker 1: for you as a human too. Um have positive outlets,
Speaker 1: I assume, right, Like whatever that is for you going
Speaker 1: to the movies or golfing or whatever, is that kind
Speaker 1: of how it works, or like how do you decompress? Yeah,
Speaker 1: And I think that's important to think about because sometimes
Speaker 1: with whatever work we do, we have trouble separating what
Speaker 1: happens at work and what happens outside of work. But
Speaker 1: just like many people, I go home to a family
Speaker 1: and I have a job with my family too, I
Speaker 1: try not to forget everything that happened during the day.
Speaker 1: But I also don't think that it's you know, part
Speaker 1: of what I need to do to go through every
Speaker 1: detail because sometimes I do need to compartmentalize that and
Speaker 1: I think we all do that with a stressful day
Speaker 1: at work. I really think it's important to be able to,
Speaker 1: you know, separate my time at home. Um So, even
Speaker 1: though you know my wife is a nurse and spends
Speaker 1: a lot of time dealing with helping our kids through
Speaker 1: difficult times and dealing with all those kind of situations
Speaker 1: that that occur in the family life, I don't think
Speaker 1: I want to take home all the details of work
Speaker 1: because there's enough going on at home to deal with.
Speaker 1: So I like to you know, read, I like to exercise,
Speaker 1: a golf a little bit, but not as much as
Speaker 1: you think. Um. I like to sail, and I like
Speaker 1: to spend time with other people and you know, figure
Speaker 1: out what they're doing. So you know, I I try
Speaker 1: and remember everything that's happening, but bring home all of
Speaker 1: that stress at least not all at once, and probably
Speaker 1: if you ask my wife, I bring home some of it.
Speaker 1: And so it's those things that are able to recharge
Speaker 1: you too when you go back to work, to be
Speaker 1: able to do it again. And you know, each day
Speaker 1: and each patient is a little bit different. But every day,
Speaker 1: you know, there are situations that are joyful and hopeful,
Speaker 1: and every day there are some that are less joyful
Speaker 1: and less hopeful, and you know, discussions about things that
Speaker 1: it's hard to discuss, and so I try and get
Speaker 1: ready for each encounter. And you know, again that's that's
Speaker 1: my job, is to help people understand and work through
Speaker 1: their difficult times, and sometimes to give them chemotherapy when
Speaker 1: I think that's the best way to help them. Because
Speaker 1: the medical part is is a big part. I don't
Speaker 1: mean to minimize that, but there's so many more things
Speaker 1: we can do now than we could even five years ago.
Speaker 1: And my hope is that five years from now there
Speaker 1: will be even more things we can do to help
Speaker 1: families like yours. Until really, right now, I didn't realize,
Speaker 1: you know, how much of a balance it is for you,
Speaker 1: that it's not just the medical part of it when
Speaker 1: you're dealing with patients and families. You know, a huge
Speaker 1: part of it is is the mental part of it,
Speaker 1: to the psychological part of it as well. From my
Speaker 1: understanding of what you're saying, it's got to be a
Speaker 1: balance between those two because you can't really separate them,
Speaker 1: you know what I mean exactly. Yeah, I don't think
Speaker 1: you can separate those and I don't think I can
Speaker 1: communicate with the patient if I don't understand where they're
Speaker 1: coming from. And I think that's also stresses the importance
Speaker 1: of that multidisciplinary approach, and you know, having a social
Speaker 1: worker help out, having a psychologist help out, having other
Speaker 1: people that can support the family, sometimes having the hospice
Speaker 1: team help out, when you know when that's a appropriate
Speaker 1: Because what I've learned over my time, you know, nearly
Speaker 1: thirty years same cancer patients, is that you really need
Speaker 1: all that help. No one person can do that by themselves.
Speaker 1: And so if you use those resources and and help
Speaker 1: your patients understand the resources that are there, I think
Speaker 1: that helps ease that communication and helps improve the understanding.
Speaker 1: Coming up next, I asked Dr Masters how he handles
Speaker 1: issues when the family wants one thing and the patient
Speaker 1: wants something else. And do oncologists ever give up on
Speaker 1: a patient and truly say it's over. On Mom's cancer journey,
Speaker 1: there were times I became so frustrated by some of
Speaker 1: the choices she made. How does an oncologist handle that?
