中A month has passed since my operation. Time for the post-op review, which brought me back to the hospital for the first time since my discharge.
Before heading to the ENT outpatients, I popped around to the ward to deliver some biscuits to the staff who gave me excellent care. Since I arrived at non-visiting hours, the sister who let me in initially thought I was a visitor who hadn’t made an appointment. I showed her my scar, pointed at the bags of biscuits, and explained that I was an ex-patient returning to say “thank you”. We exchanged a few warm words, but I didn’t keep her for long because, well, we all know it, the ward was always busy.
I had a little spring in my step as I made my way to the ENT outpatients, looking forward to meeting my consultant surgeon Mr J again. Not only was I not in such a jolly mood in my last two visits there (the initial referral, and getting the diagnosis post MRI scan), the waiting room was also full of people back then. Six months on, gone was the ninja, so were most of the patients; those who were lucky to have face-to-face appointments like me sat far apart from one another, masks on.
There were two key topics I wanted to discuss with Mr J. First and foremost of course was the analysis results from the biopsy. Related to that, I was also keen to know the conclusions drawn on my case by the multidisciplinary team (with consultants from ENT, surgical medicine, oncology, pathology and others). At that time, I still believed I had a few months to prepare for radiotherapy, regardless of the tumour being benign or not.
I had a glance at a monitor loop displaying the names of consultants on duty, and the estimated waiting times for the consultants’ clinics. Mr J’s name was nowhere to be seen! How disappointing...... which means I wouldn’t be meeting Mr J. So who would be following up my case? I saw my other surgeon Mr F’s name. Probably him then?
Yes, indeed. Finally I got to meet the surgeon who was assigned to my operation. In contrast to how Mr J always dressed smartly in shirt, pressed trousers and polished shoes when we met, Mr F was in scrubs (“surgical greens”) and anti-slip surgical slippers, perhaps squeezing time to see me in between performing operations.
“Mr F, it’s nice to get to meet you in person finally!”
“We’ve met before, but you were asleep,” was his response.
I thanked him for the successful operation, to which he said Mr J also contributed. Since he was the one who put the knife to my neck, I also couldn’t help but shared my amazement on the pain-free post-op experience. He didn’t seem to think it’s that important, “ah, numbness is fine, isn’t it, it doesn’t get in the way.” (At that time I still hadn’t learnt from Mr J about the trick of severing minor nerves in my operation.)
What new insights did I pick up from Mr F? Well, none. He mentioned the tumour bursting and subsequent spillage, as well as the presence of malignant cells in the biopsy. That was it.
Radiotherapy could only commence when the wound had healed sufficiently. It was only then that Mr F paid a bit more attention to me, the patient in front of him, when he had to examine the scar. “Ah, it looks fine.” I guess that’s the main, if not the whole point of the follow-up? If without the need for such an examination, would I have been given this precious face-to-face appointment?
Mr F knew from my records that I had an almost back-to-back appointment with oncology right after his (as organised by the hospital, not me). He wasn’t showing me the door, nor rude, but terse. There didn’t seem to be anything else about my illness that he felt worth sharing with me. I picked up all the signs and knew it’s almost time to round up the conversation.
“Any more questions?”
Questions? What questions could I have when I had learnt nothing new? If he had delved into the biopsy report or the conclusions from the multidisciplinary team, perhaps I would have asked for clarifications here and there.
It’s time to go. Before parting, a thought occurred to me that I should ask for a copy of the biopsy report, so I could munch through it in my own time, or seek opinion from my learned friends.
May I have a copy of the biopsy report so I can have a look at it in detail later?
“Sure.” A few warm pages, fresh from the printer, duly delivered. They turned out to be the most valuable take-away from the meeting.
Throughout the consultation, Mr F was looking at the computer monitor for most of the time. To be honest, I have no recollection of his face today.
Next, oncology. Another consultant.
Once she ascertained that I had family support in the UK and mentioned the tumour spillage, she dived straight into the details about radiotherapy: the dose, treatment frequency, as well as a long list of possible side effects, some with technical terms which were new to me. It took her some half an hour to go through all the details, and she wasn’t a slow speaker.
To finish off, she handed me a few thick documents regarding radiotherapy for reference, as well as presented me with a consent form for radiotherapy, waiting to be signed, as if it’s just a formality.
Isn’t it a bit strange that all patients are expected to, at the drop of a hat, sign this form? Is the fear factor really that high against cancer?
Needless to say, today I cannot recall the face of the consultant oncologist either. We didn’t meet or speak at all during my radiotherapy journey.
Is this what standard, non-old school care is like? Where are you, Mr J?
I signed it after all —— not under duress, of course, that would have been illegal and immoral, ha!
I just wasn’t given time to think about it.
The operation was a must, that I had no doubt whatsoever after meeting Mr J for the first time. But how about radiotherapy? Was it also a must? What would be the consequences if one chooses to skip it? What were the main clinical reasons supporting the decision for radiotherapy? Tumour bursting and spillage?
Why did I, as a scientist, who was trained to think rationally, give my consent in spite of the unanswered questions?
I guess it’s largely based on Mr J’s remark that “radiotherapy would follow even if the tumour was confirmed to be benign”? And since the tumour wasn’t benign and had a record of spillage, the evidence supporting radiotherapy was stronger, right? Another thing I was counting on was the professionalism of the multidisciplinary group of experts, whom I trusted wouldn’t have recommended any non-essential treatment.
I had a quick scan of the biopsy report prior to meeting the oncologist. The sea of Latin words was quite hard to cut through.
“There is a small cancerous part in your larger tumour”? Who said so?