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

[Catoni]

39 minutes ago, peterb17 said:

I have lost so many to that truly horrendous disease - my brother- told OK you have 5 years - dead within 6 weeks after diagnosis. 

 

My dear Mum - she knew she was dying -came to stay for 2 months at the Dusit Thani resort in Pattaya , she used to have a  total blood transfusion in the UK - then set off travelling. The staff there were absolutely brilliant and looked after her very well. 

 

So - doctors need to be honest - I have no fear of death - I have had a wonderful life - so you need to be told . 

How could your mom get health insurance for travel outside her home country when she had a terminal condition?

[isaanjohnno]

4 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.

Well said- but unfortunately a lot of people are like mushrooms and live on crap

[OneMoreFarang]

Personally I think we should all realize that we will all die.

 

What would I do if I would know I would die next week? Go out with my friends, enjoy life with my girl, go to good restaurants and have fun.

 

And what would I do if I don't think I will die next week? Exactly the same.

[malagateddy]

As someone who had to tell his Beloved Mother that She had terminal cancer prior to Her being admitted into a pallative care unit, I agree that any patient should be told the honest truth.
The sad news should be told by the closest relative imho.
That's my thought.

Sent from my SM-G7102 using Thailand Forum - Thaivisa mobile app

[Jonah Tenner]

2 hours ago, balo said:

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

There are several reasons, and it has been the subject of discussions on here before.

 

Liver flukes is at the core of the matter, and you can get that in at least two ways:

1. Insufficiently fermented and cured pla ra. Pla ra must, according to authorities, be fermented and cured for at least 18 months, but many locally made versions of pla raa are only fermented and cured for about six months, which is insufficient to kill the parasites from the fish. Pla ra is an important part of Isaan som tam.

2. Eating the raw fresh water fish in Isaan.

There may be other ways to get liver flukes, but these are not known to me.

[kamahele]

Telling the truth is the right thing to do but the doctor doesn't seem to have a good bedside manner....

[sweatalot]

39 minutes ago, marcusarelus said:

I gave up drinking and smoking.  I'd want to know and have the doctor buy me a carton of cigarettes and a bottle of whiskey. 

hopefully in the state then you will be able to enjoy them

 

Most people when they talk about dying think they will be in their healthy, happy and good mental state they are now, except having a fatal disease. Most of the time this is not the case.

 

When I was younger I always thought that I knew what to do in case I am told I have cancer or going to die. The more patients I have seen in that state and the older I am  the less I am sure how I would react myself

[Ulic]

Give me the straight goods so I can prepare. Sugar coat things all you want if it helps you in the matter but I want the truth. No bullshit. Just give me all the pain meds I want to ease me along everyone's inevitable destination. You can escape taxes in places like Monaco and Cayman Islands, death is not an option. When I am near, I would want to know.

[soalbundy]

1 hour ago, overherebc said:

Dylan Thomas.

 

Do not go gentle into that good night

Old age should burn and rave at close of day

Rage, rage against the dying of the light.

I've always found that poem rather stupid, it is as it is, what is there to rave about, if one is going to die then with a little dignity please..... the grace of acceptance.

[TallGuyJohninBKK]

4 hours ago, SammyT said:

Absolute rubbish. It is the doctor's job to tell them what they need to know, not what they want to hear and then rely on them asking the right questions to get the right answer. 

 

Just in general, I wish more Thai doctors would take the general approach this doctor did, and that was to be honest and medically accurate with their patient.

 

Not be vague and evasive and blow medical smoke up the patient's nether regions -- like seems to happen all too often here.

 

That doesn't mean the doctor has to be rude or abrupt or insensitive. Just don't lie and deceive the patient, and instead give them the doctor's honest best medical opinion of their prognosis, and whether anything more medically can or should be done.

 

And then talk about what medically can and should be done for the remaining time the patient has....  Not just send them off packing.

 

 

[jgarbo]

5 hours ago, PJPom said:

All that I would want is pain relief if necessary, chemo only seems to prolong life without regard to the quality.

I put forward my view concerning me only, a more youthful person should make their own decisions.

The Doctor May be blunt but should she lie ?

