Our Relationships with Cancer Caregivers

It is likely that our relationships with our oncology caregivers are quite different than those we experience with others. The closest thing that comes to mind is the treasured relationship with a family doctor. I am thinking about the kind of doctor who made house calls and knew your whole family. When we first moved to the Boston area, many years ago, my then two-year-old daughter got very sick on New Year’s Day. We did not yet have a pediatrician, so I asked a neighbor for a suggestion. She told me to call Dr. McDonald, and I did. Although it was a holiday and although we had never before spoken, he immediately responded and came to our house to meet and care for my little girl. Doctors like that may not exist anymore, but oncologists, oncology nurses, oncology social workers and others who do this work come pretty close.

Our time with our surgeons, radiation oncologists and other specialists may be less long, but our medical oncologists are in it with us for life.

We know our oncology caregivers for years, often for many years. Our time with our surgeons, radiation oncologists and other specialists may be less long, but our medical oncologists are in it with us for life. If we are lucky and stay well after cancer treatment, we may be told at some point that we don’t have to keep coming once a year for follow up. Not surprisingly, most people don’t want to give up this connection. It may be partly magical thinking (as long as I keep seeing the cancer doctor, I will be well), but it is mostly about the relationship. All relationships have boundaries, but the boundaries are more permeable in oncology than most other places.

When you know someone, whether you are the patient or the clinician, through the terror and grief of a new cancer diagnosis and then the challenges of treatment, there seems to be little time for superficialities. We all understand that we are facing possibly life-threatening illness, and we are immediately plunged into the essence of our mortality. We are all in this together. Every cancer clinician understands that we are each one mammogram, X-ray or blood test from being on the other side of the desk, and some of us have already crossed that line. It is never about us and them; it is only about us.

Later, when the crisis has abated, there is time for human conversation. Our doctors and nurses ask us about our families, remember that a daughter is being married or that a young child is starting kindergarten. We gradually learn a little about their families, too. Sometimes, when enough time has passed so the annual visits are less fraught, we talk about trips, professional changes or other parts of our lives. We know each other, and we care a lot.

These relationships are not friendships, and we all have to respect some boundaries. You can’t ask your oncology social worker to meet you for dinner or expect that your doctor will attend your daughter’s wedding (although she might and would love to be invited). As time passes, we feel carefully for the limits and must respect them. We gradually share a long and important history with milestones on both sides. For example, the first time I had breast cancer, I remember that my oncologist was almost nine-months pregnant, which sometimes made it harder to examine me. Her son is now married and in medical school. She has witnessed weddings, births and deaths in my family and our lives have become deeply woven together.

Of course, not every cancer patient/survivor or cancer caregiver wants this closeness. If either of you needs a more business-like relationship, that is what you will develop. My primary thought is that these relationships can be lifelong treasures.