Too formal

1307966-sketched-red-haired-white-female-doctor-caring-for-a-young-cancer-patient-poster-art-printI find that the culture at my cancer hospital is too formal. And sometimes I need a hug or two. Maybe I am asking for too much.

I recall my first visit. I first met with my surgeon, who was distant and to the point. He immediately did a breast exam and proceeded to tell me what the treatment plan would be for me.  I started to shake, sitting across from him. He felt bad and held my hands, “this is serious but we’re going to treat you to get the best outcome possible, don’t worry,” he said. My surgeon was very kind to me. He was also very competent. I remember him asking the nurse to contact a counselor so I’d have someone to talk to. That counselor came to meet me right away after I was done with my consultation.

Then, for my first oncology visit, I initially met with a medical resident. I thought that was odd, considering it was my first time meeting with my oncologist for such an important appointment. At the same time, this also gave me the impression that perhaps my case was not too serious. However, the resident was a bit too dramatic for me. She took long pauses between words as she drew little images of cells on a piece of paper, “so…this is…your…cell…and this is…your cancer…” She was showing me the survival rates if I opted to take chemo, Tamoxifen and radiation as my treatment regimens. She then proceeded to show me how Tamoxifen binds with the receptors so cells won’t feed from the estrogen – all done through her amateurish drawings. I already knew I was taking all the necessary treatments for my cancer. And where was my oncologist?

I wanted a hug.

Eventually, my oncologist came into the room. From the start, Dr. O was very formal and by the book. She immediately spoke about research and statistics and explained how treatments were going to benefit my case.  And I was just sitting there with my head tilted, staring at her, without really understanding what those research numbers meant for my situation. And at that point I did not care. I had already focused on the 86% 5-year survival rate the resident had given me if I took all possible treatments.  I couldn’t deal with anything else at that moment. Dr. O. was very competent but I got no hugs on my first consultation.

After several visits, I decided I would try to get my oncologist to be more affectionate with me, even if this was risky for her. I started by giving Dr. O a hug at the end of each consultation. Then, eventually, I started welcoming her with open arms as she entered the room, “Dr. O, so good to see you!” and she would reciprocate. Now she’ll playfully say things like, “Where is she? Where is she?! There she is!” as she enters the examination room. And yes, we hug, always. It feels good. Now the experience feels more human to me. I feel less tense and less afraid.

I continue to see my radiation doctor. Everything about this experience has been very “robotic” and emotionally draining— more so than chemo. It has been hard for me to get close to Dr. R. She is very serious and just takes care of business. I’ve tried getting her to be more warm after all these years, and sometimes I’ve managed to make her laugh with my jokes. Who would have thought I could joke in an oncology room? But there is one thing I appreciate about her. She is very flexible with my care, which is why I enjoy seeing her once a year. I’ve told her about my desire to build a family, and out of all the doctors I’ve seen she has encouraged me the most. Dr. R feels very confident about my situation and always encourages me to have quality of life, even if it means I stop taking Tamoxifen. Next time I see her, I am going to hug Dr. R, whether she is emotionally ready or not.

I guess you can say I have a good balance among all my oncology doctors. They all contribute to my physical and emotional care, one way or another. I am truly grateful for every one of them.

I can’t completely disregard the feelings of these oncology doctors. I am sure there’s a reason why my cancer hospital is so formal. What happens there is very serious. These doctors lose patients all the time. It must be tough for them too, which is why they don’t personally get too close to their patients. I still don’t know how they do it, but their jobs are very important and necessary. They also need to be kind to themselves in order to keep performing their responsibilities.  But I must tell you, a hug can make a big difference in a patient’s care. Maybe I am asking for too much.


How would you describe your relationship with your Oncologist(s)?

About thesmallc

I'm Rebeca. I was diagnosed with breast cancer at the age of 32. But there's more to my story: I am an animal lover. I love to cook. I have a wonderful fiancé who doesn't mind walking my rocky path with me. We currently live in New York. ---------------------------------------- “Those who have a 'why' to live, can bear with almost any 'how'.” ― Viktor E. Frankl
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20 Responses to Too formal

  1. illlive says:

    I’m sorry you haven’t experienced compassionate care throughout your time as a patient. I’ve been pretty lucky to find caregivers with a sense of humor very close to my own (except in radiation, but I didn’t spend that much time there).

    It sounds like you have been persistent in trying to make your caregivers CARE, and you’ve had some success! I hope they use their experience with you as a way to rethink the way they deal with others, to see that there is another way to be in the exam room — namely, HUMAN.

    • thesmallc says:

      My doctors are all great, but some are less warm than others. They are very good at what they do, but I am a hugger. And I do feel that in some areas, there needs to be more compassion. Oncology is one of those areas. During my last appt. with my Onco, there was a medical resident in the room and they both got a hug from me. My GYN (female) is amazing! She is a hugger like me and very kind. Having a Dr. with a sense of humor is a big plus! Glad you have that. Doctors have it tough too, I am sure. It’s a matter of finding the right balance. Competency should be priority, I think. I hope the new year is very kind to you.

  2. illlive says:

    PS When I walked in for my surgical consult, my surgeon looked at me and said, totally seriously, “You seem like a nice person. How did this happen?” My husband and I busted out laughing. It helped a lot.

