When I was diagnosed with BC, and I was having constant medical exams, I remember all the onco residents who surrounded me, as if they had just discovered gold, to examine me and ask me tons of questions about my health history. I was OK with it. In a way I felt that all this attention was for my own good. And it was a positive thing to allow the residents to study me because it would help future patients too. Residents need to train after all. But lately, I’ve become annoyed at all of them.
At one appointment last year, another resident saw me. She asked the usual questions about my health status, and proceeded with examinations. I walked out uncomfortable but not because she did anything inappropriate. However, she said things that showed she was not on the same page as my regular doctors. For instance, she was 100% against pregnancy after cancer and tried to discourage me, while my regular onco doctors are not against me trying. And it wasn’t the fact that this resident was against it, it was how she expressed her reasoning, which was not backed up by scientific evidence. I understand she had good intentions but receiving conflicting advice at the same cancer facility can be upsetting and confusing for a patient. I don’t believe my hospital would want to create such confusion for me. I made a note that next time I would let my hospital know I no longer want to interact with residents, but I let it slide.
This year, it happened again. This time there were two residents — a male and a female. They both asked questions and proceeded to examine me, simultaneously. This bothered me more than the conflicting opinion/misinformation I was given by the other resident last year. This time I got angry, and asked that only one of them touch me. Not their fault, I could have asked them both to leave but I didn’t. I am not intimidated by my hospital but I also wouldn’t want my care to be influenced if they start viewing me as too demanding or “difficult.” And that shouldn’t affect my care, right?
I’ve realized what the problem is. It’s my breasts. They are a sexual part of my body and although I know these interactions are for medical purposes, it still bothers me. I don’t want to be constantly touched by strangers anymore. I want my appointments to seem more normal than they are now. I want to be able to see my doctors and not feel like I am part of an exhibit or an experiment, for once. Because having cancer already makes me feel like I am. I know, I know, this is helping the residents become better – it’s training. Well, I don’t want to be part of it anymore. On top of that, I am already having a hard time feeling comfortable about physical intimacy as it is, and having all these people touch me makes the way I view my body even more complicated. I mean, my GYN, Onco, survivorship nurse, radiation doctor, residents, that’s a lot of grabbing. Don’t want it!
Perhaps if the cancer had been someplace else I wouldn’t feel as uncomfortable. I think having had this damn cancer on an intimate part of my body has really screwed things up for me, in so many different ways. Sometimes I wish the cancer would have been someplace else, even though breast cancer seems to have more treatment options among all cancer types – at least for early stagers. Of course I don’t really know the challenges of having a different cancer and I am not saying one is better than the other. I just feel this BC has been a big hit to my sexual self concept, and having too many people involved in my healthcare doesn’t make things easier for me.
All my doctors but one are female and it might be from some deep heterosexual memory of my Mom always changing my diapers that I don’t mind the female touch. Or some other strange Freudian explanation:-) Gender barrier? Well as a guy, I think it’s very, very important to have permission for touching a woman. Being a medical student or a qualified doctor doesn’t come with automatic license to just go grabbing around. It’s your most fundamental right to “own your space” both physically and mentally. Feel like a troll guarding your bridge? Well it IS your bridge after all.
My specialists all work out of branches of the University of Alberta training hospital and my specialists are also professors. At one level I don’t mind those moments of being on display that come with the training purpose of the hospital, but there was one time when it seemed important to describe my feelings to a group that came to my bed and the professor just talked over me. Just survived open heart surgery already the bossy people are dismissing me. Being a specimen or example is fine but I DO come with a voice and an individuality my little darlings, so visiting privileges are rescinded.
As a random thought: as a guy, it does feel a bit like it is crossing boundaries to be in a group of breast cancer diagnosed women. Out of place and probably not “getting it” entirely, but I do understand your desire to have children and think it is wonderful and you shouldn’t be talked out of it. It’s about LOVE Rebecca, not a medical decision.
Completely love this quote: “Marriage doesn’t begin with a proposal, or even an initial meeting. It begins far earlier, when the idea of love is born, and more specifically the dream of a soulmate.” The Course of Love by Alain de Botton.
