Science & Medicine

December 18 Jeremy Redux: The good hematologist.

 

What makes a good hematologist?

  • JEREMY SMITH

I would think we would all agree we are looking for a hematologist who will provide us with the best opportunity to live the longest period of time with our diseases. Most of us are going to spend a great deal of time with these folks. I have been going to Stanford now for twenty-five years and my relationship with Dr. Schrier has evolved. I have friends I do not know twenty-five years. Nor have I been able to remain in a relationship with anyone that long. Nor is this a simple question to answer.

From the first Witch Doctor to today’s physicians we continue finding ourselves placing our doctors on pedestals. Treating them as if they have all mighty powers to heal us as if we should bow to their commands.  This makes having a good relationship with another human next to impossible because we have placed them above us. Its something to think about because how you view yourself as the patient and what your role is will reflect on the type of hematologist you may wind up with.

The hematologist that I feel is best for me may be different than the type of hematologist you want advising you. The risk of course when we are the patient and blindly follow or trust a Doctors advice in the MPN World can lead to a premature death.

One of the early challenges for the newly diagnosed MPN Patients is most start off day one having never heard of the disease previously. This starts the patient off at a severe disadvantage, forcing them to rely heavily on the experience of the hematologist they are meeting with little to add. This plays right in to the psychological aspect of the Doctor taking the dominant role in the relationship, which is not healthy.

When I was first diagnosed it was by a local hematologist and my local physicians both with their own one-man practice.  I would have stayed with the hematologist even though I could not stand the way he treated me. My uncle called someone he knew in  the Hutch Center in Seattle and they referred me to  Dr. Schrier at the Stanford Hematology Clinic. At the time Dr. Schrier was the Chief of Hematology at Stanford so I assumed I was in good hands and never even thought of getting a second opinion. They must BE capable of having real and meaningful conversations with me and be willing to listen to me in return. A good hematologist thinks about how they should phrase their comments based on the personality of the patient and work with wide variety of personality traits.

Good hematologists must be able to draw out the type of information he needs when dealing with his patients. Doctors Richard Silver and Ruben Mesa are for me excellent examples of Hematologists that understand the importance of having strong relationship with their patients. From a generation perspective you could not find two hematologists on more opposite ends. Yet they both exemplify the highest standard in patient care. I have never felt rushed by either of these Doctors.

Dr. Silver more than any other hematologist redefined for me the role of the patient in the process. He explained that as patient it is as much my responsibility to be on top of my disease as it is the doctors. I should never be afraid to challenge him or anyone else about treatments. He added that the more educated and involved I am with the entire process the more involved the hematologists will be.

Dr. Mesa has spent a lot of time with me making quality of life an important aspect of treating MPN patients. His compassion and support for me as well as his compassionate understanding that ultimately all major decisions are mine and mine alone is immensely helpful to me.

A good hematologist also demonstrates patient awareness. As we all know from our recent discussions depression is a big issue with our MPN’s. A good hematologist will look for the warning signs and ask the right questions that lead to a fruitful discussion on the subject.

Defining what a good hematologist is will vary from patient to patient. I do think it’s important to remember that a good hematologist also requires a good patient. A patient who’s willing to push the hematologist along to make sure the right questions are being asked.

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