Speaker 1: Do they yell do they give up? Do they run
Speaker 1: to their office and cry? Clearly oncology isn't the profession
Speaker 1: for me? But Dr Masters gives us the truth you mentioned,
Speaker 1: like a patient's family might say, you know, we don't
Speaker 1: want them to know, we wanna handle it or whatever.
Speaker 1: How do you deal with decisions like that where the
Speaker 1: family wants something and the patient wants another. I mean,
Speaker 1: that's got to be Is there a rule book for that?
Speaker 1: Is it a decision by the doctor? How does that work? No?
Speaker 1: And it's an interesting question because over time, I think
Speaker 1: that's evolved. And you know, if you go back to
Speaker 1: the times of Hippocrates, he didn't you know, he wrote
Speaker 1: about not telling any bad news because that would hurt
Speaker 1: the patient or that would decrease their chance of getting
Speaker 1: through an illness. And it's taken a long time to understand.
Speaker 1: And what I believe is that the patient has to
Speaker 1: be part of these decisions, and to be part of
Speaker 1: the decision, you have to have an understanding. Now saying that,
Speaker 1: I also think it's important to recognize cultural differences and
Speaker 1: individual preferences. So part of what I try and do
Speaker 1: is to figure out what does the patient want and
Speaker 1: if the patient doesn't want to know pieces of information
Speaker 1: like a specific prognosis. I don't feel like I have
Speaker 1: to force that on them. Again, I think communication and
Speaker 1: listening is is so critical to me doing my job.
Speaker 1: And I suppose if you you know, if you talk
Speaker 1: to all the family when there are big differences, that
Speaker 1: there isn't always complete agreement, and so part of it is,
Speaker 1: you know, being a little bit of a referee in
Speaker 1: in deciding, you know, who gets what information and how
Speaker 1: with the understanding that that are in our current culture,
Speaker 1: the patient has a right to their autonomy and that
Speaker 1: sometimes means the independence to know, and sometimes it isn't
Speaker 1: an independence or an autonomy to not have to know
Speaker 1: every bit. That's a hard part of the job as
Speaker 1: figuring out how you balance those and what does the
Speaker 1: patient really want? Because I do want to help the
Speaker 1: family understand and and I want to honor their wishes too,
Speaker 1: But ultimately, I think my my principal obligation is to
Speaker 1: to work with the patient and what he or she
Speaker 1: tells me is most important, and sometimes they don't say
Speaker 1: too much, so it's it's communicating and listening and trying.
Speaker 1: I love that the the oncologists that had my mom. Uh,
Speaker 1: you know, I had he bless him, he had his
Speaker 1: hands full. You know. I had a real problem with
Speaker 1: her some of her decisions. There was a treatment um
Speaker 1: cyber knife, and she was going back and forth on
Speaker 1: if she should do this, and it was a lot
Speaker 1: of it was anxiety driven, and I had I'm like,
Speaker 1: what are you doing? You're going to do it? And
Speaker 1: I'm like telling my dad, I'm like, we can give
Speaker 1: her zannex put it in her drink. And this is
Speaker 1: like crazy now thinking about it that I like having
Speaker 1: this discussion. My dad's like, Kyle, what are you talking about.
Speaker 1: I'm like, we can put zanex in her drink and
Speaker 1: then we can take her to the hospital and then
Speaker 1: she can get cyber And he's like, but she doesn't
Speaker 1: want to do it, you know, or she's not sure
Speaker 1: she wants to do it yet, and blah blah blah.
Speaker 1: And I'm like, well, she doesn't get the choice, Like
Speaker 1: we're gonna get this for her because in my mind,
Speaker 1: you're gonna do any possible thing to survive. And in reality,
Speaker 1: it's not my choice, you know what I mean. And
Speaker 1: it's not that she wanted to give up, but there
Speaker 1: were some some things that she did not want to
Speaker 1: do and um, and no amount of getting angry at
Speaker 1: her or reasoning with her or whatever could change that.
Speaker 1: And I had to learn eventually after she passed that
Speaker 1: I should have respected that journey a little bit more
Speaker 1: because it is her journey, you know, and she had
Speaker 1: valid reasons for not wanting to do certain treatments and overall,
Speaker 1: you know, she'd put her body through so much on
Speaker 1: the journey of trying to get better that she earned
Speaker 1: that right to say, you know what, I don't want
Speaker 1: to do this, and that I think it was radiation
Speaker 1: or something I've done, you know, six different types of
Speaker 1: chemos over it was like two years of chemo treatments.
