The Prairie Doc Perspective: Trust

Posted October 31, 2012 at 10:43 am

It wasn’t too long ago I had to tell a sixty-something woman that her breast biopsy showed cancer cells. I explained what the next steps would be and that soon I would arrange for her to see a breast cancer specialist. I remember looking up from the chart into her eyes and seeing a strange glassy stare. She had that stunned “What is happening to me?” look.

More than ten million Americans are cancer survivors, but that number doesn’t seem to help much when you are the patient, some doctor is talking, and the word “cancer” comes up. In discussions like this, I’ve learned from experience that after the word “cancer”, all other words and advice are likely lost, and another visit for options in a day or two is needed. Then it is my most important job to make available to her the very best treatment, and to help her believe in it.

Yesterday I asked another patient, a 95-year-old friend of mine who is a breast cancer survivor how it all happened with her. She described discovering a marble sized hard lump in her breast twenty years earlier. She was referred to a surgeon who gave her options of treatment. The patient then chose to have a simple mastectomy. She said, “I didn’t get excited, I just trusted the doctor. He told me we don’t play around with this stuff, and I believed him.”

This wise woman went on to tell me about her relative who also had a breast lump, was afraid, didn’t get help, and didn’t live a year. “Better to just think of it like getting a new hip. Get it taken care of, and get on with life.” She said.

Trust is the key ingredient to this story of cancer. First, the physician must truly deliver the very best treatment options available anywhere… and then the patient must know and believe she is receiving the best treatment. Like my 95 year-old patient said, “I just trusted the doctor.”

Take home message:

1. Caring for cancer patients requires a physician to know how to communicate well;

2. When caring for any patient, physicians must promise and deliver the best treatment options available anywhere;

3. Successful treatment depends on the patient trusting that the physician is delivering on that promise.

Dr. Rick Holm wrote this Prairie Doc Perspective for “On Call,” a weekly program where medical professionals discuss health concerns for the general public. “On Call” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central. Visit