Just because we can…

I think we are jumping the shark in the scientific world on many levels nowadays.  For example, it’s possible to put a fetus in a sixty-year-old uterus.  But that doesn’t mean we should.  We have gone way past what is helpful and ventured too far into ludicrous.

I see this issue in the cancer world a lot.  Recently someone was describing pelvic cancer to me and the surgery that they do to “treat” it, called Pelvic Exteneration.  The surgery is essentially gutting the patient.  The patient is left with a colostomy bag and a bag for urine, because all of the excretory parts are removed in the surgery. A skin flap is taken from the left side of the abdomen and placed over the place where the vagina and anus were, essentially making the person’s genitals like Barbie.  It’s an 11 or 12 hour surgery with multiple doctors, which obviously leaves the patient forever disfigured and with multiple medical problems that she will have for the rest of her life.

When this procedure was invented in 1948 operative mortality was 23%.  But now, thanks to modern medicine, the 5-year survival rate is a staggering 20-50%.  To be clear – you get gutted, you can no longer evacuate and have to have 2 ostomy bags which require attention multiple times a day, and for that you get a 20-50% chance at living five more years?  Who would want to live five more years like that?

At this point you might have the same squinched up expression on your face that I had while hearing this description.  I was horrified, and then I became angry.  Because this is not a thing that should be offered.  Can they cut out all the cancer?  Possibly.  Should a person be subjected to this procedure?  Hell no.

You might be thinking, “But Brandie, we are adults.  We can always say, ‘No, thank you.'”  Under normal circumstances I would agree with that.  Cancer is not a normal circumstance.  It literally makes you insane in some moments.  It makes you agree to things that you would not agree to if you were thinking clearly.  I think the onus is on doctors to practice responsible medicine.

This is not a piece intended to bash doctors.  I know there are many, many fine doctors, my own included, who generally have the patients best interest in mind.  AND I think sometimes doctors offer treatments that they know will not be very effective because they feel they need to offer something.  I think being an oncology physician is extremely difficult for those that practice with heart.  My own medical oncologist only works three days a week now because he is writing a mystery novel on the other two days.  He has to do something to preserve his sanity.

I also know every cancer patient that walks into a medical oncology office represents an average of $500,000 in medical billing.  There is a reason these major cancer centers are popping up, and that they are extremely nice.  This letter from an oncologist is a great pointer to the conflicts that arise in oncology practices between money and humanity.

The “Ah-ha!” is that humanity must always win.  Compassion is the biggest gift we have.  One of my brilliant teachers says that wisdom without compassion is cruelty.  Many of these scientific break-throughs are the epitome of wisdom without compassion.  Extending a life for six months while also torturing the patient and making her only slightly more happy to be alive than dead is cruelty.  Gutting a patient and taking away her primary body functions to give her a 20-50% chance of living five more hellish years is cruelty.

The same teacher who taught me that wisdom without compassion is cruelty also says that compassion without wisdom is idiot compassion.  We must strive to meet in the middle, using the heart and mind in all matters, especially medical treatment.

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