Nfld. & Labrador·Blog

Dr. C: I'm cheating on my cancer doctor

Dr. Nikhil Joshi has been trying to be a model cancer patient, he writes, but he's finding it difficult to follow all the rules.

Dr. Nikhil Joshi realizes it can be hard to follow doctor's orders

Dr. Nikhil Joshi can't stop thinking about pizza. Mmmm..... (CBC)

I'm thinking about infidelity. I want to cheat. I know I shouldn't. Doesn't everyone know they shouldn't cheat? 

But I can't help myself. It's been months. Long, hungry months. I just imagine what it feels like. I know it's delicious. I can almost taste the cheese and pepperoni. 

The object of my desire is a slice of pizza. 

When you get diagnosed with cancer, there is a part of the first meeting with your medical team that sticks in most peoples' heads. 

That's the part where they talk about the treatment, what will happen to you and how your life is going to change.  I remember I was full of bravado walking into my doctor's office. What was she going to tell me that I didn't already know? 

I was going to get chemo, I was going to be nauseous, I was going to be susceptible to infection. Big deal.  But then she told me something far more scary. 

She told me I couldn't eat out anymore. 

Weak immune system means danger

I would have to give up fast food because the cleanliness of the food may be questionable. 

Let's be honest, if someone's going to sneeze on your burger it's going to happen in a fast food chain, and if you have a weak immune system and you get food poisoning, you're entering dangerous territory. 

But it didn't stop at fast food. I had to give up eating at ALL restaurants. Same reason, people could be sick. I also couldn't be in a crowded movie theatre or nightclub. 

I was unhappy with these changes, but I realized they were for the best. So I tried to be a good little cancer patient, and listen to my doctor. Doctors love patients who listen to them. 

I'll be the first to admit that before all this happened, I didn't understand why people don't do what their doctors tell them. 

Doctors sometimes miss the point

But now I can say: sometimes we miss the point entirely. Sometimes we don't see the person we're treating. 

I guess that makes sense. The triumph of modern medicine is that you can replicate it. 

Medically, it makes no difference who I am. I have stage 2A Hodgkin's lymphoma and the treatment for such is four rounds of ABVD chemotherapy. It doesn't matter if I'm 27 or 67.

It doesn't matter if I'm female or male. It doesn't matter if I like jazz or hip hop. 

I have a particular type of cancer, there is a particular type of treatment, and there are certain things I should avoid in order to minimize my chances of getting seriously ill or dying. 

We kind of have it down to a science, which is truly amazing. 

But the thing that we forget in medicine, is that there is a person with cancer who is being nailed with chemotherapy. 
That person has free will, and we're not always rational beings. 

Pizza just the start

I mean, I cheated on my doctor with a slice of pizza. But that was just the start. 

I started eating out for lunch whenever I felt well. Then I started having a few glasses of wine at dinner. 

And every bit of normalcy I got back, every smidgen of my actual life that returned, was like gold to me. 

Now, I understand why some patients' have difficulty with rules. Once I get back to work, I think I'll take the approach that I'm there to offer my patients suggestions and outline risks and choices. 

So, I won't tell patients they have to take that pill, but I'll let them know what their risk of dying of a heart attack or being disabled by a stroke is without it. 

I finally get it: it's not our responsibility to save people from themselves. 

To my doctor and my family it was just a slice of pizza, and a stupid risk to take. 

But to me, it was a slice of freedom and normalcy. 

And I'd cheat all over again.


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