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A physician's view of cancer
THE LANCET
A physician’s view of cancer
became a fight to maintain hope and the determination to use what time he “Cancer: A Personal Voyage” had to good purpose. He found some Public Broadcasting System, USA. Produced and directed by Ruth comfort in religion, but certainly no Yorkin Drazen. Presented by WHYY–TV/Philadelphia. complete answer. In the end, the feeling of being alone could be challenged but not conquered. Physicians are trained to distance had it looked into further and soon was themselves from death. Peter wrote of he ability of the human being to diagnosed with metastatic sarcoma. feeling that “he had been cast into a comprehend and sometimes Within a few days his concepts of himtheatre of the absurd”. Similarly, in the foresee his own mortality is self and his future were gone. Needing theatre of life, physicians tend to susunique among living creatures. Most an outlet for his emotions, and finding pend their belief that one day they too people, of course, would rather think it easier to write than to speak, he will be patients. As we work among the about nearly any other topic. They began the diary, which he continued tragedies of the human condition, we avoid confronting the prospect of their until his own death 2¹ years later. tend to separate ourselves from the own deaths as long as possible; this is At first there was despair and disbeknowledge that our fate will someday particularly true of physicians. lief, but mostly just the “pain, pain, be the same. Watching this programme, In a remarkable documentary to be pain”, of knowing his fate. And there I found myself with some guilt instincaired on the US Public Broadcasting was the horror of tively looking for System on June 27, Cancer: A Personal telling his large risk factors or cirVoyage, the story is told of a young and loving family cumstances that physician who kept a careful diary of the news. How made Peter more his feelings and experiences as he faced do you tell your likely to develop terminal cancer. Through readings family that “you cancer than me. from the diary narrated by actor have been chosen In that respect, Matthew Broderick, interviews with to die young?”. this documentary family and friends, and photographs, Peter was the offers no comthe moving story is told of this young oldest of five fort; Peter was man who found himself suddenly children, “the simply a bright, approaching his own death. trailblazer”, his good-looking, Peter Morgan was a 29-year-old brother explains. successful young internal-medicine resident set to begin As his friends Peter Morgan, who lived with cancer man who died a fellowship in haematology/oncology made plans for young. Yes, it when he suddenly developed an ache in practice, fellowships, and marriage, could have been you or me. For his leg that he attributed to a pulled Peter moved backwards to his parents that very reason, the programme is of muscle. When the pain persisted, he house into the room in which he had exceptional value and relevance to grown up. Peter’s family was to be his physicians. source of greatest support, although It would also be comforting to be seeing his parents and siblings suffer able to say that faced with death, Peter Heart disease in history This because of him was to cause some of his was able to find answers to the ultimate account of the development of greatest pain. His room became a questions of life. But there was no such knowledge of the clinical aspects of refuge where “his tears could flow” and magical revelation to somehow make cardiology emphasises the important where he could escape from his parents’ this tragedy of loss less real. Peter influence of cardiovascular physiol“watery eyes”. observed: “Nature, what a powerful ogy and pathology on clinical thinkAfter the first 7 weeks of “preparing force you are. One man can not beat ing and practice from 1700 to 1970. to die”, Peter found he suddenly you because we are not competing”. (A Short History of Cardiology. Peter entered a new stage of “choosing to live In the end, what Peter did have was Fleming. Wellcome Institute Series with cancer”. He declared his goal that the love of his family and friends which in the History of Medicine. Clio death, “his last act on earth”, should be left him “alone but not lonely”, and the Medica 40. Amsterdam: Editions approached “actively”. With his physisatisfaction of knowing that he had Rodopi BV. 1997. Pp 241. $21.50. cal condition somewhat stabilised, used his limited time well. ISBN 90-420-0048-1.) Peter struggled to find a setting in Faulkner lamented in his Nobel prize Where to now in public health? which he could finally do what he acceptance speech that modern writing This book gives an overview of loved—practise medicine. A voluntary was degenerating into empty stories in major health trends, the state of the position at a university health service which there were “victories without world’s health, and recent estimates led to a salaried position. His enthusihope and defeats in which nobody loses of the global burden of disease. Both asm and dedication were so inspiring anything of value”. The story of Dr epidemiology and public health, say that a special resident rotation was Peter Morgan is much the opposite: a the authors, are not fulfilling their established for students to spend time defeat with hope in which someone of potential to improve the public’s with him. Being able to work as a physireal value was lost. Peter’s successful health worldwide, with poverty the cian filled him with joy. He found that struggle to find dignity and purpose greatest continuing threat to health. his own health problems made him under the most difficult circumstances (Public Health at the Crossroads. much more empathetic. is inspiring and humbling. Achievements and Prospects. Robert As his journey into illness proBeaglehole, Ruth Bonita. Charles Gropper gressed, he found that the struggle Cambridge: Cambridge University Depar tment of Dermatology, Mount Sinai moved from the physical to the spiriPress. 1997. Pp 243. £17.95. ISBN School of Medicine, One Gustave L Levy tual.When his chemotherapy failed, “all 0-521-58665-8.) Place, New York, NY 10029, USA that was left was hope and courage”. It
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Books in brief
