This is an exerpt from my book, A Life in the Balance. It's from a chapter titled:

     Raising Oncologists for Fun and Profit


by Scott Burton

There are plenty of friendly, good natured and warm doctors, but for the most part, they aren't social butterflies. And oncologists are just like the rest of the medical profession but even more so. For many doctors, with their studies, clinics and huge case loads, their jobs dictate that they be slightly distant. And it amused me that they roamed the halls of a place full of emotion -- a place to be anything but distant -- and walk through looking at charts, poking and manipulating their clientele. That's akin to walking into a coffee shop in which everyone was stark raving naked from their scalps to their heels, ordering a latte as if nothing were odd, casually say to a nude patron, "That's an awful lot of body hair," then walk nonchalantly out.

How could they not want to sit and talk with every person on their floor? How could they not want to hold each person's hand and tell them it'd be all right? I suppose that was part of the problem: They couldn't. The sheer volume that they dealt in (not to mention a 4 o'clock tee time) meant they had to hustle through their business. Some did their best to connect, others didn't.

I fluctuated between envying and mocking the doctors on my floor. I was impressed with how much they knew and the fact that, regardless of how friendly they were, they were saving people's lives. I mocked them because they got paid just under a billion dollars to do it, they didn't always do what was right for the patient and, often, it took a whole roomful of the guys to rustle up one personality between them.

Just for one week, I wish the physician's job depended not on his or her medical abilities, but on how friendly he or she was with the patients. What a new experience that would be. On my next visit to the clinic the doctor is in the examining room waiting for me, which would be a major abnormality. A doctor waiting for and greeting patients in a clinic is, I'm pretty sure, one of the first signs of Armageddon. (The second horseman I believe.) But there he is wearing a colorful bow tie that compliments his radiant smile. On his chartreuse lab coat is a sticker that says "I hugged a clown today" and he extends his hand out, shaking mine vigorously, "Well, hi, Scott. Gee, it's good to see you again. Isn't this crazy weather we're having? I don't know whether to carry sunscreen or an umbrella. Ha ha ha! But you know what they say, 'if you don't like the weather in Minnesota, wait five minutes and it'll change.' Ha ha ha. That's so true."

I stare uncomfortably at him, waiting for him to stop and say, "You realize you get charged triple rates for my talking friendly with you." It's an awkward pause, but the world's friendliest oncologist presses on. "So, Scott. Or can I call you Scotty? Some of the staff indicated you're a little displeased in the hospital. Just so you know, we're planning on removing some of those bulky IV stands and life support systems to install some blackjack tables and slot machines. That ought to brighten your time with us, wouldn't you say? Hey, you might get lucky."

"Well, um, I guess. But that's not why I'm here. I've got some terrible pains in my chest and I don't know what they are. And about the hospital, I was just wondering if my insurance would cover my blood infection stay."

"Wow. I see you're really dealing with some issues here. I want you to know, I feel your pain. I tell you what, before we move on to the medical stuff, what do you say we have a cup of cappuccino and discuss our feelinga. Say, would you like me to rub your back?"

Maybe someday a gregarious and involved doctor will be the norm, but I was glad to have any relationship as long as I could trust them. Yet it always struck me odd that, considering the time I've spent with both of my main oncologists, it's curious that we didn't have a more personal relationship. Heck, I wrote to a couple kids after summer camp, and that was only for a weekend and neither of them saved my life.

The reality was the oncologists toured the floor because they had to. Since it was my life and all, they figured perhaps it would be a good idea to tell me where it was heading. That wasn't a bad thing as far as I was concerned, but if the doctor's intentions were bad, hurtful or misleading, that would have been a different matter. Mine were not. But just as there are people in every slice of life who use their communication skills and others who don't, or some who are hurtful and some who are not, oncologists followed the same rules. But due to the nature and demands of their jobs, oncologists were less likely to have a high percentage of extroverted communicators as opposed to, say, the Toastmasters.

I got along with all the oncologists who patrolled Masonic 3. My only heated clash was during my blood infection with one of my primary doctors. And, even then, I'm sure she only did what she truly felt was right for me. As opposed to the nurses, with whom I felt more emotional support and camaraderie, and counted on seeing the same friendly face, I didn't mind so much seeing a new oncologist every day. It was like trying a new ride at the fair -- I know the ride is popular and mechanically sound, many other people have enjoyed the trip and the likelihood of my getting hurt is minimal. The only hard part is trusting the toothless guy running the machine.

Instinctively, I trusted the nurses more. I followed the doctors orders and regimens, but my ties to them weren't as strong. The whole hospital system had a corporate feel to it. The doctor was like the CEO that the employees see only once a year at the company party. He or she makes all the vital decisions -- as well as a bundle of money. The CEO/doctor's decisions were passed to the nurses station, who served as middle management, then were given to my personal nurse who was my manager. The patients on the floor, filled the roles of the peon, minimum-wage hour workers.

I almost had pity for the doctors. On the material level they got all the accolades. They got big fat checks, wrote important papers and received all the credit. But in the end it was the nurses, the patients, the visitors and the family who seemed to learn the most. All the players in my real-life survival fight got a chance to grow as a result of it. The doctors who chose to see only the bottom line missed out on that growth. The ones who took the opportunity for growth couldn't always make it their highest priority. What the doctor got out of the relationship was a statistic, another mark in the win/loss column, maybe a bead on how to approach the next line-up. Since I had no choice but to look at my experience from all sides -- medical, emotional and spiritual -- I had a lot of potential for learning more about life. What a lot of doctors missed out on was what I and all who invested themselves into the experience got from it -- a chance to be more human.

I didn't think it at the time, but maybe what's wrong with health care in general is the loss of humanity. Without the emphasis on care, what's left is only health. As a science medicine will always be around to keep us around a little longer. But maybe, just maybe, it doesn't matter how long we keep each individual alive -- a few more years or a few more days. Since we will all pass someday, what matters most is the ability to come to grips with that -- finding peace with the life you have. Maybe health care, more than anything is just being there. A firm handshake can be health care and a warm hug. A smile is health care -- laughing, understanding are too. Communicating with love and without fear is health care.

I got health care from Cheryl. Every time we talked in the kitchen or sat on the couch together was medicine. Every time she talked about her mother's restful peace and her own grace I got stronger. Playing with the kids and eating a meal at mom and dad's house was health care. Comparing that form of health care to a doctor entering my room and not hearing a word I said because he's thinking of how he made a dot-to-dot with my x-ray that afternoon, I'd rather have the former.



copyright Scott Burton p.o. box 581083 Minneapolis, MN 55458 scott@sburton.com