a letter to my wife's oncologist
2 minute read
tana xenis died on february 27, 2022 of colorectal cancer. she leaves her husband alex and son, samson. supplied
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i lost my wife, tania xenis, on sunday, feb 27, at 9:03 pm. our 16-year-old son samson and i held her hand while she died in our living room.
when her gp refused to give her the colonoscopy she requested at age 48 — which she begged for because her aunt had just died of colon cancer — he stole 30 years of her life. this sort of medical arrogance and a refusal to treat patients as partners kills thousands every year. it killed the kindest person i’ve ever known.
‘the patient is an obstacle to be managed — not a partner’
by the time we came to you, you were faced with an impossible task. but your approach was similar. you were the expert, standard of care only requires checking boxes, and the patient is an obstacle to be managed — not a partner.
tania xenis. supplied
when i asked about exploring moffitt cancer center’s dr. robert gatenby’s novel approaches to using evolutionary dynamics in cancer and cancer drug resistance as a way to make existing chemotherapy drugs more effective, you dismissed me with the patently absurd, “cancer doesn’t develop drug resistance.”
when we asked to try the diabetes drug metformin because of a study that showed it could inhibit metastatic colorectal cancer, you refused to even consider it — even though metformin is one of the most widely used medications in the world with a good side effect profile.
even something as stupid as a joke regarding co2 levels increasing the need to poop, you dismissed it out of hand, 100 per cent certain even though it’s not your field of expertise. and my wife wasn’t constipated anyway — she was bloated because of ascites (fluid accumulating in her abdomen), not constipation, and she needed draining.
‘at least you could have tried’
primum non nocere — “first, do no harm” — shouldn’t be warped to create an act-omission distinction that kills patients just as dead as a mistaken action. in the case of my wife, doing nothing is doing harm. at least you could have tried.
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after first meeting with you, i pushed her to change oncologists. she asked me not to come to more meetings because she didn’t want the friction. in the last few months, she dreaded talking to you and agreed, but it was too late to change. gatenby’s approaches only work before resistance — not after. plus, she was always too kind to tell you how frustrated your condescending approach made her feel.
when i suggested that simply being a bit more positive might help with outcomes, your response was, “i want to be realistic.” maybe you call your approach realism. i call it medical arrogance and iatrogenic harm. if your approach toward your patients is “i’m the expert, patients are dumb, and they’re going to die anyway,” then maybe you should consider retiring, or at least shifting out of oncology.
at the very least, please consider treating patients as partners rather than objects with an annoying habit of wanting a say in their own treatment.
it’s too late for tania, but maybe not for others.
alexander boldizar is tania’s husband.
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