Each
patient is unique
and has different needs when it comes to knowing their diagnosis.
There are those who want to know everything, there are those who underestimate the risks and there are those who maximize them to the point of not being able to think about anything else.
What will it be like to know exactly what the illness you suffer from is?
To what extent is it a positive thing to be aware of each of the symptoms and risks of a disorder?
What happens
if you disagree
with the treating doctor's instructions?
What is it like to be a doctor and a patient at the same time?
There are many triggers and ways to approach a complex topic: being the patient of the disease you are treating.
And there is no single conclusion and no single way to analyze how to handle such a level of information that can both
help and harm
.
Here are three stories that show what it's like to be on
both sides of
an office desk.
He is a cardiologist, he had a heart attack and his team had to put him to sleep to treat him
The day it was his turn, Ricardo Iglesias realized it right away: he instantly recognized the symptoms of the heart attack he was suffering.
It was 2007, he had not yet been president of the Argentine Society of Cardiology (SAC), but as a cardiologist he had heard these types of stories from the mouths of his patients
for years
.
Therefore, at that moment, he called the Miter sanatorium, whose team he directed, and when he arrived they were all at his disposal.
However, he could not “escape” the professional deformation that many doctors have:
he wanted to direct
the procedure itself until he heard someone say “put it to sleep.”
At that moment, she had no choice but to surrender.
His last years had not been easy: he had to take on more and more jobs to make ends meet, in a context that he associates with his own economic and social conflicts after the 2001-2002 crisis.
Ricardo Iglesias was president of the Argentine Society of Cardiology (SAC).
Photo courtesy.
“Economic and social crises
generate many diseases
, many heart attacks, many sudden deaths.
I was married with two children, I had a lot of pressure, and the general rules of the law happened to me: you work more, you don't do physical activity due to time problems, you rest poorly, you eat poorly, within a social-economic context of pressure.” , recalls the 68-year-old cardiologist.
The trigger matters, but not without relating it to this context: the heart attack came during a week in which I had an international trip to attend a conference, for which I was preparing two talks, and I had to buy and sell a car.
“That morning I had done an exercise test, because I knew I was very tired, and it had turned out to be normal.
But when I go to leave the car because a few days later they gave me the new one, I fight with the seller because he said that the car had a mark that according to him was not there, we argued,
the fight escalated verbally
, because I thought he wanted to get me out some mangoes,” he recalls.
And he continues: “When I turned around I started to feel chest pain, I started to sweat and I had to walk from one end to the other to be able to sign the ownership of the new car before a notary.
I told my friend: I'm having a heart attack.
But I couldn't leave because I thought that
if I died,
that car would be in the middle: between the sale and the purchase."
Finally, after completing the operation, he arrived at the sanatorium where his team was waiting for him, who at one point had to ignore
his instructions
: he intended to direct the procedure for his own heart attack.
“It is difficult for the doctor to be patient:
we are complainants
, deniers,” he acknowledges, and adds that from then on, both individually and in consultation with his patients, he began to give a lot of importance to the level of emotions.
"When you see that during a World Cup the Germans had heart attacks 7-10 times more every time they played, and when you see that when the Twin Towers fell there were 11 times more heart attacks in New York, and in the earthquake in Los Angeles there were 11 times more heart attacks;
These are issues that can be appreciated because they are major disasters, but on an individual level, what you have to do is investigate, and when people tell you 'you are very crazy', you have to listen,
make
inquiries, because if it cannot end with a coronary vascular accident,” he reflects.
“Before they were not taken into account, but I am convinced that
emotions
are a risk factor to the same extent as cholesterol or tobacco,” he concludes.
He is an oncologist and had to go through two types of cancer
Rubén Kowalyszyn is a clinical oncologist, he has been dedicated to clinical practice and research for more than 20 years, and on two occasions he had to
receive a cancer diagnosis
.
The first was when he was only 39 years old, an age at which a colonoscopy is not indicated.
However, he was struck by a symptom that is not known to the rest of the people: a little
mucus in the stool
.
“I self-diagnosed rectal cancer, the
advantage of being a doctor
is that you can listen to your body in a different way, I had a colonoscopy and I had a tumor that was just starting, I had to do radio and chemotherapy, then surgery and then chemotherapy” says the professional, who is medical director of Clínica Viedma, of the Multidisciplinary Institute of Oncology, as well as head of the Clinical Oncology unit at the Viedma Regional Hospital.
Regarding his second diagnosis, he says that it was a
clinical finding
, since there is no
screening
method for kidney cancer.
“In 2019, it appeared as a result of some checks, I had a CT scan, they found a tumor in my kidney, and they removed a piece,” she remembers.
