A NEAR FATAL TALE OF TWO PATIENTS — ONE CAUSE, STRESS

Most of us have heard the expression, "stress kills".  To some it is a metaphorTo a practicing physician is it much more–it is truth.

Now academic types will often deride the notion of "anecdotal medicine".  They insist that medical knowledge and truth is only derived from randomized, controlled trials.

Granted, science needs to proceed along recognized standards of evidence.  Yet in the real world, one real patient, or two, having  real experiences are worth a great deal.

To be specific.  The first patient is none other than my father, presently 90.  Several years ago while caring for my mother, his wife of 64years with progressive dementia, he nearly died.  It was crystal clear to me that ,his overwhelming, nearly fatal pneumonia was  a consequence of his nearly defunct immune system.  There is no other explanation to explain the phenomenon.  Although elderly,  he was rarely sick and had no other predisposing factors.

Miraculously, he survived.

My next patient, may not.  Her story is incredible because she is a survivor of rectal cancer diagnosed, operated on and followed closely for over ten years.  While other types of cancer can recur after many years, colo-rectal cancer is usually considered "cured" if it has not within five years.

A colonoscopy performed just over one year ago revealed no evidence of cancer.  A recent colonoscopy now reveals one!

Now colonoscopy is not perfect, neither is the gastroenterologist who performs it.  And colon cancers are not supposed to spring up this quickly. But in this case there can be no doubt that this lesion was not present one year ago.  The rectum is the first and last part of the colon examined.  There was nothing there one year ago.

So what can explain the change?  I have no doubt that her incredible emotional stress in handling her husbands struggle with cancer and dementia, his visits by Hospice, have rendered her immunologically impaired.

I can only surmise that cancer cells have remain dormant in her rectal mucosa and would otherwise have remained so if it were not for the overwhelming, unremitting  emotional stress she has been enduring.

Science has offered explanations for this most vexing aspect of the mind/body connection and it boils down to an incompetent immunological response to infections and cancer.

The lesson here is painful and difficult.  Will we ever be able to reign in our emotions when it involves the suffering of our loved ones?  Is meditation, psychotherapy, even neurofeedback the answer?

Perhaps we need to understand that our own survival may necessitate the awareness that our suffering  may not change the outcome of those we love.  What is worse is for our families to lose two loved ones in the process.

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