Mama and Her Doctors

My mother has always been a pivotal cornerstone of my life. Though she often seemed overbearing and wrecked havoc when one of us invoked her wrath, she has always been the pillar that held up our family. She has always been both the sunshine and the dark cloud that overcasted our lives.

About three years ago, she emailed me her ultrasound results upon my inquiry of her current health. I was a meager undergraduate student, but I had sensed that something was different when she offhandedly complained to me about her doctors calling her to get a biopsy. They found calcifications and lesions in her thyroid. I urged her to get a biopsy, worried about the beginnings of a cancer, but she blew me off. Her excuses were that "the doctors don't think it was a big deal" and "I don't want my neck to be poked by some needle. It hurts." She whined about it whenever I broached the subject whenever I could, and after many attempts to get her to make an appointment, I gave up.

So I left her alone. After much arguing about it, I couldn't make her change her mind. After all, I wasn't a doctor or anything.

I hoped that it was a benign phenomenon.

The summer before medical school started, she went in for a routine checkup. When she came back, her demur reluctance about handing over her results like some grade student fearful of a parental reprimand of a recent failed exam set off all the alarms in my head. When I saw "TUMOR" and "CANCEROUS" printed on her report in all caps, I gave her a lecture and metaphorically twisted her arm to get that long overdue biopsy.

For a while, I was colored with guilt about not pushing her hard enough. Maybe if I had looked into the matter more, I could have persuaded her to go. Maybe if I seemed upset enough, I could have guilt-tripped her to make an appointment. Would it have helped it I had taken a week off of school and flew back to go with her? These were the questionable clouds that loomed over my head.

It wasn't until the day before my first medical school exam that I finally received news of her biopsy results. I knew that she wanted to save me the stress prior to my very first exam, but I guess my insistence finally wore her down. It was such perfect timing for a catastrophe on my end. She called me and nonchalantly said, "By the way, the results came back. I guess I have cancer."

What a way to go into an exam.

My mother never liked to show weakness. Despite her struggles with pre-diabetes, pre-ulcers, and uterine fibroids, she always put on the "tough supermom" act until she had no choice but to crumple. Her humor in all situations always made it seem so easy - as if all these troubles never really scratched her. In some ways, she had always seen her health as a blessing, its growing dysfunctions with genetics and age merely as the inevitable happenings of life. I have never once heard her cry of injustice or grumble about how hard it was when it came to the inconveniences her declining health had wrought her. She simply toughed it out and said, "Well, I'm can still do the things I love. I can still nag you, can't I?"

Her reluctance at seeing the oncologists and surgeons was understandable. I urged her to go at least get an opinion, no need to commit to anything just yet. But her experiences quickly shunned her away from the idea of medicine. Without clearly explaining to me what had happened, she opted for traditional Chinese medicine. I was confused, but she couldn't be persuaded. So I gave her an ultimatum that if nothing had improved at the conclusion of her chosen treatment, she would have to find a new surgeon.

This was around the end of my first year of medical school.

Her second visit to the surgeon was around May, 2014, and she called me post-appointment about how the surgeon forced her to schedule an operation time. She spent the next hour complaining about how rude and forceful the surgeon was. He had ridiculed her for trusting in Chinese medicine and refused to grant her another biopsy. At the conclusion of their appointment, at her resistance to undergo surgery, he had said, "You'll come back sooner or later." 

I was appalled.

Having felt utterly humiliated and insulted by their young surgeon, my mother felt that there was no hope for her in surgery. I felt angry in place for her about the physician's insensitivity of the situation, but her mind was set. It took a whole summer for me to persuade her back to scheduling an appointment with yet another surgeon. Last week, she called me in elation about how this surgeon was "so much nicer" than the last surgeons she had met with. 

This surgeon took the time to explain all the procedures they were doing to her. She had entertained all of my mother's questions and explained why delaying the operation was not ideal. The surgeon had palpated her own normal thyroid to show my mother the differences. She pulled up diagrams to explain to her the mechanisms involved and why the intervention was necessary. My mother had finally understood what the surgery was about. No one had told her this before. All the doctors beforehand had simply coerced into acknowledging the pressing importance of surgical intervention.

No one had explained my mother's reports to her.

No one had told her she was progressing from Stage 3 to 4 of her cancer. 

No one had bothered to tell her that her tumor was on the brink of metastasizing.

And after my conversation with my mother, I felt both stunned and ashamed for the state of medicine. How could it be that none of these physicians before had informed of these critical, decision-making things? How could it be that these simple yet so important facts were not communicated to her at any point since her diagnosis? How could it be that these physicians that had been rigorously trained, whose mission was to heal their patients, so coarsely treat my mother? How careless they were to her different state of mind. 

If only someone had told her about how things really were, maybe she wouldn't have felt so threatened to turn away from surgery. Maybe she wouldn't have spent all that money and time on alternative therapy. Maybe she wouldn't have wasted all that stress and frustration of being disrespected. 

I have only been a student of the classroom in my short experience as a medical student, but it has been emphasized to us over and over again the importance of our clinical skills. 

And now I truly, truly understand why.

And I hope from my mother's experience, I will always carry her life lessons with me. I hope that I will always be a kind and patient physician. I hope that I will remember the impact of a few words on a patient's perspective in medicine.

I hope I will always try to do good.