A Traumatic Experience of a Breast Cancer - Essay Example

Breast Cancer Biopsy: A Traumatic Experience My story tells of what happened to my mother in 2002, when she found a lump in her right breast. Her doctor sent her for a mammogram, carried out at Memorial Hospital. They told her she would need a biopsy, so I went with her to support her. The biopsy was performed with no anesthetic; a large needle was inserted into her breast. She could see and feel everything, the pain showed clearly on her face and in her body language. I was so horrified, and cried for her. Then one week later, the lump had returned and this time, they carried out a needle localization procedure, followed by a surgical removal of the lump of tissue. After all this, my mother's fear and pain, the whole trauma of the experience has made her too frightened to visit her doctor. What happened back then showed me how the way in which a person is treated can affect them for the future. If we had been fully informed, step-by-step as to why things were happening, then maybe my mother and I would have a different view of the medical profession. They did not communicate well, and I do not think they respected my mother enough. This came as a surprise to me, because Memorial was the place where I had my two babies and I was treated well, I would even call it my favorite hospital. When I was thinking back on what my mother suffered, I looked at the hospital's Mission Statement about patient care and communicated. They state clearly the ways in which staff should behave, and how patients should be treated. For examples, Core Standard 4 is "Utilize Effective Communication" "We must be committed to listening to our customers in order to fully understand their needs while maintaining confidentiality and safety." (Memorial Hospital) For me, listening is not just about what people say, but about looking at their expressions and reading body language. It also means taking into account different languages. If this had been done, my mother might have accepted better what was happening. But they just went ahead, not checking our understanding. This did not match with Core Standard 5, which says: "Treat everyone as if he or she is the most important person in our organization: Respond to all customers with care, concern and empathy." (Memorial Hospital) At the first biopsy, I truly believed they should have numbed the breast. I still feel guilt and shame that I did not insist on this being done, as I watched my mother's pain. In researching the process of diagnosis for breast cancer, I found that when a fine needle is used in the first biopsy, it is sometimes considered more uncomfortable to put in the local anesthetic than just inserting the needle. But with my mother, a large needle was used, so this must have been a core needle biopsy, but nobody clarified exactly what or why things were done. I know I should have spoken up, told them to stop and give her an anesthetic, but I did not. In writing my story, I looked at the American Cancer Society website, and it states that a local anesthetic should be given for this biopsy. I ask the question, why did nobody consider her needs They seemed to think, after this biopsy that it was cancer, another frightening thing to deal with, along with the pain. When we returned the next week, the needle localization took place, followed by 20 minutes of surgery to remove the lump. My research tells me that this might have been an 'incisional' biopsy, which "Takes out part of the lump to be examined by a pathologist. Uses local or general anesthesia." (Editorial, Native American Cancer Website). Or it might have been an 'excisional' biopsy which, "Takes out the entire lump or the suspicious area. Used for lumps that are small. Uses local or general anesthesia." (Editorial, Native American Cancer Website) My point is, why were my mother and myself not fully informed as to what was taking place The hospital standards say it will treat people as important, always keeping them informed, but I believe this did not happen. Both my mother and I remained in doubt and fear. Researching for this essay has given me some idea as to why things happened as they did. I found an abstract from an article on research into doctor-patient communication, which fits well with what happened to us. The Conclusion is quoted here to show how this matches our experience: "This study indicates that patient demographic factors, such as race, income level, education and age seem to influence the amount of time physicians spend in almost all communication categories with patients. One recurring difference across most communication categories was race." (Siminoff, Graham and Gordon, 2006) The sad fact remains that my mother mistrusts the medical profession, which could be a dangerous thing as she is now 70 years old and should be able to go to her doctor and expect his help and support. I know he would give this, but the damage has been done by that experience back in 2002. I spoke to her to find out her true feelings and she told me she would use the power of prayer and her own herbal remedies to stay well. This is part of our Haitian culture. When I reflect back on these events and try to make sense of what it means to me, I see how negative it all was, but believe that the positive learning from it is good. I know how I would behave differently next time. Most important, if I want to have a career in radiology, as a medical professional, I am very clear on what not to do with my patients. I think both my mother and I were frightened and traumatized by the threat of death from cancer. Another issue was that we believed completely in the medical 'experts' who seemed almost god-like and had more power and knowledge than we did. It was putting yourself entirely in their hands, because they knew so much and we knew so little. I was in that room when the doctor told her she could scream as much as she wanted, and I myself was crying. This seemed