The Light Within – opening discussion

This week we begin our discussion of The Light Within. The subtitle of the book is The Extraordinary Friendship of a Doctor and Patient Brought Together by Cancer and it is that focus on the relationship, a story told from two different perspectives, that gives this account its unique appeal.  It is probably safe to say that we have all given thought to our relationship with our own oncologist.  Many will read with fascination at the growing bond between “Dr. Lois”, a gynecologic oncology fellow and her ovarian cancer patient, Deb.  Is it the kind of relationship we wish we had?  Maybe and maybe not.

Last week I asked that readers consider the relationships they have had with their doctors.  What kind of things determine what that relationship is going to be like?  The personalities involved, their backgrounds, their life philosophies, the physician’s professional philosophy and training, past experiences with patients, with physicians, how the patient is coping with the diagnosis.  All of these factors are relevant and help to influence how the relationship will take shape.

I think that in this case the female sex of both the patient and physician perhaps create a fertile ground for a friendship to develop.  Both women, at various points in their growth as persons, have been drawn towards the study and appreciation of spirituality.  Dr. Lois majors in religion in college and joins the chaplaincy program.  Deborah, as we know, is a professor of religion.  Both seem given towards a contemplative approach to life.

After first reading the book jacket and several reviews I was a little surprised to find that, when we first meet Deb, she is an angry and resentful patient.  And the young oncology fellow is “clearly very tough.”  Although later she describes herself, especially early in her residency, as “radically empathetic.” It is interesting to hear Dr. Lois’ account of her residencies and internships – the long hours, lack of sleep, being on call, having to make life-and-death decisions, making mistakes, learning from them.  Equally interesting is Deb’s description of her own initiation into the dark world of cancer.  “I am what they see before them.  There is no other self, a self who might have been or who once was.  There is just me.  And, yes, I’m sick.”

I think that it is probably significant that the two met during the resident’s formative years as a physician.  The doctor says “Every day I was sitting with women who were facing almost certain deathand I wanted to know absolutely everything about them.” Very early in the book we are allowed to see behind the glitter of this budding relationship.  The young Dr. Lois sees her life in shambles, not a normal life, rarely seeing her husband and young daughter.  Deb’s husband rallies to her side but her teenage daughter is going through doubly difficult times, fostering educational and legal complications.  Behind the facade of professional patient-physician relationship, life goes on with all its stresses and difficulties.  So it is against this backdrop that their friendship blossoms.

Dr. Lois writes about the difficulties of learning to talk with patients about death and learning how to listen.  It is a skill that not all physicians learn well.  She believes that it is essential for the doctor to really know the person that is the patient.  She believes that without that knowing, without trust, there can only be “brutal honesty or a total lack ot it.”

Deb is surprised by the recurrence of her cancer.  Not that she didn’t know it was statistically probable but that she felt so well, so full of life at the time.  It is about this time that her daughter, not coincidentally, decides to be problematical.  And Deb responds with some degree of anger.  This should be her time.  She has spent a life of giving.  She wanted them “to stand with (her) in this fight against the forces of darkness, but they had their own demons to fight.”

Reading Assignment: Chapters 4 and 5 (pages 59-122)  “The Great Equalizer” and “The Art of Dying”

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About Dennis Pyritz

Dennis W. Pyritz, RN, BA, BSN, has been a cancer nurse since 1987 and a cancer and bone marrow transplant survivor since 2004. In December 2001 he was diagnosed with t-cell prolymphocytic leukemia (T-PLL), a rare aggressive form of chronic lymphocytic leukemia (CLL). Dennis was treated with the then new monoclonal antibody, alemtuzumab (Campath) as this disease has a median survival of 7.5 months. He achieved a 26 month remission but relapsed in February 2004. He was retreated with Campath and went into a second remission. In August 2004 he underwent an allogeneic peripheral blood stem cell transplant with his brother, Mark, as donor. Dennis has remained in remission since - a near miracle. Throughout his career as cancer nurse and patient, Dennis has had the opportunity to speal to both lay and professional groups. Dennis has spoken on cancer topics and survival issues across the country as well as in the United Kingdom, Norway, Austria, Portugal, Honduras, Panama, Guatemala, Trinidad, United Arab Emirates, Jordan, Cyrpus, Israel, and India.

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The Light Within – opening discussion — 7 Comments

  1. I have been nearly glued to the book since I got it. It is beautifully written from the patient POV and of course, with the doctors input, it’s helpful to define their relationship. I could see this kind of relationship develop over time though my gynecological onc gets kind of fresh (subjective — i know). The last two visits, he seems to become more genuine (and human). Maybe I stopped judging him because I realize I’m in this for the long-haul. I asked him why he got into this field and that was also asked of Dr. Lois by Deb.

  2. I think the book would be difficult to read for ovarian cancer patients. It is a difficult book to read unless you can get past your own cancer and relish the relationship developing inside the story.

  3. I am an Ovarian cancer survivor with a recurrence after two and a half years. I wasn’t sure if I wanted to read this book – thinking it would be too difficult.
    So far that has not been the case.Rather, I found myself agreeing with Deb on many issues especially when it came to her relationships with others before and after cancer. Reading the book so far has been like being in a support group listening to another survivor tell her story.
    I am lucky. Like Deb, I have a wonderful relationship/ friendship with my gyn-onc who also happens to be female.( Five out of the Six gyn-oncs at my center are female.)

  4. I began reading “The Light Within” yesterday, and I am also finding it hard to put down. I am particularly interested because my undergraduate major was Philosophy/Religion. In fact, reading this book is making me wonder if I should pursue religious studies rather than Music Therapy for my graduate degree! I find myself relating to Deb quite a bit in certain part of her reflection on her experience. On p. 7, she writes about her life right before the discovery of her cancer “But I was always tired, often sick, and even, at times, inexplicably unhappy- so much so that on the drive to work I would occasionally cry for the full hour.” In the months leadng up to my own cancer diagnosis I also found myself “inexplicably unhappy.” I burst into tears on several occasions at my current place of work, and my inability to “keep it together” eventually led to my quitting that particular job. The night before I learned of the 17cm tumor that had been hiding inside of me, was the same night I had been present at the premiere of a film my original songs had been featured in, yet I cried myself to sleep. Perhaps our unconscious mind is more aware of what is going on our body than we are sometimes. Another part of the book that stuck out to me, but I can’t seem to find where I read it, is a part where Dr. R (Lois) says to Deb that, in her opinion, Deb looks so much more radiant and alive NOW (during cancer treatment) then she did in the pre-diagnosis pictures. This is interesting when considered along with Deb’s own refleciton on how being treated for cancer really brings you into the “NOW” as in Ram Dass’ “Be Here Now.” Overall, I am enjoying (though this book is a tearjerker, especially when I look at the beautiful photos!) being able to see the intersection between the lives of Deb and Lois. They both come across as intelligent, interesting and “interested,” as Lois might say, women. (One more thing that I liked is the description of Deb listening to classical music and painting in her hospital room during the BMT! It sounds like the kind of thing I would like to do in that situation, but might not have thought possible. I can see why Lois was interested in getting to know her!)

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