Suicidal ideation - oncologist called the police.
I had a bad pathology report 10 days ago and today met with the oncologist. She said only what I thought she would say - more waiting, to do scans to look for distant metastases, followed by chemotherapy (unless there are mets. already). Tumour is large (6.8cm) with one +ve node and invasion posteriorly into muscle. Stage 3b ILC HR+ HER2-, Ki67 - 47%.
In the last few months we have moved across country and are house-hunting. I recently (4 days ago) quit my remote job due to an new and awful boss. BC was diagnosed on mammogram in mid-April and I'm still waiting, waiting, waiting on results, and each set that comes back reveals something even worse.
Pt questionnaire asked about suicidal thoughts, and yes, I have had them. Sometimes I just don't think I can go through all this again, but worse than last time (second run-in with bc - last one was 18 years ago), and inflict all this worry on my daughters, husband and 92 year mother in England. I'm so tired and afraid. Just get it over with and be done with it. Reality is I'd never have the nerve anyway. What I really want is for none of this to be happening.
She asked if I had 'plans'. I said, well the internet is full of suggestions. Really I was (am) exhausted, shocked, terrified, and alone, far from my old friends. I do have a therapist though and have spoken to their practice therapist so I have support. But that didn't seem to help.
Next thing I knew - she'd left the room and called 911 and two police officers arrived in Kevlar vests and firearms to 'assess' me. Fortunately they were really kind. One said his own grandmother had said the same when diagnosed 'I'd just rather be gone right now'. We had a nice chat and they left and I went home for a cup of coffee. But it could have ended appallingly. If they'd tried forcibly to do anything to me I dread to think what could have happened.
I know doctors are mandatory reporters, so I won't make that mistake again. In future if anyone asks me how I'm doing it's going to be a conclusive 'Just fine thanks. Probably going to drop dead any time, but hey, it's all good. No worries'.
I have a dark sense of humour as well. Probably doesn't help. 😎
Anyone else had anything like this?
PS - I am not going to do anything stupid. Saying it all aloud is one way I use to defuse panic. But obviously that office is not a safe space for that. I want this all to work out well, and I'll keep going, so please no one get the wrong idea on this forum.
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Bloody hell. What a way to top off a crappy meeting. Great that the officers were so understanding though. If you can't talk about death in an oncologist's office, where can you??
The behavior was of course understandable - but really it's an example of how the health system pathologizes rational responses to trauma. A social worker would likely have been more helpful than a cop.
I haven't been in your situation but I've been the person on the other end (disability helpline for parents) who had to call the police when someone voiced suicidal ideation. I don't know how it turned out, but I remember thinking it wasn't what this person really needed.
I'm sorry you're going through all of this at once. I hope your therapist is helpful. You sound very strong and self-aware, and I hope being able to express yourself through channels like this is helpful too. I like your dark sense of humor very much :)
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Thank you!! Thank you..!
Whatever I'd been feeling up to then was magnified about a million times while I imagined being dragged off in handcuffs.
Yes I am going through a lot, which she didn't know, but I still think responses like that can't be totally unusual. As you said, a rational response to trauma. The police officers were infinitely more understanding than the oncologist. I don't even know if I can keep seeing her again. I don't think she 'got it' at all. But as I don't know anyone here I don't know how I'd find anyone different.
Maybe my mental health problem is that if someone asks me how I feel, then I tell them honestly!
Reassuring to hear someone agree that it was a crappy episode.
So glad this place is here.
:)
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Londongirl99:
I am so sorry this happened to you. This is the result of screening protocols without adequate training. Asking if you have a plan is protocol, but your doctor clearly didn’t seek further clarification. This type of screening can be more harmful than helpful. As you said, you will be reluctant to be forthcoming in the future. When professionals screen outside of their expertise, then they should provide appropriate resources. NOT the police. Calling in a social worker would have been so much more effective and supportive. Thank goodness they were kind. Please always reach out in the future. All of us are capable of going to that dark place. You have so much going on. There are people who get it. There are so many people who have been there. Including right here!
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I’m so sorry this happened to you. I’m sure it was frightening. I don’t know what the reporting protocol is, however, your MO’s response is shameful. Rather than helping you, the doctor was more concerned about CYA. I would think the MO has mental health resources to call upon. Calling the police makes no sense (to me). I hope your care is much better going forward.
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I'd think an oncologist would ask if you were working with a psychologist or therapist. Psychologists are usually part of the cancer team.
I'm truly sorry to hear everything you're having to endure right now. Being dragged off by the boys/girls in blue would certainly exacerbate things.
My sense of humor is also a bit dark, plus I have the ability to keep a straight face while delivering doozies. As every encounter with medical personnel now include a mental wellness check, I've had to table the most important thing that keeps me going...my sense of humor.
Edited due tofor odd typos
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oh yes - the dark sense of humour with the straight face! I'm British too, so it makes it much worse. It's just hard to remember in such a stressed situation that I need to put on an act. Grrr….
I emailed the practice LCSW and told her what had happened. She'll see it in the notes anyway. I'm talking to her on Friday so we'll see. I do think their protocol might involve some steps beyond 'Is patient so upset they're talking about dying? If yes - call cops'.
It makes me wonder if I should find some other practice or center. But I've come so far now it's probably not worth it. Her actual assessment and treatment plan sounds perfectly standard. They do have some palliative care physicians. Maybe I could talk to one of those.
