HER WORDS LANDED like a hard slap across my face, but her tone was more resignation than anger: “I don't trust you.” Queasiness welled up in my stomach. How can anyone not trust me? I am the consummate professional, attired in fashionable but not flashy clothing, understated jewelry and a starched white coat. My hair is always perfect. I sit at eye level, listen generously, and address my patients with respect and authenticity. I show up for work early and stay late, because my parents always said, “If you show up on time, you are late.” I keep up with all the latest medical advances and treat all my patients with the utmost respect and compassion, whether rich or poor, Black or White. Perhaps most importantly, I am honest. I tell patients with stage IV cancer, “I am afraid your cancer is not curable”, but then I quickly add, “But it is treatable.” I epitomize trust, so I must have misheard my patient. I asked, “You don't trust me?” “That's right; I don't trust you or any of your people.” I can understand why a few of my patients may wonder, “Does this young doctor have enough experience to take good care of me? Her name looks African. Did she train in America or in some foreigncountry?” However, their skepticism quickly melts away after they get to know me and find out that I trained at prestigious U.S. institutions. I take great pride in connecting with my patients, but I had obviously failed miserably with this woman. I needed to figure out a way to regain her trust.
She was a 50-year-old African-American woman with stage I breast cancer that was highly curable with standard therapy. However, she also had a lot of things happening in her life around the time of her cancer diagnosis. She had gotten married the week before and was supposed to have a honeymoon. Then all of a sudden, we told her, “You need six cycles of chemotherapy, surgery, radiation, and then Herceptin for a full year.” Then on top of that, she lost her job due to the pandemic and was about to get a new job but had to attend to her health instead. She started a job for a couple of weeks but could not keep up her work schedule due to her many medical appointments. Despite her considerable psychosocial issues, I viewed her primarily through a medical lens: she was highly curable, and my main goal was to make her cancer a distant memory. Yes, I needed to connect with her on a human level, but she could always get another job later.
PASSIVELY ACCEPTING DEFEAT
Most breast cancer patients are vigilant about treatment. Even the word “cancer” strikes fear in their hearts, so most patients will go to any length to achieve the best possible outcome, hopefully cure. Patients ...