Johnny (not real name) is a 46-yar-old male. He was diagnosed with a Stage II B colon cancer and underwent a surgery which turned out to have gone wrong. A second corrective surgery had to be performed. Later Johnny was asked to undergo chemotherapy which he declined. Johnny related in great detail the ?frustration? about his meeting with an oncologist. The following is the transcript of our video-taped conversation.
Encounter With the Oncologist
Johnny: I went into his (oncologist) office. I sat down and did not say anything.
Nurse: Oh, you have to wait for so long?
J: Yes, three hours. The oncologist read out my name. Then he asked the first question.
Oncologist: Mr. Johnny, what car are you driving?
J: My car is Proton Saga (Malaysian made car).
Onco: What is your profession?
J: Housing Site Supervisor.
Onco: Now, I tell you. Your cancer is like a Mercedes, BMW, Japanese car or a local car. Your case is Stage 2. So you need to take a good medicine — like a Mercedes medicine to fight.
J: He (oncologist) started to ramble on. I just listened. After he stopped, I asked him: ?How much is my cost, going through all this chemo treatment??
Onco: Are you confirmed or not? You have to confirm first that you are going for chemotherapy.
J: I was stunned. Confirmed? Before knowing anything, I have to decide and make a confirmation? I asked him (oncologist): ?Sir, can you give me two minutes to digest your question.? After digesting it, I asked him: ?As a consultant, you should know better than me, what type of medicine you are going to use, how much it costs and all these. So, what is the cost and the type of medicine you are going to use on me? It is only then, can I decide what to do.? The oncologist went on rambling again.
Onco: There are many kinds of medicine. There is A ? the good one B, not so good one and C, which is an oral one. So which type do you want?
This author: He (oncologist) asked you choose?
J: He asked me to confirm first that I am going to do chemotherapy. He will then tell me which type of medicine he is going to use. But, I asked him for the cost.
Author: Why did he not tell you right away that A costs so much, B so much? Even in the nasi kandar (local food) shop we have a list of prices posted on a board in the shop. Why don?t they just do that?
J: No, he would not tell me that. He wanted me to confirm first and only then will he tell me how much and what medicine he is using. I asked him: ?For my stage, is it necessary for me to take oral chemo. See, my job is to walk around here and there.? He did not answer my question at all. At one point, the oncologist asked me this question through his nurse: ?Do you understand what I am saying??
J: I said this to his nurse: ?Tell your doctor that I fully understand what he is trying to say. But I am not sure, if he understands what I am saying to him.?
What is Chemotherapy For?
Author: In your discussion, did he ever say that whatever drug he is giving you, is it going to help you or not?
J: No, no. He just told me it is just for prevention. He said that now I have gotten rid off my cancer, there may be some more cancer cells present in the lungs or anywhere else in the body.
Author: So, the whole idea is just for prevention?
J: Yes ? and I must go for chemotherapy.
Author: In your conversation with him, did you ever discuss if chemotherapy is going to help you at all?
J: No, I did not ask. I was so fed with the way he talked to me.
Perusal of Medical Reports
J: I asked the oncologist: ?Did you go through my medical report seriously?? I used the word seriously. The way I see it, he just flicked through the pages without even reading it.
Author: He did not really read the report? I mean, the way you saw it?
J: He did not take time to really look at it at all not to say read. He just looked at it and he told me that I had Stage 2. How am I going to trust him?
Author: When you asked him ?Did you really read my report?, what did he say?
J: He just looked at me like this ? (showing his face), and replied: ?Are you confirmed or not. If you are confirmed that you are going to do chemotherapy, then come back tomorrow and I shall prepare all the things.?I asked the oncologist again: ?As a consultant, is this the correct way to talk to your patient? What if the patient tells you he does not want to go for chemotherapy??
Onco: No, no. You have to go for chemotherapy. You have Stage 2 cancer.
J: But you still have not told me how much it is going to cost ? just roughly, there is no need for the exact figure, but just give a rough figure.
Q: Okay, let me ask you about your file again. He did not read and study your medical records? What is your impression on that?
J: No, he did not read at all. That?s a fact. He is interested to know whether I can confirm if I wanted to go for chemo or not. That?s my impression.
The Explosion
J: I could not stand him anymore. I told him: ?F (four letter word and other dirty words)? ? right on his face. ?Forget about it. I am not going for chemotherapy. You give me back all my x-ray films and file. I am not going to see you again.?
Q: You told him that?
J: Yes. He responded: ?Oh, your cancer is very serious ? very serious. You have to go for chemotherapy.? He still insisted that I go for chemotherapy. I told him again: ?You did not tell me how much it is going to cost.? This is the last word the oncologist said to me before I left this room. ?Okay, it is going to cost around RM 4,500 per dose and you need six doses within three months.? He did not tell me what medicine he wanted to use or whether chemotherapy is going to be able to cure me or not.
The Walk Out
J: When I walked out of his room, his nurse came running after me.
Author: The nurse came after you?
J: Yes, and she said: ?Mr. Johnny ? er. I bring you to our Welfare Department to discuss.? I told her: ?Okay. I trust you but not your doctor.? I wanted to give another try and I went to see the officer in the Welfare Department.
Welfare Officer: He did not write how much it would cost, how to negotiate with you?
J: But the last word, he told me was: RM 4,500 per dose and I have to do six doses. That means RM 27,000. So, tell me how much discount can you give me? Then I told the Welfare Officer: ?Forget about it.? And I walked off from his office.
Why I Went to the Oncologist in the First Place
Author: You went to see the oncologist, but the way you talked to him seemed to be quite aggressive. I understand you. You needed information. You wanted to know many things. Your life was in his hands. Let me ask you this: Before you went to see the oncologist, have you already made up your mind NOT to undergo chemotherapy?
J: Yes.
Author: Then, why did you go and see him then?
J: Oh, because the nurse in the hospital (where I had my surgery) had been calling my wife every two to three days.
Nurse to my wife: Your husband still did not go for chemotherapy? We have made an appointment for him to see the oncologist. But he did not go.
Author: You mean the hospital was bugging you to go and see the oncologist?
J: Yes, exactly.
Author: How many times did the nurse called you?
J: As many times as I postponed the appointments to go and see the oncologist. So, at last, I had to give in and gave it a try.
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Tags: chemotherapy, cancer cells, Cancer, treatment, oncologist, appointment, Medicine