Vol 349 • June 21, 1997
1849
A physician’s view of cancer
became a fight to maintain hope and the determination to use what time he “Cancer: A Personal Voyage” had to good purpose. He found some Public Broadcasting System, USA. Produced and directed by Ruth comfort in religion, but certainly no Yorkin Drazen. Presented by WHYY–TV/Philadelphia. complete answer. In the end, the feeling of being alone could be challenged but not conquered. Physicians are trained to distance had it looked into further and soon was themselves from death. Peter wrote of he ability of the human being to diagnosed with metastatic sarcoma. feeling that “he had been cast into a comprehend and sometimes Within a few days his concepts of himtheatre of the absurd”. Similarly, in the foresee his own mortality is self and his future were gone. Needing theatre of life, physicians tend to susunique among living creatures. Most an outlet for his emotions, and finding pend their belief that one day they too people, of course, would rather think it easier to write than to speak, he will be patients. As we work among the about nearly any other topic. They began the diary, which he continued tragedies of the human condition, we avoid confronting the prospect of their until his own death 2¹ years later. tend to separate ourselves from the own deaths as long as possible; this is At first there was despair and disbeknowledge that our fate will someday particularly true of physicians. lief, but mostly just the “pain, pain, be the same. Watching this programme, In a remarkable documentary to be pain”, of knowing his fate. And there I found myself with some guilt instincaired on the US Public Broadcasting was the horror of tively looking for System on June 27, Cancer: A Personal telling his large risk factors or cirVoyage, the story is told of a young and loving family cumstances that physician who kept a careful diary of the news. How made Peter more his feelings and experiences as he faced do you tell your likely to develop terminal cancer. Through readings family that “you cancer than me. from the diary narrated by actor have been chosen In that respect, Matthew Broderick, interviews with to die young?”. this documentary family and friends, and photographs, Peter was the offers no comthe moving story is told of this young oldest of five fort; Peter was man who found himself suddenly children, “the simply a bright, approaching his own death. trailblazer”, his good-looking, Peter Morgan was a 29-year-old brother explains. successful young internal-medicine resident set to begin As his friends Peter Morgan, who lived with cancer man who died a fellowship in haematology/oncology made plans for young. Yes, it when he suddenly developed an ache in practice, fellowships, and marriage, could have been you or me. For his leg that he attributed to a pulled Peter moved backwards to his parents that very reason, the programme is of muscle. When the pain persisted, he house into the room in which he had exceptional value and relevance to grown up. Peter’s family was to be his physicians. source of greatest support, although It would also be comforting to be seeing his parents and siblings suffer able to say that faced with death, Peter Heart disease in history This because of him was to cause some of his was able to find answers to the ultimate account of the development of greatest pain. His room became a questions of life. But there was no such knowledge of the clinical aspects of refuge where “his tears could flow” and magical revelation to somehow make cardiology emphasises the important where he could escape from his parents’ this tragedy of loss less real. Peter influence of cardiovascular physiol“watery eyes”. observed: “Nature, what a powerful ogy and pathology on clinical thinkAfter the first 7 weeks of “preparing force you are. One man can not beat ing and practice from 1700 to 1970. to die”, Peter found he suddenly you because we are not competing”. (A Short History of Cardiology. Peter entered a new stage of “choosing to live In the end, what Peter did have was Fleming. Wellcome Institute Series with cancer”. He declared his goal that the love of his family and friends which in the History of Medicine. Clio death, “his last act on earth”, should be left him “alone but not lonely”, and the Medica 40. Amsterdam: Editions approached “actively”. With his physisatisfaction of knowing that he had Rodopi BV. 1997. Pp 241. $21.50. cal condition somewhat stabilised, used his limited time well. ISBN 90-420-0048-1.) Peter struggled to find a setting in Faulkner lamented in his Nobel prize Where to now in public health? which he could finally do what he acceptance speech that modern writing This book gives an overview of loved—practise medicine. A voluntary was degenerating into empty stories in major health trends, the state of the position at a university health service which there were “victories without world’s health, and recent estimates led to a salaried position. His enthusihope and defeats in which nobody loses of the global burden of disease. Both asm and dedication were so inspiring anything of value”. The story of Dr epidemiology and public health, say that a special resident rotation was Peter Morgan is much the opposite: a the authors, are not fulfilling their established for students to spend time defeat with hope in which someone of potential to improve the public’s with him. Being able to work as a physireal value was lost. Peter’s successful health worldwide, with poverty the cian filled him with joy. He found that struggle to find dignity and purpose greatest continuing threat to health. his own health problems made him under the most difficult circumstances (Public Health at the Crossroads. much more empathetic. is inspiring and humbling. Achievements and Prospects. Robert As his journey into illness proBeaglehole, Ruth Bonita. Charles Gropper gressed, he found that the struggle Cambridge: Cambridge University Depar tment of Dermatology, Mount Sinai moved from the physical to the spiriPress. 1997. Pp 243. £17.95. ISBN School of Medicine, One Gustave L Levy tual.When his chemotherapy failed, “all 0-521-58665-8.) Place, New York, NY 10029, USA that was left was hope and courage”. It
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Books in brief
Vol 349 • June 21, 1997
1849