Speaker 1: I'm kind of tired, you know, of trying all of
Speaker 1: these things. And in my mind, that's totally unacceptable, you know.
Speaker 1: And so I like, I'm not joking when I say
Speaker 1: I had this conversation with my dad where I'm like, Dad,
Speaker 1: she doesn't get a choice, Like she's gonna wake up
Speaker 1: and she's gonna be there and she's gonna get it.
Speaker 1: And you know, my dad's like, well, why don't you
Speaker 1: think about this? You're talking about drugging your mom. And
Speaker 1: then her waking up in a hospital like none of
Speaker 1: this is okay. And of course that's in my grief
Speaker 1: that or shock or whatever that that I want her
Speaker 1: to get better at any cost, and that's not taking
Speaker 1: into consideration, Well, who am I to say that she
Speaker 1: should be doing this? Who am I to say that
Speaker 1: she needs to go through radiation? It's not my decision.
Speaker 1: So my all of that to say, I'm assuming there
Speaker 1: are at least a few people like my mom that
Speaker 1: when they're talking to their oncologists and their oncology team
Speaker 1: that there are limits to what the things that they're
Speaker 1: willing to do and things that they're not willing to do.
Speaker 1: Is that hard for you as a doctor if you
Speaker 1: are hopeful in certain treatments or are you more patient
Speaker 1: focused where you're like, hey, this really could help you,
Speaker 1: but it's about you and your journey, Like what how
Speaker 1: do you balance that? And what is it? Like? I'll
Speaker 1: tell you, um, the things that you're describing are present
Speaker 1: and almost every family that I deal with, where you know,
Speaker 1: the wants and needs that the family sees and the
Speaker 1: patient sees are not always equal, and so sometimes family
Speaker 1: members want to be more aggressive or do more believe
Speaker 1: it or not. Sometimes they want to do less, and
Speaker 1: I always assume that it's in the best interests of
Speaker 1: the patient, because you know, everyone thinks they know their
Speaker 1: family member and what they really would want, but that
Speaker 1: does get clotted with what we want as an individual.
Speaker 1: To add to that cloudiness is what the oncologist thinks
Speaker 1: is best right, And sometimes all of those come together
Speaker 1: like a perfect storm, like a come to a point
Speaker 1: and and everyone agrees, this is something we can do,
Speaker 1: this is something we should do, and this is something
Speaker 1: the patient wants and the family wants. That's great, especially
Speaker 1: when it works out and it's successful, but just like reality,
Speaker 1: it's not always like that. And so a lot of
Speaker 1: times what I think is best medically um based on
Speaker 1: imperfect knowledge. You know, I try and look at all
Speaker 1: the research that's been done. I try and reach back
Speaker 1: to my experience as an oncologist, and and believe it
Speaker 1: or not, I think back to even when I was
Speaker 1: training in medical school and doing my residency and fellowship
Speaker 1: training and oncology. I think back to, you know, what
Speaker 1: my mentors would say in a situation like this, or
Speaker 1: what would they recommend, And that does get trickier as
Speaker 1: all the options change, but the way of discussing that,
Speaker 1: in the way of offering that to patients and families evolves,
Speaker 1: but doesn't really change. I think it's important to to
Speaker 1: listen a lot as an oncologist, because if you don't,
Speaker 1: you can end up saying this is what we're gonna
Speaker 1: do because this is medically best. And that's something that
Speaker 1: I think oncologists learn over time, because it's a really
Speaker 1: hard thing to teach, you know. So if you if
Speaker 1: you look at the discussions out in the public about
Speaker 1: well did doctors learn to talk about death and dying?
Speaker 1: Do they learn to talk about, you know, how to
Speaker 1: decide on difficult differences between a family and a patient.
Speaker 1: You always hear, well, they don't teach that in medical school,
Speaker 1: and I don't think that's totally true. I think they
Speaker 1: try and teach it, but sometimes we're not ready, you know,
Speaker 1: and sometimes um people aren't ready for information, and sometimes
Speaker 1: oncologists aren't ready to learn that information. We go to
Speaker 1: medical school wanting to learn the facts about medicine, and
Speaker 1: I'm sure there are many exceptions to that, but but
Speaker 1: if you look overall, people go to medical school and
Speaker 1: learn facts, and the problem is not only do the
Speaker 1: facts change, but your own experience and your environment changes.
