Date: February 1, 2012
Pancreatic Cancer: A Patient & His Doctor Balance Hope & Truth
Michael J. Lippe and Dung T. Le, MD (Johns Hopkins University Press, 2011)
Pancreatic cancer has been in the news a lot in recent years, given its prominent victims: Steve Jobs, Patrick Swayze, Luciano Pavarotti. The demise of these famous—mostly youthful—individuals reenforces the public’s perception of pancreatic cancer as a malignancy that inevitably leads to the grim advice: “Get your affairs in order.”
No question about it: Pancreatic cancer is bad. All cancers can be classified as such, but pancreatic is among the worst—especially so because its symptoms often don’t appear until it already has reached the stage when a cure isn’t possible.
Yet even advanced, Stage IV, pancreatic cancer can be treated, and the lives of those with it extended, in some cases for a number of years. In their remarkable joint book, Hopkins medical oncologist Dung T. Le and her patient, Michael J. Lippe, a retired international development businessman, describe in impressive detail his diagnosis of Stage IV pancreatic cancer and her treatment of him from their unique, separate perspectives. It’s a book that provides valuable insights—some moving, all informative—for patients and physicians alike.
The 11 chapters in Pancreatic Cancer were written by the authors separately, offering the reader distinct voices and viewpoints. Lippe, diagnosed in December 2007, describes with vivid, surprising candor his emotional reactions to his prognosis, what he has learned about his disease, and his physical response to its treatment. He also writes of how he has (or continues to) come to grips with his mortality; how he and his family have reacted to his illness; and how he has beaten the odds substantially and now is in his third year of treatment.
Le writes of her analysis of Lippe’s case and decisions on how to treat him; of her interaction with him and his wife, as well as with other pancreatic cancer patients and their families; and of how physicians can best attempt to serve such individuals. In some of her chapters, she reveals that Lippe’s narrative actually has told her things about his reaction to his treatment that she hadn’t gleaned during their three-year physician-patient relationship.
Brief (at just 171 pages) but powerful, this straightforward book is both sobering and inspiring. In his final chapter, Lippe writes of his terminal illness: “Sadness is inevitable, but it is possible to depart this life with a sense of having done positive things.”
By writing this book, he and Le definitely have produced just such a positive thing for future patients and their physicians.
When Your Spouse Has a Stroke: Caring for Your Partner, Yourself, and Your Relationship
Sara Palmer, PhD, and Jeffrey Palmer, MD (Johns Hopkins University Press, 2011)
Each year, about 795,000 people have a stroke in the United States, and an estimated 6 million stroke survivors strive to surmount its impact. Married stroke survivors often are cared for primarily by their spouses or other family members—a now fully recognized “social group” of caregivers that is estimated at 29 million people.
As husband-and-wife Hopkins physical medicine and rehabilitation experts Sara Palmer and Jeffrey Palmer observe, a stroke impacts both the person who sustains it and that person’s spouse. Clearly, “the effects of your spouse’s stroke on your emotional health and your relationship can be far-reaching,” they write, making it likely the “biggest challenge to your married life.” Its “shockwaves” also can have a direct, potentially deleterious impact on the physical and emotional health of the caregiver, who may be worn down by the demands of the full-time attention they must give to their stricken spouse’s needs.
Sara Palmer, a rehabilitation psychologist who has been on the faculty of the Department of Physical Medicine and Rehabilitation since 1999, and Jeffrey Palmer, a physiatrist who joined the department in 1983 and became its director in 2004, have more than a quarter century of experience caring for stroke sufferers.
They write that “a major source of inspiration” for their book has been the stories that they’ve heard from stroke survivors and their spouse/caregivers. These are adapted, sometimes combined as composites, and included as reference points throughout their narrative, providing compelling examples of how couples learn to cope with the frequently devastating impact of a stroke on the non-afflicted partner.
Jargon-free, the Palmers’ book contains a broadly informative introduction to the issues, an excellent epilogue on the future of caregiving, and six chapters. These cover such subjects as how caregivers can obtain support, especially emotional support, for their spouses—and themselves—from other sources; how to balance the role of caregiver with other marital, social, and work roles; sexuality after a stroke; and how caregivers can find ready assistance from stroke clubs and other social activities to provide help. In addition, the book deals with maintaining a satisfying marriage after stroke, as well as an overview of how to prevent another stroke and plan for the future. Each chapter concludes with a list of “Practical Tips” for following through on its advice.
Neil A. Grauer