I'm Starting to Think Oncology Could Benefit from Term Limits

The more I read about this poor girl in Connecticut, the more annoyed I get. I'm sure there are interesting legal questions about when someone's self-actualized enough to make their own health care decisions, but who the hell cares? As a human issue, this is simply appalling. But while I find the actions of both the courts and the health care team to be appalling, what's really starting to bug me are the thoughts expressed by the so-called "experts." Prevented by HIPAA by saying much of anything, the actual health care team isn't saying much about the case; but there seem to be lots of oncologists willing to chime in. 

Here's my current favorite sound bite: "I would say, overall, 80 percent is probably a reasonable estimate of how many patients are cured. It would be higher if you're early stage.... The treatment's very good. It's all outpatient, usually well tolerated. Yes, patients lose their hair. Yes, there are risks to it. But in young, healthy patients, the vast majority of them get through it and go ahead and live essentially normal lives."

And here's why this annoys me. First, on behalf of the poor cancer girl, I'm offended. This guy basically reduces her objections to the loss of her hair, when in none of the articles I've read has she even mentioned her hair. Toxins, yes; hair loss, no. Moreover, even if hair loss was what's driving her, so what? Some of us would rather die than lose our kids, our pets, our jobs, our cars -- whatever. If hair's that important to someone, who are we to say it shouldn't be? 

Second, check out the weasel words: "probably," "usually," "essentially." Is this guy even listening to what he's saying? 

Part of the reason this bugs me so much is yesterday was my getting to know you visit with my third cancer center. In the course of the conversation the oncologist stated that he'd immediately put me back on chemo infusions because it still seemed to be working and "I hadn't had to be admitted to the ICU." Really? That's the standard of acceptable? A treatment that sends you to the intensive care unit can be terminated, but everything else is fine? 

This got me to thinking. My potential (and declined -- this guy and I clearly did not see eye to eye on the definition of quality of life) oncologist seemed to quality of life like this:

Your basic bell curve with the dividing line between good and bad defined by whether or not you wind up in the ICU. Problem is, I -- and I think most people would see the world more like this:

This is to say, I think most people would say you're already in the bad territory just by having cancer, and the line between acceptably bad and unacceptably bad really depends on the person in question. 

The problem with oncologists is that the population the interact with is composed exclusively of cancer patients. They're looking at that tiny curve in the corner, not the overall picture. Hence, term limits. The minute an oncologist reaches the point that they no longer shudder in horror at what they are asking their patients to go through, they ought to take some time out for recalibration. 

Speaking as a normal person and not an oncologist, "anything short of the ICU should be tolerated" does not strike me as a normal -- or, frankly, even reasonable -- standard. But it certainly seems normal for oncologists (at least the few I've met so far, and more than a few I've heard and read about). 

Personally, I'd say that's a problem.