Saturday, May 16, 2009

The 'Why' Factor

To be a patient is to be a detective of sorts. You and the doctor need to work together to put figure out what is happening -- or not happening -- in your body. This doesn't mean that the mystery will be solved, but a doctor's job is to figure out what the problem is and, if possible, how to remedy it or alleviate it.

Gleaning the "why," "what," and "how" out of doctors is your job.

And that is somewhat harder because it requires courage to ask "why," because it may piss a doctor off, and result in getting an unsatisfactory response or lack of empathy. By satisfactory response, I am not referring to getting good medical news, but getting a response that answers your question(s) to your satisfaction. Perfectly valid questions that you, the patient, have carte blanche to ask include:

  • Why do I need this treatment regimen instead of this other one?

  • How does this medicine affect the body?

  • What are the side effects of this treatment/medicine?

  • How do you know the facts you are telling me? (Remember that Internet-statistic-obsessed doctor?)

  • Why did this happen to me?

For example, I was lucky enough to have my surgeon actually do my biopsy outpatient (I was conscious with a local anaestheic). And "why?" was the question foremost on my mind. He had just told me that the biopsy had to be done now because he had a strong feeling...he could tell...the mammogram revealed something that was likely cancer. No time to waste.

So during the procedure, I started with a search for empathy. I told him I didn't want it to be cancer (as if any patient would want that!), and his answer showed his kindness. He said, "I don't want it to be either." I felt so much better knowing that he was really on my team, and that I was important to him.

Then I asked him "why?" After all, I explained, I was young, never smoked, drank, or did drugs, exercised regularly, had a healthy family, and ate healthy foods. I thought that if my being a Ms. Goody-Two-Shoes targeted me for ridicule, at least I would have one perk: good health.

My surgeon gave me a truthful answer, which is why it satisfied me: "I don't know. I don't know why a person like you would get cancer."

Sometimes the simplest answers are the right ones, and in this case, "I don't know" helped me realize that doctors weren't magicians and they didn't know everything. His response also empowered me because prior to the biopsy, I had mulled over and over again in my mind -- even though I sensed, but didn't know if the abnormal mass was cancer -- what I could've possibly done to cause it.

I also asked every doctor thereafter "why?" I guess deep down I needed to conduct an informal poll of doctors' opinions as to why I got cancer. One doctor blamed me for not having children and tried to find flaws in my lifestyle. I left his office deflated.

So I decided to stand by the surgeon's response, "I don't know."

In this day and age, the blame game runs rampant, and we hear all sorts of nonsense about how to prevent cancer. It's human nature to want to know what causes -- and how to prevent -- all sorts of maladies. Eating healthy and not smoking improve the odds of health and longevity, but I have learned that a healthy lifestyle is no guarantee of a healthy life.

Still, I eat healthy as I've always done -- lots of fruits and veggies, grains, chicken and salmon, among others. I am going to start jogging again soon. Rather than believe that I'm doing this to prevent cancer and other serious conditions, I choose to believe that a healthy lifestyle provides a good foundation for a good life.

Beth L. Gainer is a professional writer and has published an essay on her breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. She teaches writing and literature at Robert Morris University in the Chicago area. She can be contacted at and



  1. Excellent post! Why? Because I totally related.

    I'm constantly asking Why when it comes to my mom's death. Talk about a healthy lifestyle: she walked several miles a day, she didn't eat meat and her overall way of eating was extremely healthy, 58 is too young to die, and on and on and on it goes.

    Why did she get leukemia? Why didn't the three rounds of chemo help? Why was she diagosed on Christmas and died the day before Mother's Day just four week before my daughter is born? Why did she stop accepting treatment and decide to go home to die?

    It's true. There may not be answers to any of my questions either. At least, not in this lifetime. But the ability to ask why often brings the gift of empathy from others. Why do I say this? Because like with your doctor, sometimes all we need to hear is: I hope you don't have X. It sucks to have Y. I don't know why Z is happening.

    Shared experience and empathy is part of what makes human interaction meaningful.

  2. I loved your response, Jeannie, and I couldn't agree with you more. It is comforting to know that things just "are." It is the gift of acceptance.

    I'm really sorry about your mom's death. She did everything right, but sometimes life is just random or a guessing game of sorts.

    The best thing a doctor can do is tell the patient the truth. And "I don't know" can be the most comforting of answers during the most turbulent of times.

    Thanks for taking the time to read and respond to my post!!