Dr. Cunningham and trust

So the day comes for us to go to the surgeon. We had already been told that we would wait a long time because we were squeezed in on his schedule. We waited 2 plus hours, which I was surprisingly okay with. I kept telling myself it was going to be worth it. Boy was it ever.

Dr Cunningham walked in, shook each of our hands as he introduced himself, and then sat down and read Pat's chart. Seriously, we sat in silence as he read through everything, and thumbed through all the papers. Pat and I kept looking at each other because it was kind of a long, awkward silence. Finally, he peered over his glasses at Pat and said, "so basically you had some weird blood levels, your doctor sent you to an oncologist who found out you have a large spleen, and now you're here to talk to me about removing it." Ummm....yep that pretty much sums it up. He looked older than I remember him. His hair, once salt and pepper, is now white, and there's much less of it. Still seemed pretty mellow.

He then proceeded to read each of the reports out loud to us, explaining each as he went. He started with labs and told us how Pat's red and white cells, as well as platelets were remarkably low. Yep, knew about that. Then he started reading the CT scan, "spleen remarkably enlarged, with multiple lesions throughout." Wait...what??? I quickly cut in and ask him to repeat what he just said. He does and then looks at me waiting for a response. I tell him no one has told us about lesions. He nonchalantly says, "oh. Well I'll keep reading then." He then mentions that there are 2 enlarged lymph nodes near the spleen and two enlarged lymph nodes lower in Pat's abdominal cavity. He pauses and looks at me and I tell him how that is also new information to us. He then moves on to the the PET scan and tells us how the spleen reacted as well as the four lymph nodes. We sit quietly. Dr Cunningham closes the chart and turns his chair to face us.

He explains that all the information we need to get a true diagnosis is in the spleen. He explains that he feels that the spleen needs to come out. Pat asks if they could just biopsy it. The doctor says well we could but I think it really needs to be removed. Based on the scans it seems very diseased and should be removed. He explains that he will remove it through 4 incisions and that Pat will have to stay in the hospital for 1-2 nights. I ask about the lymph nodes and he tells me that the only way to get to them is by cutting Pat completely open and removing most of his organs, and that it isn't worth the risk when the spleen will have all the answers we need. He then asks if we have any questions. So I go for it again. I ask him based on all the reports he just read, does he think it is lymphoma. I totally expect the same dancing around the topic answer that I got from the oncologist. So I'm totally shocked when he instead says "yeah, most likely."

Wow. I thank him for his honesty, and then apologize for being so pushy and direct. He gives me a wry smile, and dismisses the idea completely. He then looks at us and explains that a doctor-patient relationship depends completely on trust. If we don't trust him it's never going to work. Therefore, he has to do his part to make sure we can always trust him and that starts with him being as open and honest as possible. He tells us he won't ever hide the truth even if the truth sucks. I am all at once completely at ease with this man operating on mine.

He then goes on to explain that surgery will be scheduled 3 weeks out. 3 weeks!!!?? Before I could protest, he quickly explained that while you don't need your spleen to live, not having one leaves a person susceptible to 3 main illnesses. Pneumonia, haemophilus influenza, and meningitis, and as such, it would be best to immunize Pat against these 3 diseases prior to surgery. He tells us that the body then needs about 3 weeks to build up the antibodies and then we are good to go. It is best to give the immunizations while the spleen is still in the body and the immune system is intact. He assures us that even in the case of cancer, 3 weeks will not matter, and the risk of him contracting a bad case of pneumonia in this valley is high. I unhappily agree with the plan and so surgery is scheduled for September 3rd.