DRGEETAKADAYAPRATH 546efbec4ec0a40e503fb7e5 False 108 1
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'smart minds'
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SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… While all this continued as the standard of care for the first 65 years of the 20th century, some smart minds in the medical field started questioning the necessity of performing such radical surgeries to get optimum results. Trials got underway to compare mastectomy versus breast conservation surgery in the 1970s. A pathologist turned surgeon, Dr Umberto Veronesi, pioneered the most convincing trial in Milan. He was able to show that breast conservation surgery (removal of the lump with a surrounding 1 cm margin of normal breast tissue) followed by radiation therapy to the rest of the breast in properly selected patients yielded the same results as a complete removal of the breast. I am quite convinced that it is the pathologist in this surgeon who urged him to go for this trial. He had probably seen while looking at the breast as a pathologist that far too much was being done to address small cancers in the breast. Finally, women with breast cancer had a choice…. For more information on breast cancer, please contact Dr Geeta Kadayaprath, Breast Surgeon, Max Cancer Centre, Delhi, India
RISING TO THE OCCASION Yesterday, this beautiful young lady of 33 walked into my room. I could see she had had chemotherapy as a smart bandana adorned her bald head. She was accompanied by her mother and her husband. Her dazzling smile and her confidence as she took me through the journey of nursing a 6 month old baby, of discovering a lump which was labelled benign at first, of the lump growing in a month and she, of her own volition going for a biopsy and discovering she had breast cancer, shook me! She had visited 3 or 4 hospitals for various reasons and is on the verge of completing chemotherapy. She had come to meet me to discuss the surgical options and the implications. She told me that she was scared of needles and pain but her composed demeanour conveyed something else. I could see, I was having the privilege of interacting with a woman of utmost strength, resilience, poise and maturity way beyond her years. Her smile never left her face. Her mother contributed positively in equal measure but the sadness in her eyes of seeing her little girl suffer did not escape my notice. She required to have an injection to up her white cell count. She went to the nurse in the treatment room for the same and showed her a prescription for the same on her mobile, from a different hub of the same centre as ours. She refused without thinking what she could have done to help her-a cardinal mistake! The nurse was following a process, which said no medication without prescription, which was fine. What she did not do, was figure out a method to solve the problem. She could have got a print out, on our institute’s letter head and cross checked with the prescribing doctor and administered the medication. What happened next was no surprise. The mother was outraged. She had accompanied her daughter across half of Delhi for a consult and this Nay from the sister, truly rocked her frail boat. She truly took the nurse to task for being unhelpful and uncaring. The situation was brought to my notice.The matter was sorted out, a printout of the prescription was taken and the injection was done. However, the bitter taste in the mouth remained! I know for a certainty, that the only people who go to hospital, happily, are doctors and the staff at work. The ailing come, as they don’t have an option. They entrust us with the job of sending them back, cured or relieved of their ailment. We, as caregivers, should never forget to look beyond and see the footprints that they have left behind, as they walk the difficult path to meet us. There is a story, sometimes, most heart rending, that we need to know- a story that should only raise our level of empathy. Each one of us has to walk that extra mile, go beyond our call of duty to ensure that we do our best for the person sitting across the table, entrusting us with making some of the toughest decisions of their lives. We, as professionals, have to really rise to the occasion, every single time!
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