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Beating Cancer - April 17, 2014

September 11, 2015

 

Four years of college, four years of medical school and three years of residency training yet despite our best efforts as physicians there are some things that we can never capture through books, lectures, demonstrations or practice.  Six year after medical school and 2 years after residency training when I thought I already knew everything I needed to know about the disease Thais Lavalais taught me how to beat cancer. 

The first time person I diagnosed with cancer was a young woman who was weeks away from her wedding.  She ended up getting married in the hospital and she sent me a post it later telling me “thank you for saving my life” I placed it above my desk at work to always be reminded the importance of going the extra mile.  I left that job not long after and began practicing urgent care.  Practicing urgent care I no longer came in to contact regularly with people being screened for cancer and I certainly wasn’t a cancer specialist.  Nevertheless, when I received a call one evening from a friend asking for direction with his mothers breast cancer recurrence I knew enough to point them in the right direction.  I made a few calls, helped them set up an appointment and my work was done.  Shortly thereafter, he called so she could thank me personally. I heard fear in her voice and it made me want to help her in any way that I could.  Ultimately she was not my patient but from that moment on I was on her team.

 Over the months that followed I would see Ms Lavalais battle every possible complication of her disease.  These complications you may not be familiar with but I will share with you when these things happen individually your chances are slim, when they happen all at once while you are already battling a deadly disease the outlook is grim.  That’s what I was taught in medical school, but what I witnessed was completely different. The first time we met she lay in a hospital bed with a breathing tube.  At that time, the last time I was in the ICU I was the doctor managing the patients.  Half of the patients that walked unto the ICU floor never left.  I didn’t want her to be there.  I couldn’t talk to her but if I could I wouldn’t have known what to say anyway.  My family rarely encountered medical problems and there wasn’t a class on being a good support system in medical school.  We were only taught how to break bad news.  In my mind I thought this is bad, but it is not my place to break the news.  So I just sat quietly with her family.  That was my first unspoken lesson from Ms Lavalais, Just be still.  In life it is very easy to get so caught up in the day to day routine that we forget to spend time and appreciate our loved ones.  To touch them, talk to them and just tell them you love them “just because”.  I would only spend a day with her at the hospital on my first visit but I had already been changed for the better. 

 The next time I met Ms Lavalais she was wide awake and the breathing tube had been removed from her throat.  She spoke softly but with power.  When she spoke everyone around listened.  Shortly after I would learn why.  Ms Lavalais, a Registered Nurse and Southern University Nurse Educator, was revered amongst the nursing staff as one of the best Nurse educators in the Oschner Health System and in the state of Louisiana.  I was able to observe her teaching skills as during my visits as she would kindly ask the nurses “did you ask the patients pain level before giving the medication?” referring to herself in third person.  The nurse taking care of her would quickly make a point of correcting their mistake.  I sat there and thought to myself “do you ask?”.  Often times as physicians we take for granted that we know what is best for the patient.  We give patients the options for treatment but deep down we think we know what the right decision would be when in actuality the only right decision is what the patient wants.  When they offered Ms Lavalais a feeding tube she refused and she was eating ribs a week later.  When they offered her hospice her family refused and she is sitting at home in good spirits today.  When I worked in customer service many years ago rule number one was the customer is always right.  There was no exception.  No one said in medical school the patient is always right.  We are taught even if a patient refuses treatment you can ask an ethics board to pursue treatment, you can ask psychiatry to deem them incompetent to make decision or you can convince the family its in their best interest and get them to approve it. We spend years in school and training so we can know the best way to manage and treat but it is equally important to understand when to manage and treat.  From my view point the doctors had given up on her.  She wanted to fight and they could only see the low probability of survival.  Despite the fact the odds were not in her favor, she never gave up on herself and her family never did either. She taught me another lesson through her survival. Never trust the odds.

 As I write this story Ms Lavalais is probably at church praising God for her many blessings.  For now, she is not able to walk and she has difficulty seeing but I can tell you she still smiles the most beautiful, genuine, angelic smile despite her journey.  Someone else in her situation might question God or blame God but she thanks and praises HIM still. I cant tell you the date she was first diagnosed, how many rounds of chemo she endured or how much radiation she with stood but I can tell you she is the epitome of strength, hope and endurance.  She was recently awarded the Clinical Educator of the Year award for the Oshner Health system but I understand now her teaching goes far beyond nursing and medicine.  Whenever I visit her there are always a handful of people by her side whether family, friends, coworkers or students.  I know why we all keep coming.  Because even in her most frail state she gives us more than we give her, through her energy, her laughter and her constant testimony.

You may never meet her, and you may never read about her in Essence or Ebony but I humbly share with a small part of a long journey of a Great and God fearing woman who beat cancer.  Physically the doctors say its still there, and some days they even say the cancer is growing.  What I have witnessed and what I know is God is greater, and as long as she lives she will continue to change lives.   I continue to be blessed by her presence and I will forever be a better physician because she is a part of my life.  Although I refer to her formally in this article in everyday life I call her “Mama”.   I have a 3 year old son and the first time she met him her daughter, Enjoli asked what should he call her, and she replied “GiGi”.  In Louisiana I learned that’s a term for grandmother.  My mother at the time was working two jobs and living many states away. I always wanted Chase, my son, to be closer to his grandmother as I grew up very closely with mine.    Without knowing any of that she stepped in and with the smallest gesture filled a void in our lives. The final lesson I will share with you, that through her actions Mama shared with me is this;  we can give flowers, cards or candy, but sometimes the best gift you can give a person suffering is just being there for them and filling a need before they even know they need it. If you are battling cancer remember the treatment for cancer is not always in a bottle, an IV or a surgical knife.  You beat cancer when you keep on living. You beat cancer when no matter how many days they say you have remaining you choose to live each one to the fullest.  You beat cancer with love. 

Be blessed.

Tish 

 

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