Rubén Kowalyszyn shares his own experience with some patients.
Photo courtesy.
What particularities did it have in your case, being an oncologist who is dedicated to treating these cases?
“It has things in favor and things against, in favor is that one knows what to do, I did not manage my own disease but rather I treated myself with an oncologist friend, I told him 'manage it yourself', although I
obviously had my opinion
, like an informed patient ", recognize.
And he continues: “In addition, we had some discussions, because the treatment of rectal cancer has changed a lot in recent years, and in 2009, when I got sick, we were in
a process of change
, but there was much less evidence than there is today. ”.
In this sense, he says that after radio and chemotherapy, the tumor had disappeared.
Nowadays, in these cases, the way to continue is controls, what is called “active surveillance.”
But this option
was just beginning to be talked about
at that time, thanks to the findings of a Brazilian doctor, without much evidence.
“One group told me to have surgery, and another group told me no.
I ended up making the decision together with my oncologist and against the surgeon who operated on me, who said that there was no need to operate.
The surgeon was right,
many years later
it was proven that patients like me, 6, 7, 8 years later, were no longer operated on,” he says.
On the other hand, when the tumor was detected in his kidney, he was able to “enjoy” the benefits of not having the organ removed, as was usually done, but only a part, since in 2019 it was already defined that surgery could be performed
. partial
.
When analyzing whether or not it is beneficial to share his experience with patients, he doubts: "Many know what I had and I will tell some of them, I have a patient with rectal cancer and he has some of the
functional difficulties
that I have." , he relates.
And he continues: "When you ask me, and I say 'look, we all have this', I can tell you from experience that there are things that have to be dealt with, so if you previously wanted to go to the bathroom just once a day, and now it's 4, one day not, one day 3 and another 10, it's uncomfortable, but hey, it is what it is.
We are alive
," he ponders.
Now, it is not always convenient and, as he states, you have to
know to what extent
.
“I knew that my chances of being cured were 65%, there was a 45% chance that I would not be cured and would have a relapse of the disease, and I have patients who were cured, but also others who relapsed, both in a
situation similar
to that. mine;
So one has to take very good care of what he says: not because I have been cured will he be cured, nor will we have the same functional alterations,” he closes.
She is diabetic and wanted to specialize in the disease to better help her patients.
In the case of Sonia Hermida the process was reversed, she did not get sick after years of practicing, but when she had to choose a career in Medicine she did not hesitate: she wanted to become a nutritionist and specialize in diabetes.
The diagnosis of Type 1 Diabetes (chronic disease through which the pancreas produces little or no insulin) surprised her
at the age of 16
, a few months after another family diagnosis that was a splash of cold water: her mother suffered from breast cancer. .
Although she knew from a young age that she wanted to be a doctor, her choice of specialty was marked by her personal career: “I felt that I could give many things
back to patients
based on my own experience,” says this 61-year-old doctor, whose time divided between patient care and research for the development of drugs for diabetes.
"Illness is a limitation, like others," says Hermida.
Photo courtesy.
“I always tell my patients that at first we all feel enormous
rejection
of having an illness.
“I always felt that my illness helped me understand and be more empathetic with others,” she says.
When analyzing what it is like to be a patient in her own specialty, she assures that it is essential for her
to be able to trust
the doctors who treat her.
In that sense, being a doctor can be understood as a “plus.”
“Over the years I had to choose a treating doctor, who is my best friend and challenges me when she has to challenge me, also a very renowned cardiologist, I try to choose the best professionals, but I
always put myself as a patient
, I saw that in therapy,” he analyzes.
And she adds: “I was a patient before becoming a doctor and I always talked about my illness based on what it is: I have a pathology, which, thanks to my perseverance and working on my self-care, did not prevent me from traveling to exotic places.”
According to him,
organization
is key to treating this disease, an issue on which he places special emphasis in consultations with his patients.
“I am very interested in patients who are type 1 diabetics, and I have a group of patients who follow me, and that releases endorphins, it makes me
feel very good
, that they take care of their disease, because that is what this condition is about, which is chronic,” he says.
"In chronic diseases," he adds, "structure and organization matter a lot, because
you cannot live thinking
about a pathology but you can be organized: controlling your blood glucose, administering insulin, how you are going to schedule, what your life is going to be like for Based on that, adjusting between the relationship between meals and insulinization, trying to be organized, which is not easy,” he acknowledges.
And finally, he assures: “When you have a problem, if you do not understand what is happening to you, you have
two problems
: my help consists of explaining to you what is happening to you.
"You have to get busy and not obsess, because that doesn't lead anywhere."
***
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