Soapbox No. 6: MIA Doctors

I call them “MIA doctors”—doctors who go missing in action when their patients are dying.

Cancer patients do not expect the doctor who has cared for them throughout their illness to turn and walk away once they are terminally ill. But that is what happens more often than not. The doctor hands them off to hospice for palliative care or sends them home to die, and that’s it: These dying patients never see or hear from their doctors again. Often, during their last appointment oncologists don’t even say goodbye or acknowledge that they will not be seeing the patient again.

When my friend Surain af Sandeberg was dying of cancer in the spring of 2002, her husband Robert told me how distressed he was that they had not heard from Surain’s doctor since her last appointment.

Surain had metastatic breast cancer. Late in 2001 her doctor discovered that the cancer had spread to her brain, and she had radiation therapy to the head. Then cancer was found in her upper spine, and in January 2002 Surain’s doctor told her that it was unlikely further treatment would work.

Surain went home to the houseboat on Seattle’s Lake Union where she had lived with Robert since 1994, and a group of friends helped Robert care for her during the remaining months of her life. But during this time, and even at the time of Surain’s death in March, her doctor never once contacted her or her husband. She never called; she never sent a note.

“It’s is definitely true that [the doctor] disappeared completely after she told us that Surain had one to two months left to live,” says Rain Robert af Sandeberg (who has since added his wife’s nickname to his name). “Surain and I were surprised by that—I might say a bit upset.

“Surain liked her doctor very much. She was a famous doctor, yet she seemed to give preference to Surain’s case and gave her quick appointments when it was possible in her busy schedule.”

I was one of the people who helped care for Surain at the end of her life, and I was shocked when Robert told me Surain’s doctor had gone MIA. At that time I had no idea that this was standard practice for most oncologists. Once they feel they can do nothing more for the patient medically, they hand them off to hospice, to a social worker or pastor, or just send them home to die.

Since then, I have heard a number of similar stories, and each time I hear one, my outrage grows. These dying patients are not asking for a lot: a phone call, a chance to say goodbye and thank you, some acknowledgement of the relationship they have had with their doctor.

Read about one Seattle oncologist who is trying to change things (I was interviewed for this story): Discovering the power of goodbye

@ Jeanne Sather 2006

Comments

[Beryl Gorbman]

My parents, who both died within the last ten years, had the same doc, Dr. Doug Paauw at the U of WA Med Center. Dr. Paauw followed both of them until they died, coming to the house for comfort visits. He came to both of their funerals. Wonderful man.