QOD

“If you are open to the experience of a ‘Cancer Movie,’ this is a pretty good one.”

~ Reveiwer on Rotten Tomatoes, talking about 50/50

 

"So, wait, what do you use these clippers for anyway." "Uhh, my body......"

 

I went and saw 50/50 last night. We had planned on going Friday, but frankly, I’m currently at the mercy of my hormones and some rather unpredictable, monster PMS mood swings and I just wasn’t up for a ‘Cancer Movie’ that night. Frankly, I usually don’t like highly-emotional, tear-jerker, Nicholas Sparksian movies at all. I see enough real-life drama at work every day, thanks. But, I girded my emotional loins and headed to the theater for this one.
 
Because, it seemed like it would be different somehow, from the previews and what I read about it. First of all, its a true story, not someone’s imagined, dramafied portrait of some poor cancerous wretch, purposefully painted to wring out my limbic system like a wet wash rag. Secondly, Seth Rogan is in it. He’s in it because its the true story of his best friend’s bout with cancer. He plays the same character he always plays, a goofy, bumbly, inappropriate but well-intentioned, pot-smoking, horndog buddy character, which he seems to do in all of his movies, but it is completely warranted in this film (and strangely, its not as annoying as when Brad Pitt does it ala, Moneyball – yeah, he did a good job, but its still Brad Pitt). It might be a ‘Cancer Movie,’ but with Seth Rogan involved there’s no danger of it turning into Terms of Endearment. And third, because I liked Joseph Gordon-Levitt for the main character. He worked closely with the film’s creators Will Reiser (the main character, real-life cancer victim, Seth Rogan BFF) and Rogan to transform himself and be a true as possible to the character, and he is the kind of low-key, unassuming but super-talented, underrated, non-matinee-idol, actor that can pull it off. And pull it off he did. The whole time watching the movie, I felt like I was watching an honest-to-God, real guy going through Cancer and everything that goes with it. The testosterone-feulled denial and minimalization, struggles with girls (sexual and motherly) and loneliness, the THC-laced post-chemo giggle-fest stroll through the cancer ward, and his eventual complete breakdown in Rogan’s Jeep. Not gonna lie, the agony was so real it was f*#?ing hard to watch.
 
The other, biggest thing, that was hard for me to watch was the representation of the medical community throughout the film. The first thing The Writer said when we left the theater was, “Wow, they sure didn’t make the medical community look very good did they?” Nope. No they did not. And to my sadness and disgust I cannot say the portrayl was completely unwarranted or that it isn’t how the medical community is actually percieved by the public at large. The worst scene for me was when G-L is diagnosed. He’s sitting in the Oncologist’s (?) office, waiting to hear the cause of his persistent back pain, when the Doc walks in, picks up his dictaphone, and without so much as sparing the patient a glance, starts dispassionately dictaing the devastating findings using as many big, ugly, medical words as possible. I sat in my seat watching and shaking my head, struggling with the alternating desires to reach through the screen and b*tch slap the guy or sink as low as humanly possible into my chair, cover my face, and pray I wasn’t giving off any “medical personnel vibes” lest the audience sense my doctorishness and turn on me after the horrific display. The worst part is, I am absolutely certain that kind of crap actually happens. I found myself quickly siding with the family in the ongoing people v. medicine struggles. When Angelica Houston faced off with a nurse over the temperature in the aforementioned, Ridiculousy Inhumane MD’s office,  I wanted to tell G-L to let her have at and give Mama Bear a big high five. I wanted kick the impatient anestheologist in the nuts when he basically ripped them apart before G-L’s big, very likely disabling or fatal surgery.
 
Not all medical professionals were portrayed quite as negatively in the film. There was the slightly more-human-than-robot neurosurgeon, who still only showed up minutes before the big surgery to meet the patient for the first time (The Writer leaned over to ask me at that point, “Uh, does that actually happen?” Sigh. Yes, I am sure that kind of crap actually happens too.) and delivered news post-surgery with “this is all the really bad, scary sounding stuff that happened and, oh, btw he’s going to fine” aplomb.
 
El cringe.
 
Not gonna lie, this movie made me ashamed to be associated with the field.
 
