COMMENTARY

Can an Oncologist Be Sentimental?

David J. Kerr, CBE, MD, DSc, FRCP, FMedSci

Disclosures

August 07, 2020

This transcript has been edited for clarity.

Hello. I'm David Kerr, professor of cancer medicine at the University of Oxford.

Today, I'd like to talk about sentimentality. I grew up in Glasgow, Scotland, in the late 1950s through the 1960s, at a time when emotions were repressed and deeply buttoned down. It was unusual to display one's emotions. As I am older now, I find that I'm sentimental. I wanted to explore whether you thought there was any role for sentimentality in oncology and how we deliver cancer care.

What do I mean by sentimentality?

When I was young, I remember reading Graham Greene's The Heart of the Matter. He judged sentimentality to be the cheapest of all emotions. I think there is some truth in that. It may be an unearned emotion. Originally, it indicated reliance on feelings as a guide to truth; but, in current usage, I would suggest that it commonly connotes shallow, uncomplicated emotions at the expense of reason.[1]

Charles Bukowski famously said [in Love Is a Dog from Hell] that he drove around the streets an inch away from weeping, ashamed of his sentimentally and possible love. I still go on sentimental journeys with my brother to revisit childhood haunts. When a patient asks me, "How long have I got, and what should I do with my time?" — I suggest that they go on sentimental journeys.

How does sentimentality manifest itself in me?

There is a syndrome of men who blow their noses on airplanes while watching sentimental movies. Why do men blow their noses? Their nasolacrimal ducts are bigger than women's. Rather than cry, the tears run down their nose, and they've got to blow their noses loudly and frequently. That's a definite syndrome. For you men watching who haven't experienced it, I'm sure that you've at least noticed it.

I get sentimental in crowds. Every year, we have a remembrance service around the 11th of November, commemorating the fallen during the various wars, including World War I and II and others since then. There's something about the gathering of crowds in that act of remembrance. Those old soldiers who are battered, bruised, and unbowed and yet come together gives me a huge lump in my throat. Recently, in our small village in North Oxfordshire, we had a soldier return — not a soldier exactly, but one of our neighbors who had been ventilated for a month with COVID-19. The entire village turned out to cheer his return. It was an act of communal, collegiate, and collective sentimentality that brought a huge lump to my throat.

How does this impact upon the delivery of cancer care?

I've talked before about how we can communicate compassionately, gently, and kindly. That's an absolute given. But these days, whichever part of my brain has been switched on by my sentimentality center, I do get unbidden lumps in my throat when dealing with patients. I'm triggered by small visual cues and patterns of language used. I find that unusual.

I think it's come with age, with me becoming more sentimental. For my friends and colleagues who are listening and who work in the oncology field, I wonder whether sentimentality plays any part in your lives and in any part of the way that you deal with patients and their families. I don't just mean breaking bad news — most commonly, but not always. It's that momentary loss of control of one's emotional responses, usually against one's better judgment. That, for me, is how sentimentality somehow and sometimes intervenes.

This is an unusual topic for us to discuss, but one that I hope causes you to think a little about sentimentality in your own life and in how you practice medicine.

Thanks for listening, as always. For the time being, Medscapers, ahoy.

David J. Kerr, MD, CBE, MD, DSc, is a professor of cancer medicine at the University of Oxford. He is recognized internationally for his work in the research and treatment of colorectal cancer, and has founded three university spin-out companies: COBRA Therapeutics, Celleron Therapeutics, and Oxford Cancer Biomarkers. In 2002, he was appointed Commander of the British Empire by Queen Elizabeth II.

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