Dr. David Kaufman, a breast cancer surgeon based in Bethpage, tells about 250 of the 500 female patients he sees each year that they have breast cancer. Though he earned his medical degree at the Universidad del Noreste School of Medicine in Tampico, Mexico and completed his studies at the University of Maryland School of Medicine, “telling [a patient] they have breast cancer is not something they teach you in school.” Dealing with a conversation that is so personal, Dr. Kaufman has learned to remain compassionate on an everyday basis. He spoke to me about the reality of his everyday encounters.
How do you tell someone that they have breast cancer?
It is one of the most difficult things that I do in my job. You sort of find your way by trial and error. You develop your own style, what words to use, how to present the news, the timing of presenting the news (phone, person, with others around). These are all things you grow with and learn as you do this. There is no right or wrong, no recipe, it can be different for every patient. You have to feel out their personality to know the best way to do it for them. Most of the time, I sit down with the patient in a quiet environment, hopefully she has loved ones or close friends nearby, and just basically explain the diagnosis and reassure her that there are tons of treatments to control and cure the disease.
Do you connect with them on an emotional level?
In many cases, you have to be clear and direct but also kind, gentle, compassionate and optimistic. Having firm eye contact, physical contact by holding the patient’s hand, touching their shoulder and even holding or giving them a hug. I have cried with patients. It’s sort of a touch-and-feel situation where you have to guide your actions based on how the patient is and how they are receiving it. It is also important that you are explaining things in simple language (avoiding technical terms) so people who aren’t just physicians and nurses can understand.
What type of reaction do you see the most?
Bewildered, fearful and terrified. When I look into a woman’s eyes, I can see the terror, especially younger women. The first thing most women say is, “Oh my God I have children I have to be around for.” That is a very common thing you hear in women ages 45 to 50.
How do you respond to that?
I reassure them that we are going to do our very best to find out exactly what the problem is, how to best treat it and hopefully cure it and make sure that they live a long healthy and active life. And that is what I am there for—to provide them with the very best care, the latest technology and just reassure them we are going to do everything we can to get rid of this cancer.
What coping strategies do you suggest?
That women surround themselves with loved ones, have a positive attitude and remain active through yoga and other exercises. I find that a lot of women benefit from support groups, having the chance to speak with other people who are maybe in the same or similar situations. People in the support group [often] face similar emotions, fears, anxieties, uncertainties and family issues, which gives them the chance to share their ideas about how they cope and it [can] provide great comfort.
How do you remain compassionate?
It is not easy but what keeps me focused, passionate and committed are the patients. They need me. I know that I provide a great service for women who are sick and I also know there is tremendous positive reinforcement in what I do because we treat and cure most women these days. If found relatively early, most of these cancers are curable. Stage 0 cure rate is almost 100 percent, Stage 1 cure rate over 90 percent and Stage 2 is over 80 percent. Even worst case scenario, people are living longer. We may not be able to cure Stage 3 or Stage 4 but we are diagnosing earlier and earlier, which is why more are surviving.