Now I have a new appreciation for my good fortune in not having had much experience with hospitals—so far. As I was reading these memoirs–mostly about cancer–I made note of the bits of advice I read on how to cope with a serious illness. It seems a bit offensive, or at least overly simplistic, to sum up these profound experiences in a tips list, but the writers themselves seemed eager to try to help others learn from what they went through. So here goes:
For long periods of suffering, take it day by day. Don’t anticipate.
Being gregarious and upbeat wins you more attention from the staff. This isn’t fair, but it’s true.
A lot of living goes on in the course of dying. Don’t postpone things—like seeing friends—until you’re “doing better.” You may never do better.
If a friend is sick, show your concern. Don’t assume he or she will know, or will ask for your help. Caring silently from a distance looks like denial, or lack of concern, to the ill person.
As a friend, don’t forget about caregivers, who not only help the ill, but also share the life they lead—and aren’t cut as much slack as the person who is sick. For example, they often keep working, while assuming a huge number of new responsibilities and worries.
I wonder whether it would help or hurt you if you mentioned to the medical staff that you were writing a book about the experience.
Unfortunately, although these memoirs are packed with accounts of doctors, nurses, and others who were wonderful, they’re also crammed with stories about devastating problems and hideous frustration with doctors, nurses, and hospitals.
From this, I took the following lessons:
o You need to educate yourself as much as possible. Doctors don’t have the time or the emotional energy to explain all the possibilities to patients and their families.
o Write everything down. It’s hard to take in information the first time you hear it. And keep thorough records for insurance purposes, too.
o Every additional course of action carries pitfalls: side effects, pain, the difficulty of recovery from surgery, subsequent infections, time in the hospital, the real possibility of medical mistakes. So resist the impulse to “do everything.”
o Double-check everything you can. When my father was in the hospital, his doctor told him not to drink anything, then a nurse urged him to take a pill with water—which would have been disastrous, if he’d done it. A friend who went through chemo had a special notebook where she wrote down her prescriptions, and checked her notes against the chemo bags before she allowed each treatment to proceed.
o Before following a course of treatment, press as hard as you can—is this procedure absolutely necessary (e.g., do you really have to have that enema)? How painful will it be? How invasive is it? What other options exist, and are any of them less invasive, painful, etc? What will happen if the procedure isn’t done? Arthur Frank refused to sign a consent form when his doctor didn’t explain an operation to his satisfaction—and then ended up not having it at all.
o Note that the medical staff often minimizes the discomfort and difficulty of treatments. Perhaps this arises from a desire not to be discouraging, but the effect is often to make it difficult to plan (will it really be possible to go back to work within a few days?) or to make patients feel that they’re complaining unreasonably.
o Stay with the patient as much as possible. I don’t know what the visiting rules are in hospitals, but having read these books, I don’t think I’d leave a patient alone there, ever, if I could help it.
o Insist on understanding the true prognosis. In several accounts I’ve read, people reflect sadly that they didn’t really understand that the patient was going to die. And so they made choices they regretted—for instance, resisting using methadone, despite its effectiveness in fighting pain, because of its addictive properties. A ridiculous concern to someone who will die in three months! Terrible news is hard to hear, and it’s hard to give, so if you want to know, you need to push. Stan Mack recalls that Janet’s doctors’ talk was “ambiguous.” He recalled a doctor saying, “You don’t have a curable cancer anymore, but with medication there is a subset of women who…” They didn’t understand what they were being told.