I ran across two articles this morning, which I need to share in part because they are profoundly troubling to me.
The first is an article from Reuters, entitled Cadavers in the Ballroom. Physicians need to learn and practice new skills and simulators are useful, but still, the tactile feel of real tissue and structure has not been replaced. I have spent many a day in laboratory/operating rooms practicing on animals before transferring those skills to supervised work with humans. But Reuters reports that many of America’s resort hotels have had their ballrooms used for similar training, on human cadavers. Leave aside the question of what the bridal party might think after scheduling their event to follow this training. Or the issues of hygiene. What are they thinking?
This is a disgrace to our profession. Where is the sanctity of human life where you remove all the trappings of science and medicine and practice in a hotel ballroom? I understand the thinking of the equipment companies offering the training. They wanted to schedule these events at family-friendly resorts so that spouses and children have something to do as physicians combine tax deductible training with a bit of vacation. And there are not a lot of appropriate laboratories or operating facilities available for this kind of training at low costs. I am sure the expense of the ballroom is comparable if not less.
But again, what are they thinking? It is a privilege to care for patients; it is a privilege to be allowed to learn from living creatures and our dead. This behavior coarsens our work to an unacceptable degree, reducing us to ‘meat technicians.’ It is not surprising that companies would do this; what is surprising is the low degree in which companies understand the context of physician work and by the same measure the disregard that some of our physician colleagues show for the intimacy and yes sanctity of our work. Shame on them all.
In an equally puzzling, although less emotionally charged piece, the Financial Times reports on disclosure of cancer diagnosis by physicians in China. China has a rising cancer burden, 4.3 million new cases diagnosed in 2015, but remember China has a population of 1.37 billion (By comparison, the US was estimated to have 1.5 million new cases in 2015 despite having only 23% of China’s population).
But here is the most startling fact: In China doctors rarely disclose a diagnosis of cancer to patients. In one study, published in Cancer Biology and Medicine, a journal dedicated to Chinese cancer care, 58% of patients were unaware that they had cancer. Of the remaining 42% who knew their diagnosis, only 1.7% were informed by their physician, 16.8% were told by their family; the remaining 24% figured out their cancer diagnosis on their own, presumably from chemotherapy treatments, radiation or surgery.
Evidently, the primary reason not to share this information is that of the anticipated anxiety and worry to the patient. In the words of one of China’s cancer researchers, “It might be beneficial in the early stages, but later it can only create more anxiety and suspicion that is not favourable to treatment.” The article does go on to point out that attitudes are changing, in the words of another physician, “If patients could choose their own treatment it would be better, we can see that from the west.” It’s a cultural issue, I get that, but it should give us all a moment of pause. In my world, this is a human rights violation, not attention-grabbing, but the small daily differences that can have us talking past one another about patient’s wants and needs. In the words of famed radio broadcaster Paul Harvey, “It’s not one world.”