Serious Medicine, Light Heart

When I share that my specialty is oncology, many people’s responses are similar: it is a sad specialty. That is not what I think. Of course, there are challenging moments. No matter how many times it has been, I still feel sad when a patient passes away – not because “I should have” or “could have” done it differently. It is simply because I miss the special connection we have made.

In general, being an oncologist brings me joy, not because of the cancer diagnoses. It is because, through those diagnoses, I get to connect with the patients and their families on a deeper level. What helps is that I choose to have a lighthearted attitude in medicine.

Lighthearted does not mean to see things lightly or being dismissive. In oncology, every diagnosis is a serious diagnosis. I take the diagnoses seriously and I take the patients seriously – with respect. You may wonder how it is possible to be lighthearted and serious at the same time. It is a delicate combination, and I would say that there is no set formula. You get a sense from the patient based on the personality, what emotions and concerns there are.

Yes, lighthearted, according to the definition in different dictionaries, means cheerful, carefree and happy. That is not the same as being positive all the time. I am not promoting that we should always focus on being positive or have a positive attitude, or believing that things will for sure be better. You can be lighthearted and be realistic about the situation. While you do not have to focus on the worst case scenario, it is alright to entertain that possibility. Being lighthearted as a physician allows you to take different perspectives easier, and to share those perspectives with patients. Being lighthearted lets you practice more empathy rather than dwelling in misery if you focus on the worst possible outcomes.

Having a lighthearted attitude is a commitment to connect with your patients. It allows you to be more curious rather than being judgmental. You are naturally more willing to ask open-ended questions. Sometimes an extra question can unlock many questions, confusions or misunderstandings. The common bond is that you and the patient are dealing with the same diagnosis together. Connection requires attentive listening. While you can gather more information to treat the patient, you can also get a sense of how to communicate with that particular patient in a way that brings comfort and peace to the patient.

It is easier to emphasize control only things you can control when you are lighthearted. For everything else, we face them as they come. The lighthearted attitude allows you to come up with what you can do about those situations which you cannot control, rather than dwelling in asking why certain things happen.

Being lighthearted means you have more capacity to allow different emotions. In oncology, I believe it is important to feel all the feelings. Allow your patients to feel them. Allow yourself to feel them. Pay attention to what you are thinking that causes your emotions.

To be lighthearted is a decision, a decision you make ahead of time. Because I decide to be lighthearted and be kind to my patients, I always smile when I see them. Smiling from within, not just having that facial movement which resembles a smile. It is easier to laugh more too. We sometimes make jokes – yes, even when we are dealing with advanced cancer. For example, I call several of my patients “trouble maker” out loud in a joking way. In fact, those are the patients who are not trouble makers at all. Or for some patients who want to do something to improve their blood counts (when there is nothing extra they can do other than to continue with the treatment plan), I tell them “seriously” to talk to their blood cells before the next appointment.

By choosing a lighthearted attitude, you get to connect with the patients in a meaningful way. While you are dealing with serious diagnoses, you handle things with a human touch. Lighthearted does not mean dismissing the severity of the illness; you still carry respect and empathy with you. Lighthearted does not mean you keep up with being positive all the time; it means you are open to different perspectives to view the situation.  A lighthearted attitude allows you to better commit to connecting with the patients, and better listen to the patients. Lighthearted means you get to talk or make jokes in a way that is relatable, according to their personalities and experiences. Lighthearted also emphasizes you control only what you can control.

Make the decision to be serious about the patients’ diagnoses and be lighthearted at the same time. Smile and laugh more. Share some silly moments or jokes when it is appropriate. Your patient will have a better experience in their journey and feel more calm, peace and emotional regulation.