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Michelle Loewenstein
4 minute read
2 Aug 2013
5:00 am

When the doctor becomes the patient

Michelle Loewenstein

"It's all going to be okay." These words are often instinctively uttered when someone is given bad news – and aside from the death of a loved one, there is probably no worse news than being diagnosed with cancer.

Ghghghghghghg US actress Angelina Jolie arrives for the German premiere of the film "World War Z" at the Cinestar movie theater in Berlin on June 4, 2013. The apocalyptic horror film based on the novel of the same name by Max Brooks is about a United Nations employee that travels around the world to save the planet from zombies. Picture: AFP PHOTO / ADAM BERRY

However, what happens when you know that those words may just be a hollow promise? What do you do when you are a doctor yourself, and you know what all of the possible outcomes may be?

In March 2012, Dr Despina Demopoulos, who works in paediatrics and paediatric critical care, was diagnosed with breast cancer. Like any other patient, she was shocked. She was only 33 at the time; she was healthy and had no family history of the disease. However, despite her expertise, her initial reaction didn’t differ to that of any other patient.

“I felt sad for my family,” she recalls. “Even though I had felt the hard lump and knew it was serious, I was still shocked that it truly was cancer. I even went alone to get the results because I thought it would be fine. I think my sadness and shock was the same as any other patient but my reaction probably differed in the five minutes after getting the news. I wanted a copy of the histology, the staging and started asking medical questions about the treatment – I wanted to start ‘fixing it’. I cried because I wanted another baby and knew what the chemotherapy would do to my fertility. And then I cried because my son was two years old and I need to be there for him and bring him up, like any other mom diagnosed with cancer.”

While having a better understanding the illness that she had been diagnosed with was a plus at first, it became more difficult for Demopoulos as time went on.

“I think it made it easier to understand and handle the initial diagnosis. I found that I could explain it well to my family and stay calm. What is harder is knowing exactly what will happen after the diagnosis – the steps that follow, the side effects of the treatment and most importantly how it affects your family. I think as a doctor we’ve seen what cancer and its treatment can do to patients and to their families. You can get very ill, get many infections that can kill you and you can become so weak during the fight that this can cause a lot of strain on loved ones. And of course, there is the knowledge that the cancer can be spreading and that you can die in the end,” she says.

According to Demopoulos, many doctors won’t even go through with treatment because they know what the consequences may be.

“With my chemotherapy, I was extremely aware of the side effects and trying to prevent them, for example peripheral neuropathy where one loses sensation in fingers and toes. I would wear these ice gloves on my hands and feet because I had seen patients with peripheral neuropathy and knew how bad it was,” she says. “Some of my fellow friends getting the same treatment were only prepared to start the ice gloves if they got numbness so I think sometimes ignorance can be bliss. My fingers and toes froze because of my obsession to avoid this side effect!”

As patients, we are forced to hand over our care to a professional. They do, after all, know better. The difficulty for doctors lies in the fact that they are used to being in the driving seat.

“When treating a fellow doctor, one must realise that it’s not just the simple questions that get asked. The saying that ‘doctors are the worst patients’ is true. We don’t like to hand over control and we challenge a lot. Perhaps we know that no-one is perfect and perhaps we’ve seen that diseases can be challenging and so we don’t just accept, we challenge, even when we are the patients.

“I really understand what patients mean when they say you need to be able to trust your doctor. At one stage, I took a real break from reading so much about the breast cancer and realised I needed to let my team guide me as they are the experts. As a patient, I asked a lot of questions. My husband is also a doctor (paediatric surgeon) and so my poor oncologist had double pressure. During our first consultation when she explained the chemotherapy, we asked which regime is used, which journal it was published in, the latest evidence etc. and she really explained well and was up to date, which as a doctor made me feel confident that I could trust her. It was also the same with my radiation oncologist and surgeon.”

Since her diagnosis, Demopoulos has become more empathetic towards patients going for procedures that from the outside may seem simple, like MRI scans, which she describes as scary, and the constant taking of blood.

“It’s been good for me to have gone through these so that I can understand what my patients go through. I know now what the