Its not the patient's fault

It is never the patient's fault [unless their ailment was preceded by vast quantities of alcohol and the slurred statement of 'watch this!']. So why do people persist in being so insensitive to sick people? And then there are the people who know what you need to get better even though they never went to medical school. Or their religion will solve your problems.

"You have lung cancer, how many years did you smoke?"
"You have breast cancer, didn't you get your annual mammograms?"
"You just need to exercise and eat better and I'm sure the first 100 pounds will easily come off."
"You didn't pray enough so of course you got cancer." 


Whatever, if you have the ailment you find this all rude, insensitive, and sometimes worthy of a public bashing (e.g. Facebook slam).


But do you expect to run into it from practitioners of alternative treatments as well? I have from my accupuncturist. But at the same time she didn't understand the ramifications of my ailments. She would also ask when my lymphedema was going to resolve itself.

One person in this article is asked by their reflexologist after prostate cancer surgery - what did you do to bring this tumor on? And you hear the stories about someone passed away from cancer - and it is implied that they did not fight hard enough.

Sick people are people too. They may be going through a bad time in their life but they are still are people with feelings and sensitivity - and may be extra sensitive because they aren't feeling well.

Its not their fault.

Stigma over health issues

No one deserves any health issue. However I can say there are two types of ailments:

1. The ones which just happen - whether a cancer diagnosis or a car accident. There is not much you can do to avoid them. You may have increased your risk by smoking or driving without a seatbelt but the stars aligned for you.
2. The kind of ailment which is preceded with alcohol or other intoxicants and the statement along the lines of  'hey, watch this!'.

The first category there is no blame. Should be no stigma. Nothing. The patient needs to accept that it happened, and learn to cope with the treatment and resulting lifestyle changes. Some of these are harder than other. I mean a broken leg is much less significant than a cancer diagnosis or multiple sclerosis or cystic fibrosis. But there should be no blame on the patient what so ever.

The second group, I call the self inflicted ailments, that may also involve interaction with public safety officials are clearly containing some blame. It is never a good idea to try to duplicate stunt scenes from TV and movies, nor is it ever smart to do anything that has questionable legality or other such ideas. To these patients I would be happy to lay some blame on them for the self inflicted activity which preceded the ailment.

So why is there a stigma attached to so many ailments. Non smokers get lung cancer. Not all smokers get lung cancer. If someone gets lung cancer it does not automatically put them in to the self inflicted group of ailments which is wrong on so many levels. I did nothing to get my large share of medical ailments so no one should blame me.

Participating in the post cancer life without criticism

Yes we must participate in our lives post cancer. We need to do the right things in order to stay healthy and help reduce the chance of recurrence. The best things we can do are the things that all adults should do - they simply become more important:

• eat right
• maintain a healthy weight
• exercise
• reduce/avoid alcohol consumption

But as an additional stressor, we tie in the emotional impact of our cancer diagnosis.

Dr Bechold, here, writes about life post cancer as not a passive sport. I agree with her points but disagree with her tone. First of all, clearly although she has been a doctor for 30 years, she clearly has never been diagnosed with cancer herself. Back to if you haven't walked the walk, you can't talk the talk.

Second of all, she seems to blame the patients for their non compliance with recommendations for exercise, healthy lifestyle, and recurrence risk reduction.

"You can’t see that breast cancer survivor every 3 to 6 months, watch her weight balloon up, and not ask her what is causing this to happen. We must take time to talk to people and ask about their lives and how they are living each day with an eye on remaining cancer free. I had one patient who was clearly having some anxiety issues. As we talked, I found out that she was self-medicating every evening with a bottle of wine. While she graded papers! After I picked my chin up off the floor, I advised her that this was not an acceptable coping mechanism."

Hmm... so back to the patient whose weight was ballooning up. Did she ask about weight gain caused by Tamoxifen or aromatase inhibitors or chemotherapy or just plain emotional stress? Maybe what we used to eat and maintain a healthy weight, now makes us gain weight? I know I have tried to eat healthy and my weight has definitely increased. I go to the gym regularly but my medications cause weight gain and my other ailments have reduced my ability to move around. I know many other cancer patients who deal with similar issues.

And to the patient who self medicates with a bottle of wine - clearly a destructive behavior - but why was she so astonished? If the patient had anxiety issues, why hadn't other interventions been taken previously such as therapy?

Finally, I am somewhat appalled by this closing paragraph:

"No more excuses. No more “I don’t have time,” or “It’s too cold out,” or “I know I should, but…” It has to be done. Just like getting up every morning and going to your job—no-shows are fired! If you don’t buy gas for your car, it will not run. If you do not buy food, you will be hungry. There are just things you have to do. Compliance is required for a pill or a lifestyle and failure to comply will compromise the outcome. No matter how many tests we order."

From the point of view of a relatively healthy, active doctor, who looks fairly thin in her picture, without a cancer diagnosis under her belt, I am sure she thinks its easy. But she needs to walk a mile in hour shoes before she can criticize us. I am just glad she is not my doctor.