Hi all, as a BCNA Community Liaison I have the opportunity to speak to a group of 2nd Year Medical Students at the University of Sydney next week as part of their Oncology Unit. The talk will focus on my experiences / interactions with doctors during my breast cancer treatment / reconstruction and the support available (especially via BCNA and our online network) but in my preparations I thought I might be able to include some feedback from this wonderful group that might help these students understand what is helpful / not helpful when working with / caring for someone with breast cancer.A couple of my experiences include - 1) Not so helpful: The confirmation of my diagnosis wasn't give to me in person, with support, in the doctor's office, but relayed through my husband to me while I was at work :/ 2) Very helpful: My breast surgeon openly discussing breast reconstruction options on my first visit :smile: Would love to hear your feedback. Jane xx

Most important thing to me my surgeon came from behind the desk sat inbetween my husband and me and the broke the news, she then went out and made us a coffee and bought it back in and said so guys lets talk about a plan we will do together. I felt like l was not a number but a human being.

HI Jane, I had the opportunity to do a similar program with some new grads at Peter Mac--it can be very worthwhile.One of the things I have found most confronting during treatment is the exposure to students in a teaching hospital. It's part of the deal, but they can be very challenging--either individually or enmasse.Number 1 is manners. They may be barreling around a hospital seeing dozens of patients, but they should all introduce themselves--even if they are in a pack following a Prof around. The patients' name will be above the bed, that should be a clue about how the patient is addressed. Personally is nice.Never, ever, argue with a patient when there is someone else in the room. The doctor/student may be right, but if a patient disagrees with a course of action or has some form of complaint that discussion should be had in what ever semblance of privacy is available.Always ask if it is OK to have even the most general conversation with the patient when the patient has a visitor. Do not assume that the visitor is a close friend or relative who may be party to any medical details. I had a doctor launch into a very detailed explanation about what had gone wrong with my implants while a neighbor--commonly referred to as Radio Oxley--was visiting. No! The patients presence in a hospital bed does not imply that they can be handled without permission. Consent is not enduring and does not automatically transfer to anyone with a stethoscope and brown pointy shoes who wants so peer down your nightie. This is very quickly forgotten--familiarity breeds contempt and it doesn't seem to take long. BTW, what is it with the brown pointy shoes? Is it a rule or some sort of unofficial uniform for male med students? Please ask, I'd like to know. Marg

@Zoffiel brown SUEDE pointy shoes my son informs me is de riguer atm for med students. I’d like to add @Jane221 that some discussion be had as to post treatment likely side effects- I was fine during treatment as I knew what to expect but have gotten the jitters after when changes happen that I did not expect or understand eg nerve regeneration causing chest pains , inflamed sore breast occurring months after radiotherapy has ended. I just think ,like I think is the case in the community generally , that when treatment ends they expect all is well and the med students need to know that is not the case - they need to know about the impacts it has on ours and our family’s lives for years to come even though they may not be able to assist us in many areas.

For a better understanding of side effects, two that come to mind immediately are neuropathy and fatigue. No doubt your talk will emphasise the importance and value of BCNA however I'm of the view that is where most of us get the comfort and understanding of the side effects.............I liken it to the old saying "don't mention the war"..............they are unspoken or breezed over quickly in a medical setting. It is the forum that gives us the comfort we are not alone and the support to understand and accept.Ony@Jane221 Jane that is a great thing you are doing!

Be an expert - a thorough expert - on any drugs that you are giving to your patients. Don't guess. Know what you are talking about and tell the patients the real risks. Don't gloss over important things. For example, don't tell the patient her hair will grow back when it might not. Never minimise the impact of hair loss.

Advice to Medical Students - your thoughts

21 Replies

Afraser
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8 years ago
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Well done and many thanks for allowing us all to have a say.
mum2jj
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8 years ago
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Good for you Jane. We could maybe put you on a speaking circuit to all the med students around the country. Seriously though, it was so good that you could do this and I’m sure those young med students were really appreciative of the advice given to them.
Well done you.
Paula xxxx
wendy55
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8 years ago
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Hi just wanted to add one thing, when we went to see the early breast surgeon after we had seen him the first time and he ordered the staging scans, we sat down in front of him and after telling us that there was nothing he could do, did we know an oncologist!!! and the statistics were 7 years!!! no one should EVER be told this information in this manner, I agree with the advice of letting the students read all of these comments, some Doctors need to learn how to speak/deal with people, we have feelings and no one needs to be told they have a life expectancy of seven years before even seeing an oncologist!!!!
wendy55
socoda
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8 years ago
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@Jane221, how awesome that you were able to impart all of this information to the med students. I'm perfectly sure that your presentation has impacted greatly upon these keen young minds and how wonderful that they will be able in turn to remember and utilise their new found understanding. Thank you, it's people such as yourself who push aside anxiety and let groups know how we are feeling. Big hug lovely. Xx Cath
MKitty68
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8 years ago
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eye contact & a sense of humour.
At my initial visit, I had a close male friend with me, my surgeon turned away from his desk, sat directly opposite me, and maintained eye contact the whole time he was talking to me, the others in the room were not important to him at that moment, only i was. He did speak with and acknowledge my friend, however it was clear that I was the focus of his attention. It was a huge thing for me & because of that he gained my trust very quickly.
He also smiled at the right times & had a sense of humour. It really made a difference to me & put me at ease.
Jane221
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8 years ago
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Hi all,

Just wanted to update you and let you know that the talk with the Medical Students went really well. They were a fantastic group of young people who were so keen to understand the impact of cancer on our lives and I'm really grateful for everyone's input to this post. I took @Romla's suggestion and printed out a copy of your comments and this was a great way for them to take away some key messages about always putting the person before the diagnosis, recognising that survivorship and the ongoing side effects / worries can be as difficult, or more difficult in some cases, for many of us and that simple manners and respect go a long way. I was a bit anxious about doing this talk (it's been a while between public speaking duties!) but the Group leader, an Oncologist working with some clinical trials at the Uni was wonderful and able to put me at ease and it actually ended up being a really fun morning!

Btw @Zoffiel, I did check out the footwear but not a brown pointy shoe to be had! Perhaps it's a Melbourne thing?? :)
Jane221
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8 years ago
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Wow, so many great pieces of advice, thank you all. My focus is the person always comes before the disease / diagnosis and those small acts of kindness, compassion and understanding can make a huge difference to how we feel we have been cared for, so it's been lovely to read all your thoughts about that in particular. I also struggle with side effects post-treatment so this will be another area I will be touching on. Thank you @Unicornkisses - what a comprehensive and well-thought out list, will definitely add those in. I think I will also take up your suggestion @Romla and print out a copy of all your comments from this post for them to have a look at - good idea. Wish me luck - I hope I don't get too distracted by their footwear though @Zoffiel :D
adean
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8 years ago
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Most important thing to me my surgeon came from behind the desk sat inbetween my husband and me and the broke the news, she then went out and made us a coffee and bought it back in and said so guys lets talk about a plan we will do together. I felt like l was not a number but a human being.
nikkid
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8 years ago
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Focusing truly on patient-centred care: communicating well (openly, honestly and with respect and compassion) with patients; enabling them to feel in control; asking about them not just their cancer; spending time and allowing for questions; discussing all options available and empowering patients to make the ultimate choice (informed by experts) of what will happen to them; being present, looking the patient in the eye and seeing the human being (mother, sister, wife, daughter) in front of them.
Romla
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8 years ago
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Maybe the students might be able to read this blog a little to hear our stories