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DANA PARSONS ORANGE COUNTY

The human faces of a disease

September 09, 2008|DANA PARSONS

Seventeen UC Irvine med students sit quietly at three long tables in the small classroom, listening to the middle-aged women tell their stories, one after the other. The students are used to hearing from doctors and other health professionals; now, in their third year of the medical school grind, they're meeting actual patients while making the rounds at hospitals.

Chances are, though, they haven't heard things said the way the four women are saying it to them.

"My luck ran out in the spring of 2004," says Sandi Shirey Kars.

Skip Pedigo follows her to the lectern and tells the students: "It all started on a Friday afternoon for me."

They and the two other women after them are talking about ovarian cancer, one of the crueler diseases because its seemingly benign symptoms can be overlooked in the early stages as no big deal. And though five-year survival rates are high when the cancer is detected early, they plummet quickly as it advances.

But the women aren't here to talk clinically, although they do use plenty of gynecological shoptalk with the students. Nor are they necessarily telling the students things they don't know about ovarian cancer -- many, if not all, are familiar with its nature.

The women are here to tell these future doctors how they can save lives -- not just with wonder drugs and state-of-the-art technology but by good old-fashioned listening and asking good questions. By not automatically dismissing a woman's abdominal pains or bloating as routine episodes, especially if there is a family history of female-specific cancer. By being forceful in pushing less-assertive patients to consider all possibilities for what seem like routine symptoms.

At least for a day, there's role reversal. Instead of doctors helping patients, these are former patients hoping to help future doctors.

Three of the women are ovarian cancer survivors; the fourth tells the story of a friend who died of the disease after being misdiagnosed for several months.

"Please be kind," Ellen Miller asks of the students, noting that women with "twinges in our stomachs" may be anxious when discussing symptoms. "We're not neurotic," she says. "Most of us are not histrionic."

The students, already putting in 70- to 80-hour workweeks, listen attentively. Afterward, Kelly Okazaki tells the speakers that she paid particular attention because her aunt was diagnosed several months ago with ovarian cancer.

"It's quite special," she says later that day when asked about the effects of the women's talks. "We may hear from patients in that sort of setting maybe once or twice a year. What's so great is that it puts a human face to something."

Typically, she says, a doctor won't think cancer when a woman complains of a belly pain or bloating. Some kind of gastrointestinal ailment is a more likely culprit. But hearing the women's stories will leave the thought in her mind to ask more questions and consider more options, Okazaki says, "especially because now there's a face to the story."

Julio Echegoyen says the students' current eight-week rotation in obstetrics and gynecology has proved more interesting than he expected. Perhaps for that reason, he was touched by the women's stories. "To see the emotional part, that's not in the books at all," he says. "They look like someone you know from somewhere. That gives you a different kind of perspective."

The intensity of med school sometimes makes it difficult to connect real people to the book learning, he says. And though he says UCI does a good job of impressing that on students, "you're studying so much and trying to run your own life, it's hard to find time to think about it."

Katherine Taylor plans to specialize in ob/gyn care. "I thought it was great," she says of the women's presentations. "It was very helpful because sometimes, especially in the first two years, you're reading about diseases from a very scientific standpoint, a medical standpoint, and it doesn't really mean a whole lot, it's not really real. But listening to people talk and being able to put a face and a real story with the pathologies we learn, it kind of makes it hit home."

A bonus, Taylor says, was hearing that the women's doctors generally were helpful and empathetic. Already fretting about the level of paperwork and insurance considerations that she may someday deal with, Taylor says it's encouraging to hear "what a difference their doctors made in their lives."

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Dana Parsons' column appears Tuesdays and Fridays. He can be reached at (714) 966-7821 or at dana.parsons@latimes.com. An archive of his recent columns is at www.latimes.com/parsons.

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