Doctors are not priests. They deal in facts not fantasy. Liver (and pancreatic) cancer are terminal. LC usually two months, PC maybe a year, old friends have had both. Buddhists should accept it. Christians try magic, which never works. We all die.

[soalbundy]

36 minutes ago, malagateddy said:

As someone who had to tell his Beloved Mother that She had terminal cancer prior to Her being admitted into a pallative care unit, I agree that any patient should be told the honest truth.
The sad news should be told by the closest relative imho.
That's my thought.

Sent from my SM-G7102 using Thailand Forum - Thaivisa mobile app
 

Never from a loved one, the news is given full of emotion, competent calmness with gentle detachment is best.

[Neeranam]

5 hours ago, colinneil said:

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

 

Firstly, I'm pleasantly surprised you are saying something good about Thais. However, I totally disagree with you.

It's not about telling the truth or not it's the way they tell it.

When my first daughter died, I was told when ensuring where she was, by a nurse at the back of the nursing station shouting "she's dead already", as the one at the window thought I couldn't speak Thai. Disgusting from a so called top private hospital. 

I should have been prepared slowly for such devastaring news, and certainly not shipped at in a public area for all to hear. Anyone who thinks otherwise, had obviously never been in such a situation.

Thai doctors are shocking. I was told once, when my wife was 6 months pregnant, that she had a pulmonary embolism. I asked if it was serious and the doctor said, "yes, she's going to die"!!

[overherebc]

15 minutes ago, soalbundy said:

I've always found that poem rather stupid, it is as it is, what is there to rave about, if one is going to die then with a little dignity please..... the grace of acceptance.

Take it as being someone who does not want his father to die and does not actually say the words to his father but to himself to try and fight his own grief.

[malagateddy]

Sorry..I disagree..I took a deep breath..''summoned up" my mental strength..sat at the edge of Mum's bed..held Her hand, then told Her the truth.
Mum's reply was.." well no one lives for ever..Mum was 97 years young at that point.
Mum died 3 months later, with Dignity.

Never from a loved one, the news is given full of emotion, competent calmness with gentle detachment is best.

Sent from my SM-G7102 using Thailand Forum - Thaivisa mobile app

[DogNo1]

The book Life in a Japanese Hospital discusses the suffering caused to patients who are dying of cancer but don't know why they are dying.  Doctors in Japan didn't used to tell their patients.  I think things have changed somewhat now.  Personally, I would like to know my prognosis but it would be best if someone broke the news to me gently.  There are doctors who don't have a good bedside manner 

[Christophers200]

2 minutes ago, DogNo1 said:

The book Life in a Japanese Hospital discusses the suffering caused to patients who are dying of cancer but don't know why they are dying.  Doctors in Japan didn't used to tell their patients.  I think things have changed somewhat now.  Personally, I would like to know my prognosis but it would be best if someone broke the news to me gently.  There are doctors who don't have a good bedside manner 

How is bad news imparted "gently"? 

[OneMoreFarang]

I think the solution is obvious:

A pretty nurse should see the patient and tell him: let's have fun.

And then she should satisfy him until he sees the stars.

At some stage he will probably ask: what is this all about.

And then comes the thing with the good news and the bad news.

The good news is you just had lots of fun. The bad news is it was the last time in this life.

???? 

[overherebc]

Doctors can sometimes be or appear to be totally insensitive.

The closest I've come to smacking one in the mouth was when my dad died suddenly in hospital. I was waiting with my mum for start of visiting time when a nurse came and asked us to go with her to see my dad who had just died while we were waiting.

She left us in the room with him and after about only two minutes a 'doctor' came in and stuck paperwork under my mum's nose saying sign here and here.

He left quickly when I informed him that the operation to remove the papers from where I was going to stick them would be painful.

In UK by the way.

[whitfield]

6 years ago I went to Bangkok Hospital for a full check-up.  Just as I was leaving the hospital the doctor came rushing up and asked me to go back to her surgery.  She showed me the x ray and said she didn't like the look of a shadow on the lungs.  Could I see the chest specialist.  I went down to see him and he said:  Ah. Mr Vine, I'm afraid you have TB or lung cancer.  We need to do an MRI to determine which it is.

