Sometimes, all you need to do is listen and be there for someone who is suffering from cancer.
“Uncle, I draw some blood, OK?”
For the past week, it had been the same. To me, Mr E was an ‘only-business-and-no-play’ kind of person, as he seemed so serious despite my (feeble) attempts at cracking jokes. Whenever he asked me a question, I found myself treading carefully, for the fear of getting on his nerves.
After he was declared free of the “Big C” for the past five years, it was now back.
During my undergraduate days, one of our lecturers told us off when we said that we had a “cancer patient” to present for our class. He explained: “It’s not ‘cancer patient’. It’s a ‘patient with cancer’. Always remember the individual first before the illness. Don’t define your patients by their conditions.” It was a lesson I would never forget.
As a student, I sometimes wondered what ran through the minds of these people. Although I had opportunities to interact with them during my classes and events in my undergraduate years, I admittedly never gave too much thought to it all. It was more of a fleeting moment, when I felt a sense of empathy, but I never felt I needed to fully “commit” to the conversations.
Now, as a junior doctor, it’s different. Dealing with patients and their families, at times I find myself faced with the toughest questions: “Is it really back?”, “Is there anything, anything at all we can do about it?”, “How long does he have?”.
Up till now, I still wonder, how does one actually answer such questions? How do patients and their families deal with such uncertainties?
Similar thoughts would run through my mind whenever I reviewed Mr E’s case. How is he really feeling? Is he in pain? Is he angry? What’s his coping mechanism?
One morning, he said to me, “Thank you for being a great doctor.” I was stunned.
Partly because I don’t consider myself one yet. Mostly because those words came from him. That statement was followed by his decision, that he did not want any further treatment. I sat down by his bedside, his wife by his side, and spoke to him.
I learnt how his cancer first presented, and how he had brushed it off, “It can’t be anything serious.” Following a couple more check-ups, he grew anxious. Then his suspicion turned out to be true. Mr E subsequently experienced the Kubler Ross’s famous five stages – denial, anger, depression, bargaining and acceptance.
Treatment was a long, tiring journey. Not just for him, but for his family as well, having to deal with not just the emotions, but physical exhaustion too. His wife told me that at times, she felt helpless.
“There were times when I wished I could take his place instead,” she had said.
When he was finally declared “cancer-free”, he felt like he was being given a second chance at life. He decided that his family was financially stable enough and he left his “well-paying-but-no-rest’ corporate job. He spent more time with his family, catching up with friends, and doing the things that he had always enjoyed but never found the time to do such as painting and travelling.
I wasn’t present when he received the news that his illness had come back. Someone told me that breaking bad news is a skill. So is communicating with someone whose prognosis isn’t favourable, and dealing with the family. Some choose to be direct, while others struggle to come up with the right words to say.
Mr E shared with me that he had stayed in hospitals long enough, and seen many healthcare professionals to know the different methods people use to handle patients with cancer. Some doctors were focused on the diagnosis and treatment, and kept discussing the options available. Some were very direct, and told him that he’s “not going to last very long”. Some fed him with positivity, and told him not to give up. And some avoided eye contact, not saying much.
I told him the truth – that at times, I was lost for words at what to say – as I didn’t want to seem insensitive talking about “what’s going on out there”, but at the same time, I didn’t want to be harping on his illness.
That’s when he told me, “It’s okay not to know what to say. It’s okay to feel uncomfortable. Sometimes all you need to do is listen, be kind and tolerant.”
And then he said something that reminded me of my lecturer’s words a few years back. “Yes, we want to know about our illness. And, of course we want to be well. But we don’t want to be talking about that all the time. We want to talk about other things too,” he said with a chuckle.
The individual before the illness, I recalled.
“No doubt I wish this hadn’t happened. Sometimes I feel extremely emotional. But I’m glad that I had five ‘brand new’ years. With the most supportive company I could ask for,” he said while taking his wife’s hand. I stole a quick glance at her, and could see tears glistening in her eyes. Every morning, I would see her attending to his needs, shaving his beard, combing his hair, massaging his back.
“Not everyone gets a second chance like I did. All of us handle things differently, because no two individuals are the same. But what I can tell you for sure is that we all learn to love life and the people around us more.”
Perhaps for now, I am too young and naïve to understand why different patients, families, and healthcare professionals choose different paths and strategies when dealing with cancer. I may never fully understand what goes through the minds and hearts of patients and their families.
But what I do know is that it is not an easy road, and it takes a lot of courage to be on such a journey, for patients and their families. I’m amazed by the strength and determination displayed by these patients and their loved ones. And unbeknownst to them, they’ve touched the lives of people around them, taught others a lesson or two along the way, and made a difference. Just like Mr E did.
There’s a saying that goes “Everyone you meet is fighting a battle of their own. So be kind, always.”
And it was Emma Watson who once said: “If not now, when?”
To all the fighters, survivors and families out there: a huge salute to all of you. Remember that you’re stronger than you think you are, and that you’re never alone.
This article is dedicated to the late Cheang Hup Keong, the writer’s Add Maths teacher who passed away last month after battling cancer. He lived an amazing life and inspired so many of his students.