Speaker 1: So I think you have to learn from those experiences
Speaker 1: and try and be patient, and try and be flexible,
Speaker 1: and try and always think how can you turn it
Speaker 1: back to what is really good for the patient, what
Speaker 1: does the patient want? And sometimes that's hard for families,
Speaker 1: and sometimes it's hard for oncologists or any professional dealing
Speaker 1: with someone in these critical sort of life threatening decisions.
Speaker 1: But I think we can learn. I think we can
Speaker 1: learn to do it better. And and if we're patient
Speaker 1: and we allow ourselves the chance to learn from our
Speaker 1: patients and their families, um, we can do it better.
Speaker 1: And and that's what I try to do. You know,
Speaker 1: I try and even after a negative encounter where someone
Speaker 1: is really mad that the treatment didn't turn out right
Speaker 1: or I didn't predict something correctly, you know, I try
Speaker 1: and learn how I can do better the next time,
Speaker 1: and you know, how can that conversation go differently so
Speaker 1: that you know, I can try and help people as
Speaker 1: best I can, because that's got to be my job.
Speaker 1: It's it's gotta be tough, you know. I mean, it's
Speaker 1: it's uh. As we're talking, I'm realizing just how many things.
Speaker 1: An oncologist has to balance everything with every single patient,
Speaker 1: every single encounter. You know, so thank you for it's
Speaker 1: incredibly important work. Obviously. Is there ever a point in
Speaker 1: today's medicine and our culture here where an oncologist gives up?
Speaker 1: Are there always treatments available even if the prognosis isn't good.
Speaker 1: So there are so many different things we can do,
Speaker 1: whether it's different chemotherapy, different types of radiation, different surgeries,
Speaker 1: other different interventions to help people that we almost never
Speaker 1: get to a point where there's nothing we can do.
Speaker 1: And so if you watch TV and the doctor comes
Speaker 1: in and says, I'm sorry, there's nothing more I can
Speaker 1: do for you, I don't ever say that to patients
Speaker 1: because I don't think that's fair. There's always something you
Speaker 1: can do to help, but it may not be more chemotherapy,
Speaker 1: may not be more surgery, it may not be more
Speaker 1: radiation or CyberKnife treatment. And that's when the listening comes in.
Speaker 1: And when I see a patient and we're running out
Speaker 1: of the best options, and I think that's sort of
Speaker 1: what you're talking about, then what I try and do
Speaker 1: is to offer some alternatives of thinking, do you want
Speaker 1: to do something more aggressive that may cause you more
Speaker 1: side effects and more difficulty and sometimes may not improve
Speaker 1: improve your quality of life. Or do you want to
Speaker 1: scale back and take an approach where we focus more
Speaker 1: on managing your symptoms, dealing with comfort and quality of
Speaker 1: life and being able to stay home and not spend
Speaker 1: all your time going back and forth to the doctors.
