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Simulator Offers Doctors and Nurses a Lesson in Fatigue

Health: Many medical professionals don't grasp weariness felt by cancer patients. Experience on machine teaches empathy.


You'd think doctors would understand what it's like to be physically wiped out, what with those exhausting, 36-hour hospital residency shifts most were forced to pull in medical school.

But there's plenty they don't know, particularly about the unrelenting tiredness that many cancer patients suffer day after day.

Physicians and nurses throughout Los Angeles are finding that out this week in a mobile "fatigue simulator" making the rounds of local hospitals.

The $1.5-million demonstrator is part arcade game and part Stairmaster. It recreates the exhaustion and hopelessness that weakened patients experience as they go about such routine activities as answering the telephone.

"Right now I can really feel the pain and agony patients feel," said cancer specialist Dr. Sohail Saeed after stepping out of the trailer-mounted simulator during a stop Wednesday at Harbor-UCLA Medical Center in Torrance. "It's a terrible feeling."

Medical experts say that debilitating, nonstop fatigue affects nearly eight of 10 cancer patients. But most do not discuss it with their oncologists. And those who mention their weariness to their regular doctors often are brushed aside.

"The patient is told, 'You didn't eat' or 'You didn't sleep enough' or 'You need vitamins,' " Saeed said. "They don't think of anemia. This is a good reminder."

That's exactly what the sponsor of the mobile simulator hopes to give doctors. Ortho Biotech Inc., which has two of the trailer units traveling to hospitals across the United States, markets an anti-anemia drug for cancer patients.

The simulator has visited UCLA's Jonsson Comprehensive Cancer Center and the County-USC Norris Cancer Center as well as Harbor-UCLA Hospital. Today it is at Kaiser Hospital in Baldwin Park, and more stops are planned.

At UCLA's Westwood campus, cancer nurse Sheila Stinnett said that in the past, she has simply counseled patients who complained of fatigue "to pace themselves." A 12-minute stint in the simulator was eye-opening, she said.

Wearing a headset with eyepieces displaying a television picture, Stinnett sat in a chair with her feet clamped upon hard-to-press pedals. Sensors attached to her right hand completed the virtual reality hookup.

During the simulation, she struggled to "walk" on the pedals while trying to heat a teakettle in the kitchen, greet a deliveryman dropping off medicine at the front door and answer a telephone upstairs.

"My legs are sore!" Stinnett exclaimed halfway through. "Oh, there goes my medicine--the check slipped and went under the chair. Now the teakettle is whistling . . . the phone is ringing, but it's not on its holder--it's upstairs."

Stinnett, who is president of the Los Angeles chapter of the Oncology Nursing Society, had worked up a sweat by the time the simulation ended.

"I feel exhausted and frustrated. It's unbelievable," she said between gulps from a water bottle.

Eric Streit, a member of the five-member crew that runs the simulation, said some doctors and nurses who have experienced it since its unveiling three weeks ago in New York have been too tired to leave the trailer.

"Doctors don't know what it's like," said Frank Estrada, Biotech's Los Angeles manager.

"They really don't."

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