“Tick-tock, tick-tock.” Nathalie Fradet felt like she was hearing the timer of a clock when she received, in 2021, the announcement of her diagnosis of multiple myeloma, a blood cancer. “Clearly, the oncologist – tick-tock, tick-tock – had a lot of people to go through in his day,” she says.
Published at 6:00 a.m.
The meeting lasted around twenty minutes. She received “very clinical explanations” from her specialist doctor, “an extraordinary scientist, but not the warmest man on the planet”, according to her.
“Here’s what it is, here’s what it does, here’s what we’re going to do,” summarizes the 58-year-old woman. The oncologist told me: “If you want more information, you can go to the Myeloma Canada website.” »
It was in a leaflet from this organization that she learned that her illness was incurable. “I understand that, perhaps, there are people who don’t want to know everything at once,” says Nathalie Fradet. But I think that’s what a patient asks: How much do you want to know all the details? » She would have liked more “empathy, compassion and a little understanding” of her reality.
PHOTO ALAIN ROBERGE, THE PRESS
Nathalie Fradet was diagnosed with multiple myeloma, a blood cancer, in 2021.
Nathalie Fradet has suffered from Crohn’s disease for 36 years. Her medications were “starting” to work: she was no longer having “continuous seizures.” The announcement of his cancer “killed” any “hope” of an end to his career “without being too ill”.
A 201 course in “bad news”
Nathalie Fradet now shares her experience in front of health professionals. She is participating in training on breaking “bad news,” designed by radiation oncologist Israel Fortin and other doctors.
It is in a way a 201 course, after the “101” learned at university (looking the patient in the eyes, being close to him, giving him time and having at hand a tissue box).
The training aims for us to introspect on what we do and what we could improve.
The Dr Israel Fortin, radiation oncologist at Maisonneuve-Rosemont hospital
According to the Dr Fortin, who works at Maisonneuve-Rosemont hospital, we must leave room for emotion when announcing “bad news”. He sometimes has “a tear in his eye, his eyes in water” when he has to report a recurrence to a patient.
In these difficult times, the “non-verbal” of the professional is important, more than words, believes the Dr Fort. “This is what will seal the alliance with the patient. He will feel that we are one in this situation and that we are with him. »
A doctor who hugs
For a dozen years, radiation oncologist Carole Lambert has given most of her patients a “hug” when she finishes her meetings, which can last 75 minutes.
“It’s magical!” “, says the specialist doctor from the University of Montreal Hospital Center (CHUM), who designed the training with Dr.r Fort. “I saw the connections with my patients change when I started to open the door. »
She cites the example of a “grumpy” patient. “At one point he said to me: ‘That’s it, Doctor, there’s nothing you can do for me.’ He was in the negative. I told him, “That’s not true,” then I stood up, opened my arms and said, “I can give you a hug.” It knocked him to the ground. »
Isn’t that too close? “A hug can still be very professional,” she replies.
Being professional doesn’t mean being cold and stupid. It just means doing your job with rigor, with humanity, with all the necessary ethics and to be fair, to know what you have to do, to do the best.
The Dre Carole Lambert, radiation oncologist at CHUM
The Dre Lambert admits to being “extreme”. She recognizes that the health system puts “a lot of pressure” on doctors to “go quickly”. His students learn a basic principle: “what is important with the patient is not to find the right distance to protect oneself, it is to find the right proximity to be able to help him as best as possible and not not be overcome by too much sadness yourself.
Showing empathy and humanism “does not cost the health system much,” says Eva Villalba, general director of the Cancer Priority Coalition in Quebec. But an announcement made in a “detached, cold and rapid manner hurts” and “adds to the trauma”.
For those who are not comfortable showing their emotions, the Dr Fortin suggests “allying up” with a nurse navigator when announcing “bad news.” Nathalie Fradet invites them to “listen” at all times to their patients, “the experts of their body”.
Three years after her diagnosis, she still experiences fatigue and pain. But thanks to a stem cell transplant, no cancer cells were detected in his blood. “It could come back at any time,” whispers the mother of a 23-year-old girl. It can come back with more force. I try to take advantage of it. »
Doctor and patient at the same time
The Dr Jean-Pierre Routy, specialist in hematology-oncology at the McGill University Health Center (MUHC), was diagnosed with prostate cancer in 2022. Has he been “more human” with his patients since then? “Probably” with some having a health problem similar to his, he estimates. “I really have a bond with men who have undergone prostate surgery,” notes the author of the book. Intriguing prostate: a doctor facing his cancer (Flammarion, 2024). The Dr Routy better understands what his patients experience during tests, x-rays, scans and magnetic resonance imaging exams. “It’s a lot more difficult or painful than I thought,” he notes. Waiting for results too. “The fatigue also lasts longer than I imagined. »
Learn more
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- Two out of five
- Approximate proportion of Canadians who will be diagnosed with cancer during their lifetime. Some 127,100 men and 120,000 women will have been diagnosed with cancer in 2024.
SOURCE: Canadian Cancer Society
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