First, Do No Harm
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Wikipedia says, "It is a popular misconception that the phrase 'First do no harm' (Latin: Primum non nocere) is a part of the Hippocratic oath." I was curious to know what the modern version of this oath says and highlighted what I thought was interesting/surprising:
I swear to fulfill, to the best of my ability and judgment, this covenant:...
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick* human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
"Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today" (Wikipedia).
*We're all sick, right? I'd much rather this just said "human being" and emphasized that instead of reinforcing over and over the disease.
Yesterday I went in for an ultrasound of my chest and armpits. No big deal. I do what I try to do each time with tests like this... I ask people in my community to pray me and I make friends wherever I go. I was yakking it up with the receptionist and I was happily chatting along with the ultrasound tech. The tech wanted the radiologist to come in and look at a lymph node in my armpit on my right side, the same side as the mastectomy.
While I lay on the table waiting for the doctor to come in, I did lots of peaceful visualizations and talking to myself so as not to freak out...
"Everything is and will be okay."
"You are healthy, healthy, healthy."
"All shall be well, and all shall be well, and all manner of thing shall be well." (Julian of Norwich)
I was as calm as I could be and I was happy about that.
And then he came in.
"What's going on in here?!" is apparently his official greeting.
I reply, "Not much. Just getting an ultrasound." At this point I sit up, smile, and extend my hand in a handshake. It appears to me that he seems a little taken aback by that. I just want to make sure to the best of my ability that everyone who interacts with me on my healing journey remembers that I'm a person... and in this case, not just an armpit with an interesting lymph node to take a look at.
He says something to the effect, "There's quite a lot going on in here!" He continues to quietly but gruffly ask me questions and make comments.
At this point I'm still working really hard to keep my mind from spiraling into worry and fear and worst-case-scenario thinking. This is WORK to not allow the "This, THIS is the time you will die" thought to take over.
They scan my armpit for 5-10 minutes (it could have actually been 2 minutes but it felt more like 20 minutes).
Finally, he decides that what they see on the ultrasound isn't concerning and I should come back in 3 months.
Poof. Done. Just like that.
UGH. Why??? Why was I put through this pointless emotional down and up yet again? Why??? What purpose does it serve me or the medical establishment to make each step start with PANIC instead of PEACE?! Let's assume everything is healthy and benign until proven otherwise... not -- let's assume there is scary cancer everywhere all of the time and cross our fingers you luck out and we don't find anything.
In my mind he could have come in, smiled when he shook the hand of another soul, looked at me in the eyes, and taken a deep breath to get a sense of what was going on in the room. (This is precisely the experience I've had every time with the doctors at Hufeland Klinik in Germany.) His tone of voice could have been gentle and calm, "Colleen, could you tell me if you've had a PET scan before" instead of "HAVE YOU EVER HAD A PET SCAN?!" Granted, it's hard to get the nuanced difference across in written form here... but in the end the ultrasound result was the same (good!) and perhaps the process leading up to that conclusion could have just been a whole heck-of-a-lot more peaceful.
Maybe next time...
PS - And honestly, believe it or not, this time was so much better than last time! In December 2015 I had a very negative experience with an ultrasound tech. I love giving people the benefit of the doubt. Maybe she feels that she's doing a great service by offering patient education during the course of the screening. But what I noticed while I was sitting in the waiting room was that she was extremely rude to her co-worker. I asked Josh to come in the room with me. She said, "Well... I've never had a husband in the room before. But do whatever you want *eye-roll*." During the extremely painful ultrasound rolling-pin screening, she LECTURED me that the radiologist will want a mammogram with the ultrasound. I smiled and said, "My oncologist and I have made a plan and today I am getting an ultrasound." I explained that since the mammogram of my right breast was negative when there was a cancerous tumor AND I have extremely dense breasts, both my doctor and I agree that mammograms are not a useful screening tool for me. Now I regret engaging with her and explaining/rationalizing my decision. It is not necessary for her to know this. THEN... She went on to LECTURE me that what I really should be having is a breast MRI because they are much more sensitive. (Keep in mind, I'm laying topless on a table... in a prone and vulnerable position... and she is standing over me.) Again, I smiled and said, "My oncologist and I have made a plan and today I am getting an ultrasound." #NotPickingUpWhatImLayingDown
