mastectomy, chemotherapy
and radiation, she has been
hospitalized off and on for weeks
to treat an infection related to
her breast reconstruction. Still,
Slawson gives her oncologist high
marks for clarity and a sense of
humor. “She doesn’t talk like a
doctor,” she says. “She doesn’t
talk over my head.”
An analysis of Oncotalk,
involving 115 fellows, tracked a
marked increase in direct and
empathic language use following
the four-day workshop. Slightly
more than half of the fellows,
54 percent, used the word
“cancer” when delivering bad
news, compared with 16 percent
prior to the training, according to
the 2007 study in the Archives
of Internal Medicine. A spinoff
initiative, called Oncotalk Teach,
is training faculty members
at cancer centers. Forty-one,
including Saraiya, have completed
the program.
CR | Page No. 49 | www.CRmagazine.org
THE EMPATHIC DOCTOR
Empathy doesn’t necessarily
require a lengthy, tear-choked
exchange. Just a brief expression
of physician compassion,
40 seconds in duration, can ease
patient anxiety, according to a
1999 study involving breast cancer
patients in the Journal of
Clinical Oncology.
But such empathic exchanges
are relatively infrequent,
according to a more recent report
in the same journal analyzing
nearly 400 conversations between
oncologists and patients with
advanced cancer. In slightly more
than one-third— 37 percent—of the
conversations, a patient expressed
negative emotions, providing an
opportunity for physician empathy,
according to the 2007 study.
When that empathic opportunity
did arise, the oncologist involved
responded with empathy 22 percent
of the time.
Physicians often have a hard
time recognizing negative
emotions, but a patient can help
them, says Kathryn Pollak, one of
the study’s authors and a social
psychologist at Duke University
Medical Center in Durham, N.C.
“It’s much easier to say, ‘That
doesn’t sound good,’ than to say,
‘I’m scared.’ ” Express your fear
directly and be specific about the
type of help you need, she says.
“Say, ‘I’m really scared to tell my
wife about this. Can you help me
figure out what to say to her?’ ”
Sometimes patients may
directly ask a question—for
example, about their anticipated
life expectancy—and an
oncologist may be nervous about
responding, for fear of being
wrong or blamed in some way,
Policzer says. But patients can
ease those worries, he suggests,
by saying: “ ‘I won’t be mad if
you’re wrong. But I need to make
It’s possible for patients to find a physician they can trust emotionally as well as medically
my own plans. I need to have this
information.’ ”
Rosenthal, who recently
authored Everything Changes: The
Insider’s Guide to Cancer in Your
20s and 30s, is quick to point out
that not everyone shares her own
relatively thick emotional skin. And
sometimes scary or depressing
news can be conveyed particularly
badly, she says.
She still vividly recalls a pivotal
day, New Year’s Eve in 2007, at
her Chicago oncologist’s office.
A post-surgical ultrasound had
revealed a worrisome-looking
mass that hadn’t previously been
identified. Her oncologist fit
Rosenthal in at the last minute,
despite a jammed schedule.
“I’m lying on his [examining]
table and he’s digging all of these
needles into me,” she recalls.
“And he’s sucking this fluid out of
me. It’s painful and I can’t move.
Then he says, ‘It’s brown colored.
I always know when it’s this color
that it’s malignant.’”
For the physician to say that,
while she was immobilized, was
highly inappropriate, she says:
“I wanted to burst into tears,” she
says. But she couldn’t even glance
at her husband, just a few feet away.
Another 10 minutes or so
passed, Rosenthal says, before
all of the needles were removed,
allowing her to utter a choice
expletive or two, cussing out the
cancer.