Thank you for your comforting words, Scott. I try to help these medical students. In a way I’ve also lost a sense of shame due to my diagnosis but there are times when I don’t want to be approached. And sometimes I get sick of feeling like an exhibit. I guess it all depends on my current state of mind too, but you’re right when you say I should “own my space” both physically and mentally. So many men go into gynecology as a profession. My surgeon was a male, and he was very good, but I generally prefer females. There’s a sense of feeling understood and connected for the obvious reasons. That quote you shared is very true. Let’s see how things turn out for me. In the meantime, I’ll keep singing this song: https://www.youtube.com/watch?v=GiqOsKngc-c
I too get care at a teaching hospital and I have mixed feelings about it. I have had student ultrasound techs observe and that was okay. I have had medical students interview me. But I find it creepy when residents or med students do physical exams. It’s my neck, a rather mundane part of the body, too. I was once asked for permission for a fellow to observe radiation administration and I said no, specifically because I didn’t want someone I didn’t already know involved. I try to give permission when I can because I want to help them learn, but I also can relate to feeling like part of a sideshow.
Sometimes I am flexible but don’t always feel comfortable allowing it. I am going to request not to be seen by any medical resident moving forward. I think a lot has to do with the lack of familiarity. I got used to having my Doctors check up on me but these guys are not my part of my medical team. We do what’s best for ourselves. It’s our bodies after all.
I get it! I feel weird having a mammogram although my technicians have always overly protected my privacy and comfort. There is just something about the boobs…whether we like it or not they are a sexual part of us…I had some of,the same mind issues with breast feeding.
I hate boob scans. I know I need them but I can’t stand the exposure and the anxiety. Same goes for GYN-related crap, which reminds me, I am dealing with that tomorrow morning. Ugh! Does it ever end? I am glad the technicians at your facility try to make you feel comfortable.
Hmm, this is tough. Like you said, the residents are there to learn, but…..
I am greatly disturbed by the first incident you described, the one who was so against having children after cancer. It is very confusing to get differing info from the medical professionals on your “team”. That happened to me right before surgery–I’d already discussed with my main oncologist and my surgeon that I would have a lumpectomy and she comes along and starts talking about mastectomy, and saying I could not know for sure. It was upsetting, because I was under the impression it was all settled between me and the two docs “in charge”. It created confusion on an issue that was already fraught.
I was lucky, I guess, to not be in a teaching center–well, some nursing and phlebotomy students were around–so I did not have much experience with this. But I do remember having to be topless every damn day for the crew of 3 or so techs during radiation. And it was, uncomfortable. They could be rough, pulling me into the right position and stuff. I was very glad it was over, I always felt so exposed.
Wendi, your experience sounds upsetting to me. I would be paranoid and annoyed if my doctors didn’t communicate to each other about my health situation, especially about surgery. I am sorry you had to deal with that. I can relate to your radiation experience. Although they weren’t rough with me, that I can recall, I felt subjugated. I never cried during chemo but radiation made me feel very emotional. I am just glad we’re both finished with that (and I pray we never have to deal with it again – AMEN). My wish is that no one has to.
Interesting. I can speak as both a physician and a breast cancer patient who had bilateral mastectomy and expander to implant reconstruction with complications. All my doctors are colleagues. I have no problems with anyone looking, examining, asking. Anything. I’d like to educate them. What a unique opportunity to give my perspective as a patient. You may feel like your sexual parts are on display but I can assure you most doctors don’t see your diseased breast any differently than a diseased foot or heart or whatever. To us doctors, it’s the context. This is a medical encounters not a sexual encounter. I’m sorry you feel that way. Just talk to them. Doctors are people too. Let them know how you feel. If you are not confrontational you should not be labeled as a difficult patient.
Hi Ann, I am sorry you’re dealing with this awful disease. I’m afraid you missed my point. Obviously, I (as the patient) know and understand that the doctors treat it as a medical encounter and not a sexual encounter. But the point is not how the doctors feel about it, but how I, the vulnerable and tired patient, feel about it. Perhaps it is different for you because you come from the medical profession and have been exposed to similar situations more frequently. I think it’s great that you come from both perspectives. Thank you for reading/commenting. And please stay well.
