Trusting the Doctor
By MIKKAEL A. SEKERES, M.D.
Martin Barraud/Getty Images
We drove along the dirt and gravel roads of western Massachusetts, on our way to the Umpachene Falls.
Every summer my family and I stay for a few days at my best friend’s lake house in the Berkshires and engage in our silly rituals. Jumping off the dock into Lake Garfield while shouting “Kowabunga!” Paddling the kayak across the lake to visit the photographer whose dog once jumped onto the kayak’s deck to see if he’ll do it again. And going to the Falls.
We passed the occasional penned horses and llamas, ignored the sign warning us that, somewhere up ahead, a bridge was out, and turned into a grassy parking lot. We could hear their roar, muted by a wall of trees. I turned to my 9-year-old daughter, who was sitting in the back seat of our rental car, and asked, “Do you think you’ll do it this year?”
She nodded tentatively. Her 12-year-old brother, a three-year veteran of the falls, tried to reassure her. “It’ll be easy!” She smiled, her confidence slightly bolstered.
As the Umpachene River dumps into the Konkapot River, it creates a graded set of falls. Some are so mild we can traverse them with a simple step, but the lower portion of the river culminates in a six-foot drop, behind which is a shallow cave. Years ago we discovered that if we thrust ourselves into the falls, holding our breath while withstanding the force of the water, we could make it to the other side and sit in the cave breathing freely, the water inches from our faces.
It had rained the previous night, so the rush of water was particularly heavy, and cold. My buddy and I stood to one side. As was our routine, he went first.
We have been best friends since playing Little League baseball together 35 years ago, and I would follow him anywhere, without question. He disappeared under the falls. I waited a few seconds, and followed. The water was frigid and powerful, but only for a few moments. To make it to the cave was thrilling.
We emerged after a minute to find my son at the ready. As he dove into the falls, I turned again to my daughter, asking her if she was all set.
She nodded and came over to me. I wrapped my arms around her and we turned, our backs to the falls. “When I count to three, hold your breath and I’ll pull you through. O.K.?”
“Yes,” she squeaked, and closed her eyes. I counted, and she took a deep breath as we collapsed into the wall of water.
When I returned to clinic the following week, I got some rotten news. One of my patients, a 63-year-old man with leukemia, had relapsed after having been in remission for two years.
“O.K., so what’s next?” he asked.
His wife was sitting next to him, still processing that his cancer had returned. He was the type of person who didn’t dwell on questions of how this could have happened, or what if he had tried a different therapy. He also adored his wife, and more than once had whispered to me conspiratorially, “Can you believe I’m married to a girl as beautiful as her?” She was pragmatic, and made decisions deliberately; he was the romantic.
“You need to seriously consider a bone marrow transplant. It’s your only chance of being cured,” I answered.
His wife spoke up. “Well, you told us this might happen, so I did some reading.” She then asked a series of highly intelligent questions about the nuts and bolts of the procedure, his likelihood of finding a bone marrow match, complications, and his chance of being cured. He remained quiet.
When we had finished she turned to him. “I can’t tell what you’re thinking. What do you want to do?”
He smiled, in a way that indicated he appreciated that she would ask so many questions on his behalf, and that she cared for him enough to be bothered by his silence.
“Awww, you know I’m not smart enough to understand all these big words you two are using. I trust the doctor, and if he says this is what I should do, then I’ll do it.”
“Now wait a minute,” I jumped in. “I know you’re a smart guy. If I’m not being clear in explaining the transplant, I need to start over and describe it better.”
He smiled again. “Doc, I get what you’re saying. But no matter how much I understand it, I trust you, and I’m going to do what you suggest.”
I fought the urge to start in again, to outline each step of the transplant procedure so he could decide for himself what course to take. I was also reassured that his wife was there, advocating for him. Because in the end, aren’t most of our major life decisions based on simple trust? Like falling backward into a waterfall.
Dr. Mikkael Sekeres is director of the leukemia program at the Cleveland Clinic.
No comments:
Post a Comment