“Thank You”

“Thank You” is a frequently used term that greases social commerce. It speaks for appreciation and sometimes gratitude. Its power to convey these positive feelings is blunted by overuse. Unfortunately, our language has a paucity of other terms to employ when one wishes to convey genuine appreciation and gratitude to someone else.

This has come to mind for me because of two recent patient visits that highlight the need for a better way to express genuine gratitude to another person.

In my position as a practicing oncologist, I have become comfortable with patients and family members being very grateful to me for perceived powers to return someone to good health after facing a deadly illness. At times, I am taken aback by the emotion behind the “Thank You”. Since my daily professional life is involved with matters of life and death I have become comfortable with great outcomes as well as the disappointment when someone dies. However, I need to remember that from a patient perspective the disease they are facing is a singular event in their lives.

Most recently, a woman who has survived breast cancer and who is someone I am happy to consider a friend, was frustrated and very worried when another physician ordered a CT scan for possible gall bladder disease and an incidental finding was a bone lesion that, although quite likely to be benign, could possibly represent a metastatic lesion from breast cancer. Like most modern radiology interpretations, this was in my view a clear over read and I had no worries about it. But my patient was scared to death and the other MD chose not to pursue the lesion with another test. My patient called me in tears and asked me to intercede. Although, I had not ordered the test that showed the anomaly, I knew only I could settle the issue to her satisfaction. I ordered another test and as I fully expected, the lesion was proven to be benign. I considered this a simple intervention, one that appeased my patient. However, I had forgotten how emotional she had become with her perception that her cancer might have recurred. So, when I saw her at her routine surveillance visit some months later, I was taken aback when she repeatedly and emotionally thanked me for stepping up to settle her mind about her worries. I was happy to be the recipient of the gratitude and thought there should be other terms to better express her emotions. I am not sure what they would be but her “Thank You” was far more meaningful than most that are proffered.

I “inherited” an older patient when a former colleague moved to another medical center some years ago. His is a remarkable story involving a rare disease called amyloidosis that had infiltrated his liver and caused the organ to fail. The underlying disease lived in his bone marrow. At the time his liver was failing, he was considered too old by several very well regarded transplant centers to be eligible for a liver transplantation, the only medical intervention that could save his life. But because the inciting disease lived in his bone marrow, a bone marrow transplantation was considered necessary to avoid damage to a newly transplanted liver. No medical center would take on this arduous sequence of transplantation except my medical center. He survived these transplantations twelve years ago and now at age 78, he has been very grateful for his life. Unfortunately, last year amyloidosis again became active. His liver remained healthy at the time but I knew that time was not his friend and I offered him a therapy that recently was found to be successful in suppressing the disease. And it was relatively nontoxic. The therapy was well received and tolerated and the data strongly suggested amyloidosis was again arrested and quiescent. At his recent appointment when we reviewed the information that strongly suggested he could do well for years to come, he and his wife somberly thanked me. I could tell they were very moved by the good outcome and his new lease on life. I felt it was all in a day’s work but then I remembered that “Thank You” can carry incredible emotion and that there are no other words that can express that important feeling.

 So, why do I dwell on this? Because I can find no other words to express my gratitude to my mentor Dr Arthur Bank, who passed away recently from a difficult cancer problem. He died as he lived, full of life and with no regrets. He was passionate about medical science and patient care. He was my beacon for all of my professional life and I can find no words to express my gratitude to him other than THANK YOU! I will dearly miss you.