About one and a half years before she died, my wife Uzma, undergoing treatment for stage 4 breast cancer , started looking for an appointment with a palliative care physician close to home. She called a few different palliative care physicians’ offices. The conversations would always go the same way.
“Hi this is Uzma Yunus. I have stage 4 breast cancer. I want to make an appointment with Dr. ABC.”
“Have you been referred to hospice?”
“No, but I know that eventually that’s coming my way.”
“Mmm…I am not sure how to do this. Leave your information with us. We will call you back after speaking to the doctor.”
Uzma was an optimist. She continued cancer treatments almost an year longer than a part of her really wanted to because she thought, “There is a chance that the next treatment regimen might click for me. If that happens, my kids will have me around longer.”Uzma was also a realist like none other. She always tried and hoped for the best but knew, based on her review of the literature regarding stage 4 breast cancer, that she was unlikely to make it past this year.
It is really hard to be an optimist and a realist at the same time. It is even harder to be both and be one who plans ahead. Uzma had changed her cancer care from a nearby cancer center to Northwestern when her local oncologist had made treatment recommendations that were inconsistent with treatment guidelines. On most days, however, Northwestern was an hour drive away each way. She knew that ultimately she would need palliative care/hospice and decided she wanted her palliative care team to be local, not based an hour away.
So she started calling the local docs. The conversations always went the same way as above. No one ever called back. Then she got hold of her internist and asked her help in getting an appointment with a palliative care physician. This finally got her the appointment she was seeking.
The palliative care physician was surprised that she was seeing him while still in active treatment. Uzma saw this doctor 4-5 times in his office over the course of her last year alive. When she was eventually referred to hospice by her Northwestern oncologist, she proudly said, “I already have a palliative care physician. I want to be referred to the hospice for which he works.”
When she began hospice it gave her comfort to already know the physician and I’m sure it helped the doctor to already know his patient.
[This post was originally published on Left Boob Gone Rogue at www.UzmaMD.com. It has a companion post The Hospice Way To A Good Death. The creator of that blog was my late wife Uzma Yunus, MD. Her blog is about finding inspiration and humor in the breast cancer experience. Its themes are love, life, loss and resilience in the face of one’s mortality. She wrote and published a book named after her blog, “Left Boob Gone Rogue: My Life With Breast Cancer.” It is available as both paperback and Kindle edition on Amazon]
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