RFS news highlights resources, issues, and news relevant to in-training members of the ACR. If you have a topic idea or would like to contribute to the blog, please email RFS Secretary Nathan Coleman, MD.
Radiation Oncology Corner: The Healing Arts of Cancer Medicine (Part 2)
I recently spoke with Patrick W. McLaughlin, professor of radiation oncology and medical director for the University of Michigan’s community practices at Providence Hospital in Southfield and the Assarian Cancer Center in Novi, Mich. While McLaughlin’s primary focus is treating prostate cancer, and while he has achieved much acclaim for pioneering MRI-guided, vessel-sparing prostate brachytherapy, he has another passion that is outside the box of classic physician scientist and instead coincides with the healing arts of medicine. In part 1 of this blog post, McLaughlin discussed how the Assarian model come to fruition.
What interested you in the field of radiation oncology?
I migrated from medical oncology. During my research year of fellowship at the University of Michigan (UM), my lab research was on radiation sensitizers. The idea of moving to radiation oncology with the medical oncology background was attractive. My current chair, Theodore S. Lawrence, MD, PhD, had done the same. Besides, I was a bit of a Peter Pan and probably would have been happy moving through residencies my entire career. I love learning and the intensive rush of learning in residencies, but as I used to say, our body only has so many residencies in it.
Early in my career, I truly loved laboratory approaches. An emergency need for staffing in the UM system brought me to Providence, Mich., as a full affiliate. Even though Providence is a community-based hospital, it has a unique commitment to research. I love the incredible power of therapeutic radiation to cure and relieve suffering acutely and without too high a toll.
How have you changed your practice to incorporate science and soul?
This is very much a group effort and is the strongest argument I have as to why democracy is the greatest of all systems. Years ago, before Assarian existed, we had emerging conflicts within our department — interpersonal conflicts and sometimes competition between colleagues, because recognition of superiority was a drain on the mission. Instead of accepting the chaos as the normal bump-and-grind of humanity, we decided to shut down the department for a day. We had discussions of conflicts without judgment, except to remind those present of the disruption to department operations. At one point, I presented the “manifesto.” Mission statements are lofty ideals and at times a bit too lofty, so they are ignored. Manifestos are more urgent, realistic, and achievable.
It was simple: when you walk through the doors of the clinic, leave every personal issue behind. When you are here, let go of every grudge or ongoing conflict with your colleagues — respect them even if you disagree with them. We are here for a greater purpose than self-satisfaction or assertion of will. We are here to create an environment of healing, and that is simply impossible if there is palpable conflict in the air. None of your problems compare to the problems of those we serve. They are paying for your help and deserve your purest effort.
It was probably closer to a military boot camp than a medical training. To a remarkable degree, the day-long seminar worked. At the end, we played a roll of pictures of the patients we had served and we were in tears remembering them.
Humor really helps in diffusing tension. We had two wonderful nurses who had different styles of excellence. I jokingly called one “good nurse” and the other “bad nurse.” “Good” and “bad” were terms of endearment and respect, but two cooks in the kitchen gets very complex unless you have clear ground rules of engagement clear: we are here to make it work, so make it work.
Just two weeks ago, I heard from a patient a sentiment expressed many times:
“I have been in many medical situations over the years, but I can honestly say I have never experienced what I experience here. Every single person is wonderful and helpful and positive.” When I hear that, all our efforts in this direction are worth it.
In what ways have your patients inspired you?
As far back as I can remember, I have found patients inspiring — there is suffering we still cannot relieve, and in that situation, providing is powerful in diffusing the pain of suffering. This is the power of family, the “corner team,” as I commonly refer to it, to transform suffering.
Chelsea Miller, MD, is a radiation oncology resident at Loyola University of Chicago.