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During my long hours of seeing patients in my practice as a medical doctor we always encounter different life perspectives through our patients. It is a privledge to have the opportunity to have patients trust their lives in your hands. We learn everyday with each and every one of them, their conditions, life experiences, opinions, etc.  On occasion, I feel like a Catholic Priest during confession, we listen and we pray that our patients will do better than the last time we examined them then, we give our patients our blessings until the next treatment. During that transition, we also grow as individuals, we learn the steps of empathy, sympathy and patience. I always tell my patients that I am their co-pilot throughout their treatment plan. I help them to pave the way by assisting them with coping skills to manage their rheumatological disease and ultimately to own that responsibility for a better treatment outcome.

I am honored to share a short emotional and yet inspiring story of one of my current patients of course with her consent, you know we would never violate HIPAA guidelines or laws. With that being said, I remember one busy afternoon when I saw for the very first time Mrs. Shirley, eloquent, articulate and soon to know a very resilient lady. Mrs. Shirley presented with a new onset of an aggressive form of rheumatoid arthritis. At the beginning of her new diagnosis, she appeared to be in shock and in denial, "How is this possible? What am I going to do now?" After a full explanation of her condition and treatment options and with some added TLC we both agreed on her treatment plan. It was important to start an effective treatment plan right away becauase her arthritis was significantly affecting her quality of life. "My quality of life comes first" she said.

Mrs. Shirley and I had a bond from the very beginning, the kind of bond that you wish for as a physician. Months after she began her treatment therapy, Mrs. Shirley started to feel great once again, she was improving and back to her normal activities of daily living.  About a year later, I received the sad news that Mrs. Shirley had been diagnosed with a new aggressive form of lung cancer.

Soon after, I requested she come to my office so that I could make sure she knew I was here for her at any time and also to explain the upcoming changes in her arthritis treatment due to her new cancer diagnosis. I was thinking, goodness, how I am going to tell her that I have stop all of her current arthritis treatment?

A few weeks later she was in my office and as I started to explain that we needed to stop her treatment, she said "no way, I am not going to stop my arthritis treatment, even if I am dying. I am single, dont have any family around and my quality of life is very important to me. I want to keep my quality of life and never experience the amount of pain that I was suffering. I have lived long enough and although the medication will worsen my cancer,  I also remember those days of pain and I choose quality of life over pain so doctor my wishes are not to stop my arthritis medication"  

" I have lived a wonderful life, travel, adventure, wonderful friends, love blessed with all. My late husband would also say if I died tomorrow my life has been fuller than 75% of so many. I have to know of him that was true and we sat about making it a adding to many adventures."


I was perplexed with her decision, thoughtless and in awe. I took a minute to think about her wishes and I realized once again that although I recognize the importance of the treatment guidelines, years in medical school, textbook materials;  everything is secondary to the patients quality of life, empathy, resilience, acceptence and will. To this day, Mrs Shirley continues with her rheumatoid arthritis treatment and her lung cancer chemotherapy and she continues to have a positive outlook on life. Patients like Mrs Shirley teach us how fragile and precious life can be and that every whether the outcome is positive or negative, we should accept the circumstances and that we must work through our fears in order to see the beauty on the other side. Thank you Mrs. Shirley for sharing your story.

I found this poem from a poet that suffered from rheumatoid arthritis and I wanted to share with you as well.


I am not my usual self, for days I've felt unwell.

I've lost my mojo anyone who knows me can tell.

I feel so ill, my back hurts, my arms and legs hurts too,

My neck is so sore, I really don't know what to do.

I could ring the doctor again, what good would that be?

I could go visit him but there's nothing new to see.

I can not drive today, my fingers are so sore.

I can just complain and mope but that is such a bore.

No one knows how I feel, I can't make them understand,

When you feel as low as this your thoughts gets out of hand.

I'm not a hypocondriac, nor one to complain,

I could whine all the time but that would be in vain.

Unless you are a sufferer, you wouldn't believe

The lengths I will go to, to have the pain relieved.

Maybe tomorrow morning when I get out of bed

I will feel much better and love the day ahead.

Days I ask myself questions, there are no answers back,

Days I go out and enjoy myself, life is back on track.

I keep my pain and suffering private so no one will ever know,

They only see the "ME" which I force to "get up and go"

By Dorothy Logue (Patient with rheumatoid arthritis)

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