  3. Terri Guttilla says:

    Another great blog- HUGS and kisses to you my friend. 😘💟

  4. Mandi says:

    Some I hug and get hugs back, others are very formal. Some of my doctors will joke around with me, some are very by the book. I prefer the warmer doctors by a long shot, but have found that you just can’t get away from the cooler shoulders. I also noticed that surgeons and radiologists tend to have less affectionate /caring personalities – but their interaction with patients is usually much more short lived, so they can get away with it.

    • thesmallc says:

      Hi Mandi! You’re right, there will always be a mix of personalities. I realize that with me it has a lot to do with their specialty. Although a surgeon would probably only see me a couple of times, he will still cut me open so I def. need compassion. But a cardiologist or a dermatologist can probably get away with being formal. Wait, maybe it depends with a cardiologist. If I have heart disease, maybe I’d still need my hug. If there is a threat to me, I need the compassion.

  5. Well, my friend. I read, don’t comment much because life has totally gotten in the way. My observation? There have been **many** changes over the past 10 years. Sadly, I don’t think any are for the better. I have an issue with a family member and I’m opting for another hospital. Go Figure! ❤

    • thesmallc says:

      AnneMarie, trust me, I get it about life getting in our way. Last year, specifically, was not very kind. So you’re looking for another hospital. I hope things aren’t too difficult for you right now. Maybe next time we catch up, you can tell me about it. I am curious to know what’s going on. I wish you (and your family) well. Good luck finding a place you feel more comfortable with. And it felt great seeing your note. xo

  6. From what I understand, most doctors learn to detach from the emotional aspect of their work; otherwise, they’d never last. They also have to be careful because of current-day legalities, so they take on a certain professional stance. Despite that, many are caring human beings who do connect with many of their patients. I think you just know which ones would appreciate the hugs. I’m glad you found at least one hugger!

    • thesmallc says:

      Eileen, the point about current-day legalities is an important one. Sadly a lot has changed (insurance-wise too) because of some people who, well, take advantage of the system (both sides). There are still ways to show compassion, maybe they can use a different tone or vocabulary or spending those extra minutes in the examination room to listen. I am lucky all my doctors spend enough time with me, but I find that is another issue many patients face. And yes, I feel very lucky to have found a hugger (actually, two!). But I am also aware of the complexities of this situation and need to consider those too. xo

  7. nancyspoint says:

    Hi Rebecca,
    I have had five different oncologists. Most of the changes came during my second year post-diagnosis and all the changes were hard, but necessary. Some were my choice, and some not. My present oncologist is warm, but not too warm. He always shakes my hand and smiles. I like him a lot because he listens well. I think hugging him would actually feel weird to me. I have often thought about the serious work that goes on in cancer centers and how hard it must be at times for those who work there. I think we have to respect boundaries we all put up to protect ourselves. At the same time, anyone working in the medical field has got to develop interpersonal skills. There should be courses on it and maybe there are. Good communication skills are a must and, of course, some people are just naturally better at it. I’m glad you have good balance over all with your doctors. Can’t ask for much more than that, right? Thanks for another thought-provoking read. xo

    • thesmallc says:

      Hi Nancy! You’re right about respecting boundaries. After publishing my post I thought maybe I should have focused on more general ideas that fall under ‘compassion,’ for example, spending more time with the patient and using certain tones could also be helpful. I’ve always been very sensitive when it comes to medical situations (even doing blood work makes me feel vulnerable) so I tend to appreciate the hugs because I get a sense of peace. At the same time, I understand how some patients wouldn’t want that level of connection with their oncologists (or even see them that frequently). I am glad you feel comfortable with your oncologist. In an area such as oncology, every patient should feel comfortable with their medical team. xo

  8. Jennifer says:

    My oncologist is very straightforward and to the point, which I really appreciate. But he also does little things, like he holds out his hands and then I put my palms on his for just a few moments–it’s sort of a calming thing that he does every time we meet. He also cracks jokes, too, which I appreciate. Those little things help me a lot. So, I totally get what you’re saying about needing a bit more of a connection. It definitely helps.

    • thesmallc says:

      Jennifer, your oncologist sounds wonderful. It’s very kind of him to do those little things for you from time to time, especially if they calm your nerves and give you some sense of security. It has def. helped me to receive the same type of attention from my doctors. Please stay well. xo

  9. Pingback: Weekly Round Up | Journeying Beyond Breast Cancer

  10. bethgainer says:

    Hi Rebecca,
    I’ve been away from the blogosphere for awhile, and I’m catching up on your terrific blog. All I have to say after reading this post is GOOD FOR YOU!! I love it that you initiated a hug with Dr. O. You helped this doctor meet your needs. All doctors are different as you know, but there are huggers out there. My docs and their staff either held my hand or hugged me. They were all very respectful, and they acted like they loved me like their own family. I am grateful for them.

    • thesmallc says:

      Hi Beth, always nice to hear from you. I’ve been away from blogosphere too, dealing with some personal issues, including a dramatic uterus (sigh). Yes, all doctors are very different. I am so glad you received that kind of attention from your medical team. This contributes to our recovery. I hope you’re doing OK. I will be catching up soon. xoxo

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