Some years ago, I wrote about the use of male urine bottles for nocturnal emergencies in hospitals, describing how the colloquial word “vase” could sow confusion.
When asked for a vase, a night nurse, without full training, replied, “How big is your bouquet, sir ?” I have heard that the object also causes embarrassment in Cork, where the said male urine bottle is known to gents as a “pigeon”, perhaps relating to the shape of said receptacle. Years ago, a correspondent of mine was in a hospital where a Swiss nurse was working. The sister was a formidable lady, with five languages under her belt. But, alas, the lass did not have Corkese. A patient called out for a pigeon during the night and, in confusion, the nurse asked: “Do you want to go out to feed them?” “No,” the man replied. “Do you want pigeon for lunch?” she asked. “No,” the man replied, getting desperate. So she asked him what he wanted a pigeon for. “I WANT TO PISS IN IT!” was the response. He got his wish. And his pigeon. Just in Swiss time.
“Dear Dr Gueret, do you agree with chemo? I don't!” I do get some good letters and, though I am behind with my correspondence, they keep me going. Idle doctors enjoy reading about what patients get up to and think about the health service. Most of us assume that chemo is short for chemotherapy, and that the lady in question wants my opinion on pharmaceutical cancer treatment. Before I start my dissertation on medical oncology, I shall tell you a true story about the word chemotherapy, and how it once affected a patient. An elderly man was undergoing TB treatment as an outpatient in a Dublin sanatorium. His therapy was going very well, but, despite this, he was noted to be very down in himself, fretful and fearful of the future. He was even starting to get his final affairs in order. It was assumed he had been visited by mental illness, but the true diagnosis, obtained by a good nurse, was far more interesting. It transpired that, during a visit to the TB outpatients, the man overheard his doctor recording a letter about him into the dictaphone. The word “chemotherapy” was used to describe the range of antibiotic treatments used for his TB, and the man assumed he must have cancer, and that the doctors were being kind by not telling him. When the truth was explained, and it was pointed out that the word “chemotherapy” actually means the treatment of any disease with drugs, all his worries floated away.
Words are very dangerous things in medicine.
Now, back to the question of whether I agree with the medical treatment of cancer. Of course I do. A few minutes in the blood or cancer outpatients at Our Lady's Children's Hospital in Crumlin should cure any doubting Thomas of the |life-saving difference such medicines can make. There must be thousands of adults walking this country today who would have perished as children without cancer chemotherapy. Now, I'm no Professor Crown, and I don't have the intimate or up-to-date knowledge of modern cancer therapeutics that he has.
But, in layman's terms, cancer treatments strive for three outcomes. One is the complete cure of a disease. Another is remission. And, if this is not possible, the third is slowing the disease in its tracks so the patient can have a better quality of life, fewer symptoms and, perhaps, live longer. There are always valid questions to be asked about whether cancer chemotherapy should be used. This depends on the age of the patient, how well he or she is, whether they have other diseases, what sort of cancer they have, and the stage of the road it has reached. Every cancer is different, just as every patient is different. You retain the right to refuse treatment, just as you have the right to request treatment. You have the right to know every minor detail of disease, treatment and prognosis. But you also have the right to ask not to be informed, and be kept cheerful and positive. You probably know what kind of doctor you have, but he or she needs to be told early, and clearly, what sort of patient you are.
I personally would choose to be in the ignorant-but-cheerful camp. As for the wisest question you could ask both your GP and oncologist, it's probably, “Well, what would you be having yourself?” Cancer chemotherapy with powerful medicines tends |to grab the headlines, but other treatments to be availed of include surgery and targeted radiotherapy.
When I began editing the Irish Medical Directory 20 years ago, we listed just 10 cancer specialists in Ireland. We now have more than 70 — half using radiation, half medicines. There were just 11 blood specialists (haematologists), and now there are more than 60. Still not enough, but we are getting there.
A retired pharmacist from the Queen's County of Laois has been in touch with enough gems about old remedies to fill a book, and that's what I might do with them someday. In the meantime, we'll dip in and out, starting with the early 20th-Century Pure Wine Movement, which encouraged Irish folk to take remedies such as Sharman Crawford's Invalid Cross Port. When the Dangerous Drugs Bill was going through the House of Commons, medicated wines were not covered. This Invalid Cross Port was promoted as a “restorative” from nature, free from “adulterants” and made from grapes grown on the southern slopes of the Alto Douro in Portugal. If anyone has one on top of the wardrobe, I'd very much like to try it!
- Dr Maurice Gueret is editor of the ‘Irish Medical Directory’