 

I spent 4 hours regretting every spliff I'd ever smoked and then when the results came through there was nothing on the image.  In my view his behaviour was nothing if not totally unprofessional.  I strongly suspect they just wanted another 15,000 Baht for the scan.

 

 

[simon43]

Quote

 

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

 

 

When my disabled, elderly mother was in a care home, she was forbidden by the doctor/staff to smoke or drink alcohol, and should eat only bland, healthy food.

 

Oh the fun I had smuggling in cigarettes, alcohol and chocolates for her!  She was unable to speak coherently, but her eyes told me exactly how much she loved what I was doing ????

[DrTuner]

18 minutes ago, whitfield said:

6 years ago I went to Bangkok Hospital for a full check-up.  Just as I was leaving the hospital the doctor came rushing up and asked me to go back to her surgery.  She showed me the x ray and said she didn't like the look of a shadow on the lungs.  Could I see the chest specialist.  I went down to see him and he said:  Ah. Mr Vine, I'm afraid you have TB or lung cancer.  We need to do an MRI to determine which it is.

 

I spent 4 hours regretting every spliff I'd ever smoked and then when the results came through there was nothing on the image.  In my view his behaviour was nothing if not totally unprofessional.  I strongly suspect they just wanted another 15,000 Baht for the scan.

Word of advice, never believe a single word out of a Thai's mouth, doctor or not. Verify with farangs and that at least twice too. No matter what the issue is.

 

The 'Don't Thai to me' didn't just appear out of thin air.

[nikmar]

1 hour ago, soalbundy said:

I've always found that poem rather stupid, it is as it is, what is there to rave about, if one is going to die then with a little dignity please..... the grace of acceptance.

"Death comes for me? Im gonna rip it's nipples off!" Lister, Red Dwarf.

[brian2f2f]

People don't seem to realize that telling a patient they are going to die is the hardest thing a dr can do. It takes an incredible amount if strength and currage to be able to tell someone you can't save them and they are going to die. And then if you are and lied too and left to believe going to live then later tiu die and never got to say good bye to family. Thats far worse then knowing you are going to die. Ive lost family members and i regret not spending time with them not being able to say goodbye and  so forth. Lies only sugar coat the truth. But the truth and rotten reality is still there. 

[garyk]

 

Doctors should never tell them they are doomed that far out. 

 

[Neeranam]

21 minutes ago, DrTuner said:

Word of advice, never believe a single word out of a Thai's mouth, doctor or not

Wow, I hope you don't have any Thai relatives, especially kids.

I know a guy like you who comes out with this racist ***** , despite being married to a Thai. His kids have grown up thinking that half of them is imperfect.

[Jaggg88]

6 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.

It was always thought that they could never repair injured spinal cords but they are making great progress with regenerating nerves injuries so don't give up hope Colin.

[GreasyFingers]

I have been through this with my first wife, just 40yo. Started with breast cancer which seemed to go away for a couple of years after treatment but eventually it spread to the liver where her doctor told the both of us that her time was up.

That did not stop her hope and she tried many other faith or otherwise remedies.

In the end her body was so weak but she continued chemo and radio therapy in the local hospital until they could do no more and sent her home for us to look after her until the end.

If the patient does not need to know the people that are going to be with her certainty do.

[DrTuner]

28 minutes ago, Neeranam said:

Wow, I hope you don't have any Thai relatives, especially kids.

I know a guy like you who comes out with this racist ***** , despite being married to a Thai. His kids have grown up thinking that half of them is imperfect.

They probably grew up knowing that spewing BS will never be allowed. People who lie for whatever reason must be called out and torn a new one.

[marcusarelus]

1 hour ago, DrTuner said:

Word of advice, never believe a single word out of a Thai's mouth, doctor or not. Verify with farangs and that at least twice too. No matter what the issue is.

 

The 'Don't Thai to me' didn't just appear out of thin air.

I take it you are married to a Thai and have Thai children.  I trust my Thai wife.  On the other hand my father and grandfather were German and lied to me every other word when I was a child.