28 May 2012

Ian Gawler Blog: You Can Conquer Cancer goes into the medical schools


Big day today. Sending off the completed manuscript for the rewritten new edition of You Can Conquer Cancer. So I have been reading new research that found 55% of oncologists said grief had caused them to burn out, half said it meant they now distanced themselves from patients, and 65% said it had spilled over into other parts of their life, and thinking how good it would be if the new book were to become a medical textbook used in the Universities.

Thought for the Day

Men occasionally stumble over the truth
But most pick themselves up and hurry off as if nothing happened
                                                                                        Winston Churchill

Oncologists experience ‘unique’ grief

It seems remarkable that this new research claims to be the first to examine the impact of grief on the lives of oncologists – both professionally and personally. It also claimed that more than half of oncologists and a third of trainees experience burnout. What the study said was that the impact of patient loss on their lives was “a unique affective experience that had a smoke-like quality”.

“Like smoke, this grief was intangible and invisible. None-the-less, it was pervasive, sticking to the physicians clothes when they went home after work and slipping under the doors between patient rooms,” the authors wrote in the Archives of Internal Medicine (online).

Another report, based on interviews with 20 oncologists working in Canada and attending a support group,  found oncologists frequently failed to deal appropriately with grief after their patients died – a failure that “may negatively affect not only oncologists personally but also patients and their families”.

One said: “I’m up to the point where I probably lose one or two patients a week minimum ... it’s a physical sensation of being ground away ... it takes me a long time to recover from that.”

The group, which “allows staff to systematically share their loss and grief with others who have common experiences and values,” had helped its members cope.

It was proposed that education on how to manage grief, beginning during residency, would be one way to ameliorate the negative impact.

“Ongoing study and development of optimized coping strategies for oncologists” is needed, they argued.

So how good would it be if You Can Conquer Cancer was read by doctors in training? The new edition has a major new chapter on understanding death and helping the dying, that could be of great benefit to young doctors and other health professionals. At the same time, they could be informed of what can be done by an actively committed patient who is working collaboratively with them towards the best outcome. They would understand their patient’s point of view better.

I know when I began working with people affected by cancer, I had very little experience of death or dying. I wondered how it would affect me and how helpful I could actually be. Over the years, I was fortunate to learn from many experts in this field, to sit in many groups that discussed these issues, and to share in the last days of many wonderful people and their families.

To be frank, the greatest help I received both personally and professionally came from the Tibetan tradition courtesy of Sogyal Rinpoche, author of the international classic “The Tibetan Book of Living and Dying”. Because the Tibetans consider it wise to live a life informed by death rather than in denial of death, and because they believe the moment of death is one of our greatest spiritual opportunities, they have studied death in great detail.

So like the oncologists, I have come to know many people well who have died. And yes, it is wonderful to know of the people who have survived long-term, but it is also wonderful to know how many people have been helped to die well, and how the colleagues I have worked with over the years have been able to sustain working in this field.

Perhaps understanding the issues of unresolved grief and burnout can help us to be more compassionate with the way some oncologists and other health professionals behave.
But still, I look forward to the day when we see the headline;

You Can Conquer Cancer becomes a medical textbook!”

In the mean time, for anyone in the Brisbane area, I will be presenting a day workshop on understanding death and helping the dying and my hope is many people will overcome what seems to be a common reticence to talk about or learn about this crucial part of life. This particular workshop is one of the very best things I have to offer. It can be life changing.

NEWS

 Brisbane workshops coming soon: June 14 – 17 at the Relaxation Centre


June 14th  Evening public talk: Eating Well Being Well

Including the latest research findings (I recently attended and spoke at the International Nutrition in Medicine conference) as well a comprehensive guide to how to prepare really healthy food that is easy and tasty. Lots of time for questions, and good for those on the healing path too.

June 15th Day workshop: Understanding Death & Helping the Dying

A day workshop for Health Professionals, caregivers and others. Based on the workshop I co-presented with Sogyal Rinpoche at the recent "Happiness and its Causes" conference.

