Medical oncologist experiences role reversal

Medical oncologist experiences role reversal

Dr. Colin Germond studied medicine in South Africa. He completed two years of training in Ottawa and began practicing as a medical oncologist in Sudbury in 1989. He was diagnosed with lymphoma in 2008 and retired from practice last year.

In 2008, Dr. Colin Germond of Sudbury felt numbness in his jaw, developed back pain and started losing weight.”I was sick, but I didn’t know what was wrong,” he said. “I saw some very clever people, who were really struggling (with a diagnosis), so it wasn’t clear to me that I had cancer at all” until the results from biopsies of his jaw and back indicated a rare subset of lymphoma.

Usually, lymphoma is relatively easy to diagnose, he said. “People present with a lump or something like that and it’s quite obvious. You biopsy the lump and that’s it, but I didn’t have any palpable lumps.”

Germond, 56, finished his last chemotherapy treatment August 4th and spoke with the Northern Ontario Medical Journal at his home in Sudbury about what it’s like being a medical oncologist battling the disease he was trained to treat.

The prognosis isn’t good, he acknowledges.

“Seventy per cent are dead within eight months, but I’m doing amazingly well. When you first start off, you think of what you’ve lost, but as time goes on, you think of what you still have. I could have and should have been dead ages ago, and I’m not, so that’s nice.”

When he first got sick and learned that he had lymphoma, he thought he’d never see his eldest daughter graduate from high school because it was a year and a half away.

“You watch the snow melt and think you’ll never see snow again and then you have another winter,” he said.

Dr. Germond quickly got over the temptation to be his own doctor.

“I thought that I knew what was going on, but I realized very early on that I had no idea. It was at that point that I said, ‘That’s it. I’m not being my own doctor.’ I’m not second-guessing. I’m not questioning. I will put my trust in my physicians. They will look after me and that’s that. I may say, ‘I don’t like that, or can we do it differently,’ but I’ll do it as a patient, not as a doctor.”

Chemotherapy

Chemotherapy was no picnic.

“I was generally good for four or five days following treatment because I was on steroids, but when I came off them, I felt terrible,” said Germond. “I felt so bad I thought that if I’m going to die, let it be soon, so I can get it over with. I couldn’t do anything. I could barely move.”

It has been an eye-opening experience dealing with cancer as a patient. Physicians try to tell patients what to expect and advocate for them, but side effects are difficult to predict and, sometimes, the treatment can be worse than the disease.

“There’s no way you can prepare people for what it’s going to be like for them,” said Germond.  “Sometimes, you tell a patient it’s going to be tough, but they come back and say, ‘You must have been trying to scare me off the treatment, because I had nothing like that.’ Others come back and say, ‘If I knew it was going to be that bad, I never would have taken it.’

“I made this mistake myself as a physician. You think a patient is doing OK and you encourage her to keep going, but sometimes you’re wrong. I remember one occasion when I was clearly wrong. I was convinced this patient was getting better. Actually she was getting worse. She was telling me she felt worse, but all the evidence I had at the time suggested to me that she was just feeling bad about herself, so I kept encouraging her to take treatment. I think I would have bailed much earlier if I ‘d known what I know now.

“As a physician, you have to advocate for the patient, but I think, sometimes, we advocate a little too strongly and, being on this side of it (as a patient), you recognize that it’s quite a burden.”

Germond relates a personal example that illustrates the balance between physician advocacy and a patient’s tolerance for treatment. After undergoing a half course of radiation and losing his sense of taste, he chose to call it quits.

“For six months, my life was misery,” he said. “I couldn’t taste anything. I couldn’t have a glass of wine because it tasted terrible. I lost my ability to enjoy life, so I said, ‘Why would I want to go through that again?’ Unless I was going to be definitely better off, which I wasn’t, why would I do it?”

Music program

Germond tried to return to work at one point, but got sick again and decided to call it quits. While undergoing chemo, his time was pretty much taken up. He has agreed, however, to help the hospital with a computer project and was persuaded to launch a concert series at the Cancer Centre called the Colin Germond Music Program.

An amateur violinist himself, Germond performed with several colleagues at the launch of the program and works with a committee to recruit local musicians for a monthly performance.

He hopes that funding can be secured to transform it into a proper music therapy program, but in the meantime, it’s an opportunity for cancer patients and families “to take their mind off things.”

Germond was impressed with the quality of care he received, but attributes it only partly to the fact that he was a physician.

“There were people who had never heard of me. They didn’t know me and didn’t know I was a doctor. They didn’t know anything about me, but they were extremely nice to me like they are to everybody.”

However, hospital bureaucracy can be infuriating, as he learned when a booking clerk asked him one day to come in for blood work at 7 a.m. – a full two hours prior to his 9 a.m. appointment.

“I live five minutes from the hospital, but what if I lived out of town?” he asked. “I’d have to get up at 5 a.m. – it takes two minutes for blood work. Then I’d have to wait two hours for my appointment. It might work well for the hospital, but not for the patient. Having been on the administrative side, I know why these things are introduced, but you hope there’s a human face to it.”

Germond has made peace with his fate.

“It takes time to come to the realization that you’re not going to live forever,” he said. “Until you make peace with it, you can’t deal with it effectively. Once you have, you can say to yourself, ‘I’m not dead yet’ and you can carry on living.

“It’s going to happen to all of us. The only difference between me and someone else, is that I have a timeframe in mind that’s a little shorter.”

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