- Attempts to find a cure for cancer are intertwined with the race to find the cure for death, the very natural process that becomes part of us on the day we are born.
A friend of mine pointed the other day that among few things that are constant in life are death and paying taxes. This was a reminder to a fact that we as humans pretend to forget and that’s why for the taxes, we are ever evading them. Death on the other hand has remained a mystery for humas to solve but we have not given up.
Attempts to find a cure for cancer are intertwined with the race to find the cure for death, the very natural process that becomes part of us on the day we are born.
As an oncologist, it seems like I see more people [my patients] dying than what my colleagues in other specialties witness.
Currently in Tanzania cancer is the sixth killer after HIV, malaria and respiratory infections. A death sentence following a cancer diagnosis was more obvious in the last century before the advent of the many novel treatments that we have today.
Death should be an open subject
How many of these patients are literally wanting to talk about dying? How prepared am I to initiate this discussion.
I admit that the medical schools that we attended didn’t prepare us to face the realities of the failures of the medical world, during the moment when the disease seems to be winning.
So when we give up many a times, we say nothing to the patient and the patient is left on his/her own to find out that death is knocking at the door.
What if we talked about death to our patients that we feel that we have nothing to offer them to redeem them from the claws of a cancerous condition. The talk could relieve them of pain and enable them to spend their last days in a more meaningful way.
At times, I attempt to initiate this talk with my patients but it’s the response that is not always positive, either from the patient or relatives.It’s important for the discussion on death to be gradual and should involve the whole family with the patient at the centre.
In Africa, I have observed that we prefer making decisions for the patients. This habit that is shared by the Chinese is meant to protect the patients, but for how long?
I believe the sooner the better as it allows the patient to prepare, as well as the relatives, and in the long run, save them the resources and pain.
Breaking the bad news is unwelcomed even for the messenger. I remember once a reknown lawyer in Dar es salaam lamented on the burden her clients put on her shoulders. She made these claims on the basis that to represent her clients well, she must know them well-hence her tribulations. It’s the same for oncologists and other doctors and death makes the experience even worse.
I still remember every patient I have lost, from a strong vibrant boy whose life made short by acute myleoid leukemia to a wonderful lady who had come to love me like a son in the short period our lives crossed path.
Death will not be a topic for most of us because until now our culture has not allowed us to do so. I, however, encourage those like me to never shy away from attempting to talk about death with their patient. Incorporating this talk for such patients outstrips the silence.