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BANGKOK 21 March 2019 04:22
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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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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 

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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"? 

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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.

😉 

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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.

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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.

 

 

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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 🙂

Edited by simon43
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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.

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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.

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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. 

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

 

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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.

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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.

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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.

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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.

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6 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?" 

A very sensible comment.

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