Speaker 1: And what I hope I can do with those conversations
Speaker 1: is to help people see what I see as the
Speaker 1: options and often choose what I might choose, but they
Speaker 1: don't always choose what I would choose or even what
Speaker 1: I recommend. And I think you're describing that. You know,
Speaker 1: CyberKnife is a type of focused radiation that can be
Speaker 1: very effective on a localized spot of cancer. So is
Speaker 1: it worth going through all the logistics to get to
Speaker 1: that for what the benefits going to be? And for
Speaker 1: some people it is, and for some people in some
Speaker 1: situations it is, and then other people it isn't worth
Speaker 1: doing that, even if we think that might buy a
Speaker 1: little more time. And those are those are hard conversations,
Speaker 1: especially when our goals might not be totally in sync
Speaker 1: with the patient's goals, or the or the family's goals
Speaker 1: aren't totally in sync with the patient's goals. And again,
Speaker 1: I think it's part of my job to help not
Speaker 1: only the patient but also the family understand why would
Speaker 1: you choose this option and how can that option be
Speaker 1: a better option? And when it seems so obvious that
Speaker 1: the other option is the right option and there's no
Speaker 1: magic to that. It's it's patients and trying Wow, and
Speaker 1: it's got to be uh, you know from what you're saying,
Speaker 1: there is no to duplicate conversations that you're having. Yeah,
Speaker 1: it's uh, it's completely tailored to that person, which is uh,
Speaker 1: pretty crazy, you know if you think about it. Yeah,
Speaker 1: but if you think about society and you know what
Speaker 1: we see on TV and what we experience, you know,
Speaker 1: driving down the street, you can imagine that there are
Speaker 1: gonna be different ways of dealing with problems and different
Speaker 1: ways of trying to come to the best answer, right,
Speaker 1: And so you know the reality is medicine is like
Speaker 1: that too. They're the best answer may not be the
Speaker 1: best answer for everyone. How do you work together to
Speaker 1: get to either the best answer for that patient or
Speaker 1: the best compromise for that patient, because sometimes it is
Speaker 1: the best compliment. Yeah, I mean and that's ultimately what
Speaker 1: was I think what it was with my mom was
Speaker 1: that where the tumor was was at a place like
Speaker 1: right next to an artery or something, so they could
Speaker 1: do cyber knife, but they could also continue chemotherapy, which
Speaker 1: was working and shrinking a little more, so the margins
Speaker 1: were more and my my dad and I was like, well,
Speaker 1: if they're saying they can do cyber knife, now, like
Speaker 1: let's do it. And she's like, well, I don't know that,
Speaker 1: you know. And and then of course what ultimately happened
Speaker 1: was she had to stop chemo altogether, which they had.
Speaker 1: She had done a chemo I think believe believe it's
Speaker 1: called chemo holiday or something um where she went like
Speaker 1: six months with no treatment and it had barely almost
Speaker 1: nothing grew. So we were very hopeful. I mean, I
Speaker 1: was terrified waiting for those results because I'm like, it
Speaker 1: might have been three months or something, whatever it was,
Speaker 1: I'm terrified waiting for those results. And then it's like,
Speaker 1: oh wow, like it was almost nothing. But then you
Speaker 1: got to this point where she couldn't get treating and
Speaker 1: at all. Why didn't it do what it did when
Speaker 1: she did the holiday? You know? Why is it all
Speaker 1: of a sudden. Now you know, it's crazy and it's
Speaker 1: a roller coaster. I would hang on any positive bit
Speaker 1: of news that the doctor would give, like, oh, you know,
Speaker 1: it's been three months, she has she said, no treatment
Speaker 1: and it has you know, not grown at all or
Speaker 1: microscopically grown or whatever. And I'm like, yes, that's awesome,
Speaker 1: I'm happy and blah blah blah blah blah. And then
Speaker 1: that follow up visit a couple of days before, I'm
Speaker 1: all like nervous again, and I'm waiting by the phone
Speaker 1: for my parents to get out. And it's kind of
Speaker 1: hanging on to every word that the oncologist says. And
Speaker 1: sometimes that's great and I'm up here, and sometimes that's bedding.
Speaker 1: I'm done here. But it's ultimately, you know, what I'm
Speaker 1: learning is it's my mom's journey. You know, I'm along
Speaker 1: for those highs and lows, and I want all the
Speaker 1: highs obviously as she does. She did too, But these
Speaker 1: aren't my decisions to make, you know, and that that
Speaker 1: was the hardest thing I think for me, so so kindle,
Speaker 1: I think what you're describing as something that a lot
Speaker 1: of families go through, and um, you even said, you know,
Speaker 1: when you saw the oncologists, you might pick up on
Speaker 1: a little glimmer of hope, some piece of good news.
Speaker 1: And I think what I try and do is to,
Speaker 1: you know, see who's there and who's listening, and who's
Speaker 1: hanging on every word. And when some people need to
Speaker 1: hear something positive, find something positive to discuss, and when
Speaker 1: some people sort of can't stand something that feels like
Speaker 1: false hope, I try and temper that. And what's amazing
Speaker 1: to me is that um people can come out of
Speaker 1: a conversation and take what they want out of it. Now,
Speaker 1: sometimes that's good and healthy. Sometimes it's not so good
Speaker 1: and healthy because they get the wrong message, because they might,
Speaker 1: you know, really grasp on to one part of the conversation.
