Through the Eyes of a Radiation Oncology Resident: The Power of Hope

June 10, 2015

By Sheela Hanasoge, MD, PhD

The unfortunate truth about oncology is that we see our fair share of patients who will not be cured and will ultimately succumb to their cancer. Not everyone relishes the palliative aspects of radiation oncology. I have been asked more times than I can count why I chose a field that is so depressing. There is no doubt that I absolutely delight in stories of patients being cured of their cancer. But, I am also grateful if, using the tools of my trade, I am able to alleviate someone’s debilitating symptoms and offer them a better quality of life, albeit temporarily.

My role as a physician is to provide the best medical advice. To do that objectively and without bias requires a certain amount of detachment. But doctors and residents are not always intrinsically strong and emotionally invincible. No amount of logical advice will prepare you for that one patient who will touch your heart in a special way and make you break every rule in the book about detachment and professionalism.

It may be the breathtakingly beautiful five-year-old girl wearing a bright yellow sundress, sparkly shoes and a heart-tugging smile who has a terrible childhood tumor with few long-term survivors. It may be the silent teenager with the inoperable tumor who has gone through harsh chemotherapy and radiation therapy that have ravaged his body and left him weak and hurting, who looks back at you from his wheelchair with a calm gaze and permits you to hug him. It may be the young mother of two elementary school-age kids whose life is turned upside down with metastatic disease coming out of the blue, who is now torn between trying yet another experimental treatment that might prolong her life by a few weeks or spending her remaining time with her young children. Or it may be, as it was for me, just another patient with just another cancer story with whom I instantly connected during a routine clinic visit and now all I want is for him to do well, not suffer and be at peace.

I saw all the scans. I looked at the labs and reviewed the data. But I found it extremely difficult to acknowledge the evidence. I checked in on my patient and his family frequently. I researched experimental therapies they heard about on the news. I was eager to help in any way—gratified if they reached out to me and anxious if I didn’t hear from them.

How do you continue to take care of all your other patients when one patient is breaking your heart? I’m not sure what the right answer is, but what I do is pray. I pray for the patient, for myself, for all my other patients and all their other providers. I realize that religion is a touchy subject and extremely personal. For me, there is something inherently comforting in the very act of asking for help from a higher power and acknowledging that I don’t have all the answers.

I think I now appreciate why patients get angry at the physician giving them bad news. I think I understand why some patients and their families refuse to accept a grim diagnosis and keep insisting on more treatment that you know is futile. Now I get it. I wish for a miracle for my patient, that he can be cured and go on to live a life as long as he wants, free of pain and debility.

Cancer is a great equalizer. I’ve seen people sleep on sidewalks in front of cancer centers to be treated as well as wealthy people arriving in fancy cars. I’ve seen people who developed lung cancer from smoking and others who got cancer regardless of the fact that they have never touched a tobacco product in their life. They are all afraid, shaken, suffering and looking for hope. They each deserve our love and compassion.

My experience as a resident has taught me to give thanks each day that the tables are not turned and I’m not on the other side, battling cancer, anxious for help and desperate for hope.

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About Dr. Sheela Hanasoge

Dr. Hanasoge will complete her physician residency program in Radiation Oncology this June. She holds a PhD from the University of Michigan and earned her medical degree at Seth G.S. Medical College in Mumbai, India. Following graduation, she will begin a position as a radiation oncologist in Calhoun, Georgia.