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Focusing on the Illness, Not Just the Disease

By Heather Maloney
Beth Israel Deaconess Medical Center staff


David Roberts was your typical young doctor: busy, hardworking, and, with a hectic schedule, not always careful to take the time to eat right and exercise.

That was before he was diagnosed with cancer.

In fact, he diagnosed himself with cancer, but that's jumping ahead a bit.

It all started in 2002. Dr. Roberts, now the Clinical Director of the Division of Pulmonary, Critical Care & Sleep Medicine at Beth Israel Deaconess Medical Center in Boston, was giving a presentation one morning when he began to feel terribly ill. He didn't know it at the time, but his spleen had spontaneously ruptured.

He sought out a colleague to examine him, then walked into the ER to be treated for what they thought were kidney stones. When he didn't respond to the treatment, he was sent for a CAT scan.

"While I was in there, the head of GI radiology walked in and I thought, 'gee, I wonder why he's here,'" Roberts says. "And then it hit me."

"I asked him if I could look at the scans," he said. "As soon as I sat down in front of them, I said 'this looks like I have lymphoma.'" It was May of 2002. Roberts was 33 years old.

He was treated with surgery and chemotherapy, and was out of work for seven months. But through it all, one thing kept coming up.

"When I was sick, I found that colleagues kept asking me 'What's it like to be a patient?'" Roberts says. "And I realized that, despite seeing thousands of patients, most doctors don't really know what it's like to be a patient with a life-threatening illness."

That gave him an idea.

Roberts applied for the Rabkin Fellowship in Medical Education, BIDMC's premiere professional development program for medical educators, and spent a year learning how to teach. This led to the development of his teaching module, "Reflections From the Other Side: Doctor as Patient."

Today, Roberts frequently speaks to physicians about his cancer diagnosis, and what it's like to be on the other side of the proverbial fence.

"I've given this talk to medical students, residents, nurses, laypeople...just about everyone," he says. "And I tell them all the same thing: as doctors, we tend to focus on disease, not illness."

Roberts believes this disconnect is not the fault of the doctors, it's just that most doctors have never experienced the anxiety and fear that goes along with having a serious illness.
"Being a patient opens your eyes," he says. "I tell all of them that they can use the experience of patients to improve what they're doing."

Roberts relates the story of curious colleagues who asked him what he did with all of his "free time" during his seven-month recovery.
"It was a question that seemed hard to understand," he says. "There I was, sleeping 16 hours a day because I felt sick and exhausted. But that's the part of illness that we sometimes don't see."
And Roberts is careful to practice what he preaches.

"When I was sick, I was followed with PET scans and CAT scans," he says. "And I found that each time, I got really worked up waiting for the results."

"As pulmonary physicians, my colleagues and I order 100 chest CAT scans a month. It occurred to me that my patients were probably going through the same stress and anxiety waiting for their results as I did," he says. "Now, we make a big effort to call patients as quickly as we can with their results."

The response to Roberts' program has been overwhelmingly positive.

"It really resonates with medical students, especially," Roberts says. "And it resonates with the both physicians and the public because everybody understands that illness is devastating no matter who you are."

Today, Roberts is healthy.

"I feel pretty lucky, and I appreciate all the excellent care I received," he says.

Above content provided by Beth Israel Deaconess Medical Center
For advice about your medical care, consult your doctor.

Posted December 2009

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Boston, MA 02215
617-667-9235

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