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March 19, 2016

Why I insist on peer-reviewed research and EBP instead of anecdotal evidence when we debate. A personal story.

By | Advocacy, end of life, Nursing | 6 Comments

Once upon a time, I was a brand new, wet behind the ears nurse working in SICU. I got an admission that was so far off of our 65–80 year old renal failure, or septic, or s/p some surgery normal patient that I was in complete shock.  I met a woman who was just my age, and assigned to me as a patient that night. She had breast cancer.

She had breast cancer that had actually eaten through her breast. There it was; this horrific grayish-black tumor sticking out of her breast. It smelled awful. It smelled like death, and I really mean that. The entire SICU was permeated by this smell of death, decay, and frankly…….. despair.
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You see, this woman decided not to have chemo or radiation because she wanted more children, and she didn’t want to put ‘poison’ in her body. After getting all of the recommended exams over the years, and her breast cancer having been detected early, she decided to dump conventional medicine for a natural approach. As a nurse,  I have to respect her choice….though even now it make my eyes fill with tears.  I remember her name, her husband’s name….and have a picture of her children.
She nearly bankrupted her family and stayed away from her children to go to a far away state for treatments with a naturopath. Though she could see and feel the tumors growing, this charlatan took tens of thousands of dollars of her money to administer completely useless herbal treatments. He convinced her that she needed to give it time, and let the treatments work. She needed to have faith in him, and in God. This guy even told her that GOD wanted her to forego chemo.
After the biggest tumor broke through the skin, her husband put his foot down and demanded she see a conventional physician. By the time we got to treat her, the stage 2 breast cancer was stage 4 and everywhere. The outcome was not good. She left her children, eventually.  She never had that next baby.
I talked to her that night and she cried, voicing what she considered her stupidity and blind faith in this guy, who promised a cure. I told her that he was completely unethical and a con man, and that she should concentrate on her family. She was not to blame. She knew she would die of this mistake. It was not my place to drive the point home, and I would never have done that anyway.
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I actually wrote this blog years ago and edited it a little bit to reflect my current writing style.  Since then, I had my father-in-law die of cancer he ignored for 7 months because he wanted to die.  He knew it had returned since his last bout.  His brother died of cancer that he ignored as well, just a few months ago,  It must run in the family.
Please remember that snake oil salesmen do not sell miracles. If it sounds too good to be true, it is. Also, get a second opinion from a licensed physician, not a guy who set up shop in a strip mall. If we could be cured of cancer by flowers and berries in their nearly unprocessed form, I can think of some people in my family who would still be alive today. In short, chemotherapy, radiation and mastectomy is not a pleasant experience, but it beats the hell out of dying and leaving four kids under 12 and a grieving husband.
This is why I am such a restrictive jerk about the ‘natural’ remedies for serious illnesses.  I know some of them work.  However, I absolutely have to have scientific evidence that physicians and researchers have done large studies about the alternative treatment for it to be posted in Show Me Your Stethoscope.  Because I do not ever, EVER wish to be responsible for that.  I can see her face, and the tears running down it when I think about her, years later. I can smell that smell.
That is all. Except this lovely picture of an ulcerating tumor.
Love,
Janie
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