Speaker 1: But I think that's sort of like, you know, it's
Speaker 1: it's reality, right. There are good and bad things and
Speaker 1: everything that happens. How do we try and hope for
Speaker 1: the best, but prepare for the worst. And some days
Speaker 1: you're ready to grab that best part of it and
Speaker 1: the hope, and other days you really need the reality
Speaker 1: of I don't feel well today. I don't like what's
Speaker 1: going on with my treatment. I don't like how the
Speaker 1: cancer is behaving, and that's okay too. I Mean, one
Speaker 1: thing I've found is I can't change all that. People
Speaker 1: come in and maybe they've had a long discussion about
Speaker 1: what we're gonna do if the scan is better or
Speaker 1: the scan is worse, and how we're going to react
Speaker 1: to that. And I come into sort of a dynamic
Speaker 1: where there's a lot of water boiling, you know, and
Speaker 1: and I can say one thing, and I really am
Speaker 1: surprised by how much emotion can be released with that,
Speaker 1: And so, you know, again, I try and think about, well,
Speaker 1: what what would it be like to be in the
Speaker 1: other chair and hearing this news, and how are things
Speaker 1: going to be when they leave the room, you know,
Speaker 1: because that's all something that I am not a part
Speaker 1: of um. And yet you and your family and your
Speaker 1: mom were a part of all of that. Right, there's
Speaker 1: that whole two weeks in between where I don't know
Speaker 1: what's happened, you know, How do you catch up in
Speaker 1: a half hour visit with all the fears and hopes,
Speaker 1: you know, and emotions that have happened in between. One
Speaker 1: thing that I'm or I think the biggest thing that
Speaker 1: I'm taking away from our conversation is that you are
Speaker 1: really not a doctor of death at which is I
Speaker 1: think a big misconception that people have, like, oh, you
Speaker 1: don't want to go to the oncologist, you know what
Speaker 1: I mean, that's that's never good. Really, you're not a
Speaker 1: doctor of death, but a doctor of hope because you
Speaker 1: are offering potentially all of these treatments that could get
Speaker 1: you to where you want to be. Yeah, I certainly
Speaker 1: hope that's the situation. I have a lot of hope
Speaker 1: in my work and hope that when I am interacting
Speaker 1: with patients and families that I'm going to be able
Speaker 1: to help them understand where things are. Part of that
Speaker 1: is understanding the reality, and part of that is grabbing
Speaker 1: some of that hope and saying, well, this is a
Speaker 1: bad situation, but what can we do to make it
Speaker 1: a little bit better. What can we do to understand
Speaker 1: it a little bit better? What can we do to
Speaker 1: work on it together? And and some of the things
Speaker 1: that we work on are, you know, improving communication, improving relationships,
Speaker 1: and improving understanding. Even if we can't fix the cancer,
Speaker 1: which is important because that gives any remaining time that
Speaker 1: can make it more meaningful. You know, yeah, I hope so,
Speaker 1: because that that's what there is, is trying to grasp
Speaker 1: whatever you can of that time that's left. And you know,
Speaker 1: you talked about trying to have memories of you know,
Speaker 1: maybe some of the better times or or some of
Speaker 1: the good times. I think that's an important thing that
Speaker 1: we can focus on. And sometimes going through more treatments
Speaker 1: or at least discussing more treatments allows that chance for hope,
Speaker 1: but that has to be balanced with you know, what
Speaker 1: are the consequences of more treatment and how is that
Speaker 1: going to potentially drag someone down? And ultimately, you know,
Speaker 1: my goal is to help the patient and the family decide,
Speaker 1: you know, what's the best choice for them with some
Speaker 1: guidance from me. And what I think is, you know,
Speaker 1: medically the best option, but not with a feeling like
Speaker 1: they're letting me down if they don't have treatment, because
Speaker 1: I think that's a real thing. I think, especially over time,
Speaker 1: people are are afraid of letting you know, the patients
Speaker 1: particularly are afraid of letting their family down if they
Speaker 1: don't do something, of letting their doctor down or the
Speaker 1: nurses or you know, other people who are helping them
Speaker 1: if they decide not to do a treatment, why are
Speaker 1: they deciding that? And and if they're deciding not to
Speaker 1: do something that maybe we think could help. Part of
Speaker 1: my job is helping everyone understand, well, that's okay, because
Speaker 1: we're making our own choices and we're trying to decide
Speaker 1: what's right for me. Now to end on a bit
Speaker 1: of a positive note or a big positive note. When
Speaker 1: my mom's cancer journey started, the five year expected survival
Speaker 1: rate of pancratic cancer was nine percent. Three years later,
Speaker 1: now it's eleven percent, which is a huge jump in
Speaker 1: three years when it was nine for the previous decade.
