Monday 3 November 2008

In which I'm left flabbergasted


I’m on the ward seeing patients before the morning’s general surgical list and the next patient is Mr Barnes, a 52-year-old man who’s come in to have his hernia repaired.

“…Mr Barnes, aside from the problem with the hernia, do you have any other medical problems?”

“Yes, I’ve had lung cancer.”

“Lung cancer?”

“That’s right doc.”

“Is it still a problem for you?”

“No doc, I’ve had it treated and they tell me it’s gone away.”

“Right… What treatment have you had?”

“I had radiotherapy and chemotherapy for a few months last year.”

“And do you still see the cancer doctors”

“Yes, I saw him about three months ago, but he said that it’s in remission and there’s no need to do anything else about it.”

A bit later on

“Do you smoke sir?”

“Yeah.”

“How much?”

“When I try to cut down, about ten a day, but I’m smoking about twenty a day at the moment.”

………………………………………………………………………..

I really, really don’t understand some people. I’ve tried to get my head around it but I really can’t fathom where Mr Barnes is coming from.

I know that some people find giving up smoking really hard, but this is totally ridiculous. I could have understood Mr Barnes’ smoking more if he had terminal cancer and he’d said something like “I’m going to die anyway, so there’s no point in stopping now – it’s too late for that.” But he doesn’t have terminal cancer. His cancer is in remission.

Chemotherapy and radiotherapy is horrible ordeal to have to go through. It’s months of feeling awful, feeling weak, feeling sick, not to mention the emotional strain it puts on you and the people around. Why on earth would anybody put themselves through all that and then continue to smoke afterwards?!? So he can go through it all again in a couple of years’ time with his brand new cancer?

Mr Barnes is one of the lucky ones. He’s one of the few that actually get batter from their cancer and didn’t die along the way. He’s one of the people that we in the medical profession talk about when we say “To see Mr Barnes walk out of hospital for the last time after all those months of heartache, knowing that he’s actually got better, makes it all worthwhile you know. For all those that don’t make it, it makes it means so much to see somebody come through it.”

But Mr Barnes continues to smoke. He continues to spend his money on those little white sticks that gave him the cancer in the first place. In the not-too-distant-future, he’ll return to hospital either with a recurrence of his old cancer or with a new cancer and we’ll have to try and make him better again. What on earth is the point?

Sometimes I don’t know why we bother. This strikes particular chords at a time when there’s so much debate about top-up payments for cancer treatments because the NHS can’t afford to pay for everybody. If patients like Clive Stone really want to know why the NHS can’t afford to pay for their treatment, they should just pop in and have a word with people like Mr Barnes.

That’s where all the money’s gone.

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