Tools of the Trade

It's hard to be excited about being cut-off from a potentially life-saving drug. At the same time, it's difficult to be devastated about being freed from the grips of a toxic, potentially lethal cocktail. Modern medicine has made for a nearly impossible dilemma: "Accept out potions -- they may help you, but we promise you nothing", or "Reject our therapies, and we can promise you nothing". Or perhaps these decisions are not new to modern medicine. I presume they were faced by every patient over the millennia.

At the Mayo Clinic in Rochester, MN last Summer, I took an enlightening stroll through the beautiful and historical Mayo Building, in which the Mayo Museum was contained. The museum included biographies of the founders and medical milestones achieved at the Clinic. This being several months after my first surgery, I had already "seen" the scalpel and other tools of the trade although I had never laid eyes on them. But all this experience did not make me ready for what I encountered in the next room of the museum: the "tools of the trade" from days gone by. I was not prepared to be horrified. The scalpel, the drill, the saw, the clamps, the stitching needles. These did not look like the tools to be found in a sterile operating room. Rather, I imagined them scattered on my father's dirty work bench in the dingy basement among metal shavings and wood scraps! I envisioned my kind doctor using such instruments to cut through my flesh.

Needless to say, these horrifying sights changed my perception of medicine. I am not alone when I classify these tools from a century ago as barbaric! I have made a decision not to look at currently used tools, as they come too close to home.

Through the course of my current infirmities, I have experienced many of the tools: chemotherapies, radiation, surgeries, invasive testing. The mechanisms by which each of these is designed to work astounds me. Chemotherapy, although it has come a long way over the years, is designed to kill a wide variety cells -- unhealthy and healthy. Radiation is designed to kill a wide variety of cells -- healthy and unhealthy -- along the way, doing extensive damage to fine DNA. Both of these tools have a nearly infinite list of known risks. Some of the risks include cancer. The list of unknown risks certainly extends much further. Surgery, too, has more risks than I care to think about and has consequences that are often as frustrating as the primary disease.

I write this as I am waiting, once again, for my oncologist to call with the recommended course of action. The reprieve from chemotherapies gives me great joy! I have no notable aches or pains, no skin rash, no digestive disagreements, and no fatigue. Minimal symptoms from the ailment, and no side-effects from the treatments. I am at ease, but not for long. Soon the dilemma will return: disease or poison. I believe that the later term will commonly used by those of later generations looking back as the 21st Centry fades into the next. These plush, high-ceiling radiation therapy rooms in which we place our trust will be museum items that terrify. And descriptions of the barbarous chemotherapies will send shivers down the spines of children. These are the tools laid out in the sterile 21st Century operating room.