Using Difficult Life Experiences to Become a Better Doctor

Using Difficult Life Experiences to Become a Better Doctor

David L. Graham, MD, FASCO

Sep 01, 2015

Many of us put a lot of effort into keeping our work and personal lives separate. It certainly helps to improve our quality of life and prevent burnout. In my training, however, I was taught that it can be very helpful to open part of yourself to your patients. They get to see you more as a person, which can greatly improve your relationship. I’m learning another way using my life experience can make me a better doctor.

We regularly face situations where a patient and their family are looking at a lack of good options and having to face the option of discontinuing therapy or even letting their loved one go. We are a needed resource for them in these difficult times. I am pulling more and more on certain times in my life to help me help them.

When I was in high school, my father was diagnosed with inoperable pancreatic cancer. In the ’70s, there were essentially no good options for therapy. At the time, I dealt with it like any teenaged boy would . . . I basically ignored it as best as I could. I did pick up on the ways my mother went through the time, including the little things that would remind her of what was to come. For example, at one point, he bought a new car. She immediately recognized that he did that so she wouldn’t have to deal with upkeep issues on the older car. That seemingly nice thing was very tough for her. One night he fell asleep and just never woke up. It was peaceful for him . . . the best we could hope for. Looking back on it now, it’s easier to see and respect the journey she traveled.

Al was the first dog I had as an adult. He was a magnificent white German Shepherd that I was lucky enough to be able to rescue. We came across each other at exactly the right time for both of us. Too quickly after I got him, he developed a mass on his hind quarter. It got larger than it should of because I never used to pat my dog’s rear end (that may have changed). I had it biopsied, and it turned out to be a high-grade nerve sheath sarcoma. I had it resected but the margins were positive. I could have considered post-operative radiation but that would have been very toxic for him and he would have had to stay in a facility for a month or longer. We had a great eight months, and he was completely normal until one night he became very weak. He was found to have an abdominal recurrence, and I made the call to let him go at that time.

I didn’t meet Astro, a Great Dane/Shepherd mix, until he was about 13. He spent the last year and a half with my two other dogs. That was the first time he had actually been part of a pack, and he thrived. Over the last month or two, he became progressively weaker and showed significant atrophy in his back legs. He became unable to do the things outside that he enjoyed. This last weekend, his previous human and I decided it was time to let him go. The last thing either of us wanted was to have him lose his dignity but we constantly worried that it was a decision made too soon. He seemed to know it was time and, on his last day, graciously accepted a lot of attention. He went home, surrounded by his pack and those who loved him.

The feelings I continue to experience from these times in my life are a part of me I will never ignore. I can’t. As painful as they are, I know that they are part of what makes us human. I also know that I’ll face them again at some time in the future. What I also know is that tapping into these feelings helps me identify with what patients and their families are going through. By sharing with patients the things I saw my mother go through, the feelings I have gone through, the struggles I have had in making decisions, they see that I am not just making some distanced clinical decision. I’m also coming at it from a humanistic approach. That strikes a chord with many of them. That is a connection that I want to have with all my patients. It’s also the best reason and best way I know of to connect my life and my work.


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