If there is one thing that I have learnt from this whole cancer malarkey it is the difference of mindset between that of the ‘surgeons’ and that of the ‘oncologists’.
That is not to diminish the value or skill set of either of them, indeed they are both subject matter experts, extremely skilled and phenomenally talented, but different.
Metaphorically cancer treatment is like the passage of a car through a production line with various things being undertaken in sequence to deliver a successful end product (hopefully). From a clinical perspective this line is represented by a linear line of GP- Consultant- Surgeon – oncologist- CNS nurse and so on and so forth.
The ‘production management’ is performed by the MDT (Multi Disciplinary Team) who decide on the best form of treatment, whatever that may be.
Whilst the overarching driver amongst all of them is the best treatment/ curative options for the patient it is the individual approach to achieving this that is very different amongst the various protagonists in this scenario.
For me the surgeon is the master craftsman, a cross between an artisan butcher and a Swiss watch engineer. Find it, cut it out, piece it back together.
The oncologist well in military parlance they would be the ‘intelegence officers’, dealing with things that ‘lurk in the shadows’ , things that cannot be seen but we know are there, subversively trying to destabilise us and cause us harm.
Between these two protagonist they overcome the enemy, each in their own way providing strategies that defeats and overcomes with ruthless efficiency.
The interplay and symbiotic relationship between these two protagonists is something for which many patients never get to see, but moreover rely on the two players coming together harmoniously to deliver a successful outcome.
It was yesterday that I had a brief conversation with my consultant “we must do a Gastrografin enema” he said.
(This delightfully sounding procedure is required to test the soundness of the truncated bowel and involves pressurising the remaining colon with. Liquid isotope under X-ray whilst establishing if there are any leaks within the abdominal area’ – this procedure is undertaken prior to ileostomy reversal)
This throw away comment immediately got my hopes up, ‘reversal, already’ I though.
But of course the surgeon is thinking about his next role in the process, the chemo bit that’s the oncologist, once the batton is handed over from him again, then yes it will be the gastrografin enema, until that point it’s chemo (which is yet to start).
My next meeting will be with the oncologist who hopefully will have gathered intelligence that tells me the enemy is not advancing any further than we thought, and that he has a particular nerve agent that will stop them in there tracks.
In the mean time, much nail biting
Tracey Honeychurch
Nail biting times for you but your true grit and determination will pull you through difficult times ahead xx you have an amazing wife, family and friends supporting you Simon xx onwards and upwards darling xxxxx
Rosemary and Francis Polglase
Thinking of you Simon…..your friend Tracey has said it all xx
Mark Bullard
Your explanation of your production run is brill, to help us lay people understand what you are going through. I very much like the military comparisons.
Am in Weston Super Mare this weekend and currently we are snowed in.
In true Harry Potter style, I am still talking to he who must not be named about you and Ali.
Steve Boot
Hi Simon, you could use much of your material to teach project management especially when it comes to sequential relationships of key milestones. The positive we can take from your consultant’s Gastrografin enema comment is that it gives us a new target to look forward to, when you post the positive result on this blog. We know you like to be outdoors but hope you are staying wrapped up warm in this horrible weather. X