At the same time, it only makes me more determined. I honestly do not believe that most physcians or medical professionals act like this on purpose. Especially not when they start out, but I do believe that many end up exactly as the film shows them. Most probably do it unsciously, after years of patients (and pressures to see as many of them as possible with factory-assembly-line-like efficiency), scads of devastating diagnoses, immersion in CYA politics, etc. I am more determined than ever to not succumb. To make an ongoing, concerted effort to be the kind of doctor that lives and works daily to fly in the face of, and smash such public perceptions. The kind of doctor who always takes the time to talk to patients, in terms they can understand, to listen in turn, and treat them like human beings deserving of the best possible quality medical care that CAN be delivered, with a modicum of empathy, kindness and gentleness, WITHOUT compromising any clinical or professional standards. A highly effective, evidence-based, disease eradicating, hand-holding, hug dispensing, patient-centered medical ninja. Oh yes, it CAN be done. Because I believe that mix is the real secret to being a Good Doctor.
 
I, Nurse, MD, hereby promise, to never forget this.
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Bullsh*t. Or, What Really Makes A Good Doctor.

Special K and I have been hard core study buddies since first year. She is one of the hardest working, most down to Earth, big-hearted individuals I have ever been lucky enough to know. A few weeks ago we got together for one last session before taking our school’s Dreaded OSCE. During one of our requisite chat (gossip) breaks we started talking about tests, grades, and the Imminent Future. As we were talking I noticed a change in her demeanor. Her face fell, her shoulders slumped and her eyes fixed on her hands nervously twisting in her lap. “So and so and Yadda yadda’s grades are so much better than mine,” she finally said dejectedly and sighed, “I know they are going to be better doctors than me.”

I was gobsmacked. Uhhhhhhhhhhh that’s Bullsh*t, I replied.

Do you really think getting the best grades makes a person The Best, or even a “Good” doctor? I asked. Really?? Because I have talked to a lot of patients over the years about a lot of doctors and when people have told me how great their doctor is or how much they like them, they have never once been been referring to anybody’s grades or test scores.

And why would they be?

The fact is, anyone who makes it through four years of medical school and a residency has to have at least a modicum of brain function. But it doesn’t exactly take genius (obviously, they keep letting me go). Honestly, a chimpanzee with more than average mind power, manual dexterity, and determination could probably stop throwing feces long enough to click on a link for UptoDate and formulate a reasonable treatment plan for most clinic patients. Shocking, but true.

I’m not saying that some serious intelligence doesn’t come in handy in medical school. Naturally, we have quite a few freakishly smart individuals in my class and I have often looked on wistfully (enviously, resentfully?) as they blissfully napped through lectures, if they showed up all, only to subsequently, effortlessly ace every exam. As (slightly) less intellectually gifted individuals like Special K and I studied day and night, chasing PPI’s and NSAIDs with gallons of caffeinated beverages, sweating, laboring and praying through each potentially career-destroying multiple choice marathon, just hoping to make it to the next round. (Though I will say, whatever we may lack in IQ points we more than compensate for with sheer mule-headed stubbornness and blind determination. Okay, maybe that’s just me with the stubbornness.)

I’m not saying astronomical levels of cleverness aren’t helpful for a practicing physician either. How great would it be to have a mental Wikipedia wealth of information with Google-like instant recall? To not have to mar the silhouette of your spiffy white coat by stuffing the pockets with essential clinical references or spend more time with your PDA than your significant other because you constantly have to look crap up? Seriously, how great would that be? Because I wouldn’t know.

Which leads me to one of the doctor traits I’ve heard patients most commonly praise. Patients appreciate it when doctors admit that they don’t know stuff. Even though they come to us for our expertise, with expectations of benefitting from our superior knowledge, they know we are not infallible and welcome a show of humility, humanity and honesty when we are in over our heads. Of course it also helps when we then bust our butts to figure it out or to find someone else who can.

Which shows that we really, truly care. One of the top two patient responses to the informal “What really makes a Good Doctor?” survey I conducted after my conversation with Special K. Patients like, value, and trust doctors who sincerely care about them. And intuitively so. Because if someone really cares about you, they are going to do their d*mndest to help you.

One of the ways doctors can most effectively show that they care is the second most common response I heard in my informal investigation into quality doctoring. Patients like it when doctors listen to them. It simultaneously makes perfect, and no sense at all. They come to us for our knowledge, to receive the benefit of all information we’ve spent years internalizing, and expect us to spend our time listening to them. Because patients know, that if we don’t really listen, and appreciate what they have to say about what’s wrong with them, all of our hard-won (for some of us anyway) knowledge is completely useless.

And there you have it. What really makes a Good Doctor. A Good Doctor listens to their patients. Because they care and truly want to help. Because in order to effectively use all the information (or medical references) they’ve spent years accumulating, they always, first and foremost, have to engender the trust of their charge. To get the patient to open up and share their story. To listen and learn from the most important instructors we will ever have, which is the only test that ultimately matters. I think anyone who remembers this is going to be a Good Doctor.

Take that Biochem.