June 16th & 17th Weekend workshop The Mind that Changes Everything

A weekend focusing on using the power of the mind along with meditation and imagery techniques using ground breaking scientific research.

Where: The Relaxation Centre, 15 South Pine Rd, Alderley, Brisbane, 4051 Hide/Show Map

Bookings & Info: Click here for the link and go to the 14th -17th on the calendar

or call The Relaxation Centre on (07) 3856 3733

RESOURCES

RELATED BLOGS

Recovery from cancer is possible

Just give me the facts

BOOKS 
You Can Conquer Cancer Ian Gawler

The Tibetan Book of Living and Dying Sogyal Rinpoche

CD 
Understanding Death, Helping the Dying  Ian Gawler





7 comments:

  1. Ian, what scientific research have you drawn this informaiton from - I would be interested in reading it

    Thanks

    ReplyDelete
    Replies
    1. A recent review concluded that that there was some evidence that a low-fat, high-fibre diet as well as physical activity might be protective against cancer recurrence and progression in breast, colorectal, and prostate cancer. (See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3251953/?tool=pubmed.) A more intriguing question is what role diet plays in the initiation and promotion of these cancers in the first place. According to the WHO's International Agency for Research on Cancer (IARC) Australia has the highest age-adjusted rates of prostate and bowel cancer and the second highest rate of breast cancer after Western Europe. Interestingly there are regions of the world such as East Asia which have (until recently) had one tenth of the age-adjusted rates of these cancers that Australia has. This difference has been correlated in epidemiological studies with saturated fat and fibre intake. See the Globoscan data at http://www.iarc.fr/

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  2. Great news about your completion of the new edition of 'You Can Conquer Cancer'. When can I get a copy? Lee S.

    ReplyDelete
  3. Hi Ian,
    I have the last 2 editions of 'You Can Conquer Cancer' but will eagerly await the next edition. As a nurse I do struggle with death & dying and probably cope by denial & avoidance!

    Looking forward to seeing how to turn this around!
    Claire

    ReplyDelete
  4. While I agree that the Gawler approach does overinterpret the evidence, a recent review concluded that that there was some evidence that a low-fat, high-fibre diet as well as physical activity might be protective against cancer recurrence and progression in breast, colorectal, and prostate cancer. (See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3251953/?tool=pubmed.) A more intriguing question is what role diet plays in the initiation and promotion of these cancers in the first place. According to the WHO's International Agency for Research on Cancer (IARC) Australia has the highest age-adjusted rates of prostate and bowel cancer and the second highest rate of breast cancer after Western Europe. Interestingly there are regions of the world such as East Asia which have (until recently) had one tenth of the age-adjusted rates of these cancers that Australia has. This difference has been correlated in epidemiological studies with saturated fat and fibre intake. See the Globoscan data at http://www.iarc.fr/

    ReplyDelete
  5. Ian: Congratulations on the completion of the new edition of your book. And thanks for the alert on the impact of grief on oncologists.

    I also wonder about the impact on them of 'poisoning' people's bodies in order to save their lives. It is a testing occupation from many points of view.

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  6. Jacklyn O'ReillyMay 29, 2012 at 9:12 PM

    I found interesting the observations on oncologists' grief following the loss of patients. My husband died "well" at home and I received hundreds of condolences , expressed by letter, email and in person.
    Among them was a heartfelt card from a palliative care doctor, with whom he had just one appointment.And who was situated 600 kilometres away.And a letter from nursing staff on the ward where he spent 4 months. Also 600 kms away.

    But there was never any acknowledgement of his passing from doctors who had been responsible for his care for four years. As if he had never existed.This actually caused anger in me at the time, and I suppose still does.

    The strange thing , to me, was the fact that my husband was the kind of man who could establish relationships that mattered, and engender respect from medical staff and nursing staff because of the way he cared about other people's lives, even though his life was presenting him some huge challenges at the time.

    Perhaps your explanation of their repressed grief, and I suspect maybe even a bit of guilt over outcomes of surgeries etc has helped to explain this phenomenon a bit for me, and I shouldn't take their apparent lack of concern for my husband's plight so personally .

    ReplyDelete