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 death…and 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”