cold and unkind at the time, her feelings of privacy and modesty were also ignored. In looking back, I believe there may have been racial and educational issues, which allowed the doctor to behave that way, and made me keep quiet when I should have spoken up on my mother's behalf. But I did not fully understand what the doctor was saying, about the technical aspects of the procedure; English is not my first language. Why did the doctor not check this out and make sure an interpreter was present As I said earlier, understanding was not checked or matters clarified, our emotions were ignored. Negative feelings towards people from Haiti and cultural differences played a part in what happened, as at the time, boat people were being put in detention camps and treated as a nuisance. Haitian immigrants of any status had a bad image. I have thought about these matters in making sense of the events. In another article I found, by Charles Kemp (no date) he mentions that Haitian people do not like to speak up to people they believe to be better than themselves, and do not like confrontation. Certainly the doctor was better off and had more education than we did, so this may be why I kept quiet. About two weeks after the lump was removed, my mother received a letter that told her there was no cancer, and everything was negative. That was two weeks of fear, pain and uncertainty, all because the lack of communication and respect during the diagnosis left us unsure of what had been done and what to expect. Thankfully, now she is well, but I know neither of us will ever forget the terrible experiences of those few weeks, it still haunts my mother, so many years later. I have learned from it, I am happy to say. Where I deal with medical professionals in any role, I will make sure I ask questions and get clear answers and so will be able to make choices and to be part of the treatment. I will not just accept what is being done, but I will be assertive and ask for all the information, pain relief, explanations, other opinions and so forth. I recognize that doing this is not just to cause trouble, but is a right for every human being in pain or need who seeks help from the medical profession. This is learning I intend to take forward, so that when I treat people in a health care situation, I will see the whole person, and try to meet their needs. I understand how communication is not just telling or talking or filling in history sheets, but about looking and listening and reading signals. It is about involving the patient, respecting their needs and individual differences. I intend to involve family members too, always checking understanding and seeking permission to continue, taking their feelings and views into account. I see how important it is to consider a person's background, culture and language. The most important learning point for me, on reflecting back on my mother's experiences, is that communication is the key. Not just that, but seeking ways to reduce discomfort, to help people deal with their fear and pain is a vital part of the health care role. While I accept that there will often be discomfort and pain, I believe it is the responsibility of the medical profession to relieve this with every means at their disposal. They must treat the patient as a whole person, not just a 'case' or a 'test candidate'. In conclusion, I would say that by looking at this experience with the medical profession, I have become aware of many issues, personal and professional. I am hopeful that these will assist my own personal development, though fear it is too late for my mother to see anything positive. I have increased my knowledge of the diagnostic processes involved in detecting breast cancer and learned something about physician-patient communication and what behavior should be in place. The biggest issue here is definitely communication in all forms. By looking at aspects of Haitian culture, I have deepened my understanding of my own behavior at that time, as well as recognizing the prejudices that may get in the way of giving respect and human kindness. I have identified the meaning of Mission Statements, and see how they should be put into practice. By seeing how things should not be done, I believe I have learned how they should be done and will act on that knowledge in future. I believe in the right to ask questions and to seek help. I think also that I could improve my assertiveness skills so that I am more able to deal with any situation that causes problems. This would be a good thing to do for my future role as radiologist, as well as parent, wife, daughter. It might be that I can one day convince my mother that out of bad can come good. I certainly hope so. Reference List Diagnosis: (n.d ) Types of Procedures to Determine If a Lump or Suspicious Cluster is Cancer. Retrieved January 8 2007 from http://natamcancer.org/page133.html How Breast Cancer is Diagnosed (n.d.) American Cancer Society. Retrieved January 8 2007 from http://www.cancer.org/docroot/CRIcontent/CRI_2_4_3x_How_is_breast_cancer_diagno Kemp, Charles. (n.d.) Refugee Health- Immigrant Health. Haitians. Retrieved January 8 2007 from http://www3.baylor.edu/Charles_Kemp/haitian_refugees.htm Interview with Mother, January 5 2007. How I Feel About Biopsy and Visiting the Doctor. Memorial Healthcare System - Memorial Breast Cancer Center (n.d.) Delivering a Superior Standard of Care. Retrieved January 7 2007 from http://www.mhs.net/CancerInstitute/BreastCancer.aspx Memorial Healthcare System - (n.d.) Our Mission and Vision. Retrieved January 7 2007 from http://www.mhs.net/employmentmission.aspx Siminoff, L.A., Graham, G.C., and Gordon, N. H. (2006) Abstract from Research Cancer communication patterns and the influence of patient characteristics: Disparities in information giving and affective behaviors. Patient Education Council. Retrieved January 8 2007 from http://www.ncbi.nlm.nig.gov/entrez/query.fcgitool=abstractplus&db=pubmed &cmd=Re. Read More