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Saying it like it is or dashing a patient's hopes? Cancer patient told to prepare for death

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Why is liver cancer so common in Thailand , anyone knows ? 

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2 hours ago, colinneil said:

Sorry i disagree with people getting upset when a doctor tells the truth.

Doctors were telling me and my wife 8 months to 1 year and you will be walking again.

My wife got angry with me when i told them BS, my spinal cord is broken and i know i will never walk again.

Only 1 doctor told the truth his words were....you can only look forward to a wheelchair nothing more, and i thanked him for being truthful, the others were telling me what they thought i wanted to hear.

 

+1... and then some!

 

(Sorry that you are wheelchair-bound).

 

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No. Tell the patient she will live a long, happy and prosperous life. Might even pick up a few winning lottery tickets on the way too! And thank the doctor. Publish a story about how the doctor is such a life-saver and a miracle worker.

 

Then, when the patient bites the dust in two years, sue the lying bugger of a doctor.

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2 hours ago, sweatalot said:

I have been working with a lot of dying humans - they all knew.

It is not simply telling the truth or lying - there is a third way: withholding the truth until it is requested, and there is a difference between offering a fatal truth - or force it on someone

Patients sometimes are not ready to hear the truth. And you don't know. Then it could be a good idea to start slowly, giving them a piece of truth that would make them ask for more or just the full truth. If they don't ask I'd leave it this way. May be next time they will be ready. I don't think it is a good idea to force the truth on someone who does not want to know. But always be ready to tell the truth when it is wanted. If you want to find out you could start with a question "what do you think how your ailment will go on?" 

At last someone who knows what they're talking about, every patient is different and must be treated as such. Treat the patient with respect, if they ask for truth then give it to them, gently.

Relatives are an entirely different kettle of fish !

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1 hour ago, Enoon said:

 

Everyone who contributes comment (and/or responds to it) on thaivisa.com is a netizen.

 

Do you really think all of them fit your description?

 

 

Netizens as far as I'm concerned are a special contingent of stupid.

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2 hours ago, sweatalot said:

I have been working with a lot of dying humans - they all knew.

It is not simply telling the truth or lying - there is a third way: withholding the truth until it is requested, and there is a difference between offering a fatal truth - or force it on someone

Patients sometimes are not ready to hear the truth. And you don't know. Then it could be a good idea to start slowly, giving them a piece of truth that would make them ask for more or just the full truth. If they don't ask I'd leave it this way. May be next time they will be ready. I don't think it is a good idea to force the truth on someone who does not want to know. But always be ready to tell the truth when it is wanted. If you want to find out you could start with a question "what do you think how your ailment will go on?" 

I saw an American program on youtube about people dying in hospital. The woman doctor had a lot of experience. She had to speak with an elderly man who was terminally ill and was being visited by his wife. She started by asking about their plans for the future and from the answers it was clear that they both thought they could carry on as normal. When his wife said that they would be moving to their holiday home in California the doctor asked a simple question, "Have you made hospice arrangements in California"? Silence, then "erm no, is that needed"?  "I think it would be a good idea to think about the option, I can help you with picking the right hospice if you like and I will speak with your medical insurance". They took the news this way very well, as it was the man died a week later still in the hospital.

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23 minutes ago, balo said:

Why is liver cancer so common in Thailand , anyone knows ? 

There is a lot of alcohol of substandard quality consumed, especially lao khao upcountry. 

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2 hours ago, bannork said:

In my experience the patient took the news bravely and stoically, Thais often seem to, I've met three who told me they had little time to live, 2 were suffering from liver cancer, and they were right.

I think the consultant had good intentions, it seems a previous doctor hadn't been straight with the family, still her manner of delivery was somewhat abrupt. She could have adopted a softer tone. Perhaps she was overworked and tired.

You are correct, there is such a thing as, “bedside manner”. Telling the facts as gently as one can ..... 

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30 minutes ago, balo said:

Why is liver cancer so common in Thailand , anyone knows ? 

It's more prevalent in Isaan and is due to diet....

 

[For decades, certain populations in the north-east have been known to have abnormally high levels of liver cancer.

In men it comprises more than half of all cancer cases, compared to an average of less than 10% worldwide.

The high prevalence has long been linked to infection by liver flukes, a kind of parasite, found in raw fish.]

 

https://www.bbc.com/news/health-33095945

 

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32 minutes ago, balo said:

Why is liver cancer so common in Thailand , anyone knows ? 

Uncooked fish etc and ending up with liver flukes and that can lead to it or be helping its development has been suggested as a possible cause

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Have watched many of my Thai wife's family and friends die, mostly from liver or stomach cancer, then a funeral party, monks chanting, procession, cremation. Thai's have a very different way of dealing with death compared to most western countries. I watched my wife tell her mother she was going to die soon from advanced stage terminal cancer and saw her go through the stages of panic, sadness, acceptance, and eventual peaceful departure with all the family at her side. Everyone dies - you/me/they have that time. Thais just don't sugar coat it much. 

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Doctor: "I've got good news and bad news. Which would you like first?"

 

Patient: "Give me the bad news doc."

 

Doctor: "You've got lung cancer from decades of smoking, 6 months to a year at most. I'm sorry."

 

Patient: "Dang....what's the good news?"

 

Doctor: "Packs of cigarettes are 2 for 1 at the canteen all week!"

 

Seriously though, I've had loved ones be diagnosed with terminal illnesses. They want it straight, not sugar-coated.

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I must be getting soft in my old age as I had no interest in watching the video of a woman about to be told she will die. I'd prefer the honesty too, but damn that's got to hurt.

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4 minutes ago, Captain_Bob said:

Have watched many of my Thai wife's family and friends die, mostly from liver or stomach cancer, then a funeral party, monks chanting, procession, cremation. Thai's have a very different way of dealing with death compared to most western countries. I watched my wife tell her mother she was going to die soon from advanced stage terminal cancer and saw her go through the stages of panic, sadness, acceptance, and eventual peaceful departure with all the family at her side. Everyone dies - you/me/they have that time. Thais just don't sugar coat it much. 

 

 

Yes, well put.  The thing is, every single person in the world (and on this thread!) is a dying human being.  As Shakespeare put it: "we are born astride the grave".

The problem is that, especially in the West, we somehow expect to be immortal.  Only the other guy, down the street, has to die.  And if some doctor tells me I have X months to live, I  will "battle" this horrible enemy called Death (Cancer whatever).

This notion of "battling" Death is what makes us miserable (and allows the pharmaceutical companies (not to mention the Naturopaths and all such quacks)  to make millions from our fear of Death.

 

 

 

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20 hours ago, PJPom said:

All that I would want is pain relief if necessary,

as required.

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