I had to deal with residents, too, during treatment, primarily with radiation oncology. And what bothered me first off was not being informed beforehand that my appointment was not, in fact, going to be with my doctor. A few of the residents were actually much nicer and more informative than my doctor was, but the second thing that bothered me was the lack of consistency inherent in having different people for each visit. Part of good medicine is building a relationship with your doctor, so that both of you get to know each other, build a rapport, and therefore understand each other better. That is important to me with my own patients as a physical therapist. If you see a different practitioner every time, it’s not possible to have the advantage of that rapport, which means that important issues may be missed entirely. I’m glad you spoke up for yourself. We have every right to do that. If we don’t advocate for ourselves, who will? Great subject. xoxo, Kathi
Interesting, most of the residents I see are from radiation oncology. Although I am done with that side of treatments, I continue to see my Dr. once a year. Perhaps because I was involved in a new experiment (at the time) to receive the radiation face down. They probably want to keep track of how I am doing which is fine. I am never warned about the residents either but I do see my main doctors after they examine me, which is one reason why it’s so overwhelming. And I agree it is very important to build a relationhsip with our doctors. However, the culture at my hospital is kind of cold. I hug my onco when I see her though. Maybe they are trained not to get too close to the patients to protect their emotional state. In a way it reminds me of the military. I’m planning to provide feedback to my hospital soon. I am sorry you’ve been disappointed with your care. I hope things got better. xx
Hi Rebecca, this is a great post on an important topic. I totally get where you are coming from. Residents have asked me questions like I was some carnival animal on display. That resident that told you not to have a baby was out of line. She didn’t really know you or your history, and it is indeed unsettling to have conflicting views at the same hospital. As a patient, you have a right to tell your doctor you do not want to see residents anymore. Truth is, there are many other patients whom residents can learn from. Regarding the sexuality after cancer, I totally get that, too. Breasts are sexual, and breast cancer has a way of making physical intimacy and body image difficult. I have body image problems as a result of doctors repeatedly cutting up my breasts. I also want to be tamper proof and don’t want residents touching me. Keep advocating for yourself!
Hi Beth — Thank goodness I am not the only one who feels this way. Personally, I don’t mind the questions as much as the ‘touching’. You’re right, there are so many other patients residents can learn from. The fact that this cancer happened on a sexual part of our body makes things very complicated for many of us. I’ll let my hospital know next week that I no longer want to be seen by residents. By the way, I just got your book in the mail! Looking forward to reading it. xx
I was a bit creeped out by the idea of two residents at the same time. I think that is rather inappropriate. As a patient you have every right to say that you do not want to be examined by residents. I found that when I had palpable tumors I wanted them to feel and learn from it. When chemo melted the tumors I was comforted by the idea that even the most meticulous resident could no longer find the tumor … but now, I don’t know I want to be wasting so much of my time … but also because the residents (actually in my case it is mostly fellows) don’t have the same history with me … so they don’t know me, they only have my history as it appears in a file, but they don’t have history … I know that my surgeon was there … she held me hand when I needed it held … so I have no problem with her doing my exam … my only concern is that I’m no longer “interesting” now that I am cancer free … I want to stay not interesting but also want to know that my surgeon is there if/when I have a serious scare …
Hi Rebecca — That’s exactly how I feel now. At one point I did not mind all the touching, because in a way, I felt like the more feedback I received, the better. Plus I didn’t mind educating others through my awful experience. But the fact is, they don’t know me. Like you said, they only know what’s in the files. This is too personal and intimate for me and I’d rather keep it between my doctors. I no longer want the attention, especially because now I feel uncomfortable about it. Oh! And I don’t want to be interesting either. Here is to staying boring forever! xx
I also receive treatment at a teaching hospitals and, in general, I have no problem allowing students to poke and prod. [After surgery two summers ago, in particular, I was so out of it and so drained, I didn’t even care if I was completely exposed. BUT that changed (the OK with being exposed part) once I recovered a bit.]
As far as allowing people access to ANY part of your body, it’s totally up to you and, as the patient, you get to say when it’s OK and when it’s not. And, no, you don’t have to be consistent. That’s part of the beauty of being the patient. One day you can be the crash test dummy and the next you can say “everyone out.” I’ve done it both ways. Either way, it feels good to have that power.
My point is: no need to be apologetic. Go with how you feel on any given day.
As for the resident who dispensed advice on pregnancy: don’t doctors often have differing opinions, even if in the hospital? I assume your oncologist is the lead member of your care team, so go with what s/he has to say, assuming you’re comfortable with past advice.
Anyway, keep it up with the writing!
Hi Alan! I appreciate a man’s perspective on this topic. Thank you for sharing your experience. It makes me feel less alone. I will def. allow myself to say no if I am not feeling comfortable about the situation. I like the idea of feeling powerful in a situation where I really have no control over the outcome – thanks for the tip! You may have a point about doctors having different opinions about care, but considering this was a research hospital, I thought the comment should have been backed up by some scientific evidence. That part made me feel uncomfortable because I had my hopes up. xx
Well, as for pregnancy, I still think you go with your original plan, assuming your lead oncologist is supportive! Plus, have fun with the best part: trying!!