Are Oncologists Different From Other Doctors?

Neil Chesanow

Disclosures

October 10, 2013

In This Article

What Sort of Doctor Chooses Oncology?

Much about oncologists is counterintuitive. These are the cancer doctors. Whatever one feels about cancer tends to get overlaid onto them. If we believe that cancer is sad, grim, horrific, depressing, death-haunted, and the antithesis of fun, what are we to think of the doctors who choose to study and treat cancer?

None of these adjectives accurately describes them, oncologists point out.

"Most oncologists I know are pretty happy people," says lung cancer specialist Jyoti Patel, MD, Associate Professor of Medicine-Hematology/Oncology at Northwestern University Feinberg School of Medicine in Chicago. In her experience, far from being moody and depressed, oncologists, by and large, are pictures of mental health: "positive" in outlook and, given the large number of patients who ultimately succumb to their disease, surprisingly "optimistic."

More counterintuitive still, oncologists say that the specialty is well known (at least among its practitioners) for having a sense of humor. "We use humor a lot in our coping mechanism," Patel admits. "Among ourselves. Among our teams. Certainly with our patients."

But isn't humor, well, inappropriate to the gravity of the situation?

Just the opposite, as it turns out. The use of humor in medicine in general, and in particular with patients with cancer, has been well studied. In 2005, for example, the Journal of Clinical Oncology published a literature review, "Humor and Oncology."[4] It found that "anecdotally, the use of humor is widespread in the oncologist-patient relationship and in the patient literature."

"Humor serves many roles for the patient, their family, and the treating physician," the investigators concluded.

As an example, the authors quoted the comedian, conductor, and pianist Victor Borge. "Laughter," Borge quipped, "is the shortest distance between 2 people."

Closing that distance is extremely important in oncology, where doctor-patient interaction is among the most intense in medicine. Patel, who takes medical students on hospital rounds to give them a taste of her specialty, notes that the "very personable long-term relationships with patients" make a big impression.

"A fair number of people are initially attracted just by the science," Patel elaborates. "But when you walk into a clinic as a medical student or resident and see patients who are so close to the MAs, nurses, and physicians, it's very attractive for young physicians in training to have someone have so much confidence in you or have that kind of relationship with you."

That appeal is often rooted in early personal experience, she has found. "I think most oncologists get into it because they have a personal tale to tell," Patel believes. She offers herself as an example. "My father was a physician who died of cancer when I was very young," she recalls. "When I decided to practice medicine, it was clear to me that this was what I was going to do.

"Many of the oncologists I know had a very personal experience with a family member, friend, or teacher when they were younger," she says, "and then, armed with knowing what made that bearable, wanted to do it for other people."

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