Speaker 1: How do you, as a professional see Are you seeing
Speaker 1: a trend positive we in regards to cancer treatments? Obviously
Speaker 1: from my understanding, I believe that cancer diagnosis is have risen,
Speaker 1: but it also seems like cancer treatments have also become
Speaker 1: expanded as well. Can you talk a little bit about that?
Speaker 1: Is that accurate? As so, we're getting better at understanding
Speaker 1: medical diseases and particularly understanding cancer and understanding the biology
Speaker 1: of cancer. So as we understand how to reduce risk
Speaker 1: factors for cancer, as we understand how to encourage people
Speaker 1: to quit smoking, to exercise more to eat healthy, to
Speaker 1: get their screening tests. UM, we can improve the outcomes
Speaker 1: for cancer. Also, as we understand the biology of the cancer,
Speaker 1: we can offer better treatments. We can come up with
Speaker 1: more targeted or precise treatments for individual patients that may
Speaker 1: not cause as many side effects but may offer a
Speaker 1: better chance to control the disease. We're seeing more and
Speaker 1: more that some patients have long term control of their disease.
Speaker 1: So even something where before we would have said, well,
Speaker 1: there's no cure, now we're seeing many patients live beyond
Speaker 1: five years, and and some of those patients maybe are cured. Um.
Speaker 1: New targeted therapies that that target a specific gene mutation,
Speaker 1: or new immuno therapies that target the body's response to
Speaker 1: a cancer and using the immune system to help fight
Speaker 1: off the cancer are things that in the past we're
Speaker 1: really just hopes and now are our reality. And so
Speaker 1: continuing to understand the disease and to help people understand
Speaker 1: the options available and hopefully to understand that oncologists are
Speaker 1: there to help with those decisions, that's what gives me hope.
Speaker 1: Thank you, doctor, I really appreciate you being so open
Speaker 1: and honest and candid about your career, the mist of
Speaker 1: buying a lot of the myths and kind of opening
Speaker 1: the curtain if you will, into something that can be
Speaker 1: scary for a lot of people. Just your professional title,
Speaker 1: no offense, but I think it's extremely important what you've
Speaker 1: had to say to you know, help to demystify that. Yeah,
Speaker 1: and thanks Kyle for going after such a difficult discussion
Speaker 1: that obviously hits close to home for for you and
Speaker 1: for many people. And it's important to be able to
Speaker 1: talk about these things and to give a chance to
Speaker 1: let people learn, because I think knowledge and understanding and
Speaker 1: communication and information is is critical. So I'm glad you're
Speaker 1: doing this. Thank you, Thank you very much. It gives
Speaker 1: me comfort to know that oncologists truly are doctors of hope.
Speaker 1: Dr Master's certainly opened up my eyes to the humanity
Speaker 1: behind not just oncologists, but the entire are oncology care
Speaker 1: team or any team relating to end of life care.
Speaker 1: These are people who choose decades of study followed by
Speaker 1: a lifetime of work in this field. They want Mom
Speaker 1: to succeed, They want your loved one to succeed, They
Speaker 1: want you to succeed. Knowing that mom had a team
Speaker 1: behind her like that does bring a smile to my face,
Speaker 1: knowing that everyone working with her was giving her everything
Speaker 1: they had and for now, that's all we can ask for.
Speaker 1: On the next episode of Death, Grief and Other Ship,
Speaker 1: we don't discuss we explore what happens before people pass
Speaker 1: away and what about people who have passed away and
Speaker 1: come back. I talked with Dr Jan Holden, president of
Speaker 1: the Inner National Association for Near Death Studies, about the
Speaker 1: science behind near death experiences and more. For more information
Speaker 1: and resources, please visit our website at Death and Grief
Speaker 1: dot show and joined the conversation on our Facebook and Twitter.
Speaker 1: I'm going to see my mother, she said, She me
Speaker 1: me when I crab. Just Google