Matters of taste

My friend John and I had very different taste in doctors. Two years before I met my dermatologist, John had an appointment with him. After the appointment, John called him a cold fish with no personality. He knew his stuff, he said, but there was no chemistry between them.

It took Jane three tries…

My primary care doctor sent me to see the same dermatologist for a spot on my face. I went to that appointment with an open mind–knowing John and I were different people. The doctor and I hit it off immediately. We’d both been serious runners in our youth and still ran recreationally. Our appointments always end with us catching up a little.

Individual judgements

Jane went into the hospital for a blood clot that may have been related to her cancer the same day we learned about her NET cancer. An oncologist met with us while she was there. When he left, Jane’s reaction was, “Not him.” The man was as knowledgeable about NET as most oncologists were at the time–which is to say he didn’t know very much beyond what he’d read. But Jane found his tone offensive and his manner abrasive. I’ve since known other patients who liked him just fine.

The doctor and I hit it off immediately.

A week later, we met with another oncologist from the same office. She, too, had very little knowledge of NET cancer beyond what she’d read. But she and Jane hit it off well. She referred us to Dana-Farber for a consult that turned into Jane being treated there. But if that hadn’t happened, Jane really liked that second local doctor a great deal. The chemistry worked.

Powerful chemistry

Matt Kulke, the head of the NET cancer program at DFCI, was out of the country at the time. We went to see Jen Chan instead. I watched two long-lost sisters meeting for the first time when Jen walked through the door. That encounter was a confluence of chemistry, biology, and physics in a single second.

The chemistry worked.

I’ve heard wonderful things about Matt as a doctor and a person from his patients over the years. I’ve worked with him on committees, gone on walks with him, had dinner with him. I’d take him as my doctor in a heartbeat–as I would Jen. But given the instantaneous chemistry between them, for Jane, Jen was the better choice.

Why the relationship matters

Especially with a disease like NET cancer, having a knowledgeable doctor is not really enough. The personal relationship matters. Patients need a doctor they are comfortable talking with about diarrhea episodes and other uncomfortably intimate matters. Sometimes, the only way a doctor can know what is really going on with a patient comes out of those kinds of conversations. It informs treatment just as much as knowledge of the treatments does.

…a confluence of chemistry, biology, and physics in a single second.

But the chemistry that exists between any particular doctor and any particular patient does not provide an indicator  of the chemistry between that doctor and any other patient. Nor does it help describe the chemistry between that patient and some other doctor. Each case is different. The doctor I like, you may hate; and the doctor I can’t stand, you may love.

Each relationship is different

I’ve met a significant number of NET cancer specialists over the last seven years. Some, I’ve immediately hit it off with. Others, not so much. But they’ve all had two things in common. First, they all were really knowledgeable about NET cancer, though all have more expertise in some forms of the disease than they do in others.  Second, they all have patients who love and respect them who say they have the best doctor they could ask for.

The personal relationship matters.

And they do. Knowledge matters. So does being comfortable with your doctor. But just because a particular doctor is right for you, doesn’t mean that doctor is perfect for everyone. And just because you don’t get along well with a particular doctor, doesn’t mean they are wrong for everyone else.

Are you comfortable?

It took me four tries to find the right cardiologist for me. I like him so much, I made him my primary care doctor, as well. Those other doctors were just as knowledgeable, but I never felt quite comfortable talking to them. I have friends who like them fine. It took Jane three tries to find the perfect oncologist for her. The others were fine doctors, just not the right people for Jane.

…they have the best doctor they could ask for.

Like the elements in the Periodic Table, we are all different–and we all react to each other in very different ways. We all need to keep that in mind while we search for the right doctor for us–as well as after we’ve found them.