You have all been so kind. I was a bit afraid that I'd get responses saying 'well, absolutely she did the totally right thing and you were out of line letting yourself get that upset'. It's her job to manage cancer, not namby-pamby around hysterical women who should know better…..lalalala….
But every single one of you have comforted me instead. Which is what should have happened all along.
Thank you. hugs,
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I do believe that dr's are mandatory reporters, but that doesn't mean calling the police asap. She could have called in a facility social worker and let that person take it from there. She also could have called adult protective services for a consult, and they could have arranged for someone like a social worker to speak with you, etc. I feel really bad for you re that experience and it didn't have to happen! That would scare anybody off from seeking help in the future, or saying how they honestly feel. All this stuff goes into the notes too and then all the medical people who look at your chart can see it. It tells me to just shut up about these kinds of things and like you say, Londongirl99, "put on an act".
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Putting on an act at work, or a function/activity that you didn't really want to attend is difficult enough. Why can't we be ourselves at quite possibly, one of the worse times of our lives? That's so unfair. At times I wish these "professionals" could relate to us because they've been through similar issues (not wishing ill will towards them). I struggle relating to most of my doctors, therapists, friends, family etc. It's exhausting to have to fake it all the time. My mantel should be overflowing with trophies.
Londongirl99...I'm so glad you found comfort here.
Why are my edits wonky, too?
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American culture is totally different from European culture. Europeans do express themselves way more openly than Americans. Your doctor totally misunderstood you and this is very unfortunate since doctors should have some training on understanding a cancer patient.
I am an ILC cancer patient myself and I want to let you know that this type of BC is very treatable with AI. Was your first BC the same type, ILC?
On another note, thank God we don't have virtual police on this website otherwise, all of us would be in jail :)
Please keep us posted on what your MO will recommend. If I was you, I would change the doctor.
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We are here for All of you, anytime 🤗
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Virtual police on the message boards!! Arghhh.. I suppose then I'd have to keep quiet that I still haven't gotten around to changing my driving license to the new State I'm living in. 😕 (Don't worry everyone - the DMV appointment is booked).
Thank you Mods and all.
It's good to hear someone tell me that ILC is very treatable. I know that in one part of my mind, but my lizard brain keeps taking charge. I had IDC last time. It was HER2+, and they'd only just invented Herceptin. I was fortunate.
My primary care doc rang me this afternoon. The oncologist had passed on a note to her. Hopefully just to say that someone should keep an eye on my mental state. Which is fine. I don't mind people asking after me. Anyway, she also said that I should remember that BC is a very treatable disease and not to throw in the towel. That was comforting too. If the oncologist had just added something simple like that I might not have fallen off the deep end.
My primary also asked if I wanted to change doctors. She's going to ask around and see if her colleagues can make any suggestions. I'm thinking about it. It's hard to know what to do. I don't hate the oncologist. She was trying to keep me safe, and I understand that. We had a bad interaction due to misunderstanding on both our parts.
Maybe I'll give it one more try and see if we can get things back on track. That won't involve me just rolling over and saying it was all my fault and I'll never be upset ever again. But perhaps we can work out where the communication broke down and then we'll both be better for it.
As long as she's willing, and as long as lizard brain stays out of the way….hahaha!!! Oh goodness.
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I think that's a great way to approach the issue, @londongirl99. Hopefully having this conversation with her will allow her to realize that she would benefit from including mental health professionals in the fold before involving the police, and that might benefit her future patients. You are far from being the only person who has these thoughts come up. It's a normal reaction to a very stressful situation—one that weighs on you for an extensive period of time. It makes sense that the weight of that will occasionally lead to heavier thoughts as a release from the stress.
I am glad that your Primary Care doctor was cognizant of the fact that the oncologist jumped the gun though, and is supporting you in finding a new oncologist—should that be what you want. I think this is a very valid option if the conversation doesn't end up where you hope it will with your onco. You don't have to settle for the care if it is not meeting your needs. It can take time, but it's worth it in the long run to have a care team that you can communicate with comfortably and be transparent with. You shouldn't have to censor yourself. They're there to support you.
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@londongirl99 I am so sorry that you are going through this. I am a therapist and mandated reporter. I know what to say to ensure to avoid any red flags popping up. However, my MO was no dummy and knew very well that I knew how to play the game, but she was great and reassured me that my depression/feelings were normal. I went to a very dark place when I was diagnosed, we all do, I think, but my team of doctors/surgeons made sure that I had all of the resources I needed to get me through without putting any more stress on me.
Some doctors don't look at the overall picture and react based on what a patient says , which is ridiculous. My clients knew they could talk to me about anything and when conversations of self harm came up we discussed further and I analyzed the whole picture before making a decision. I also let them know what was going to happen next and not go behind their back and surprise them. I'm glad that the officers were more sympathetic of your situation.
You have come to a great place for support. I hope and pray that everything goes well for you. ~Hugs~
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@londongirl99 and all here — we also wanted to share this helpful podcast that discusses this very topic:
We hope this helps!
—The Mods
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I am sorry this happened to you. Your Dr. really jumped the gun on that call. I do think she could have handled it better. Letrozole sends me off the deep end. Not only do I get suicidal thoughts I get aggressive. I wanted to hurt people. When I called my Dr. the first thing she did was calm me down and ask how I panned to carry out my thoughts. I had no idea. She them gave me an action plan to help.me.feel better. She followed up with an appointment. She reassured me that what was happening to me was an uncommon side effect but she had seen it before and she would help me get through it.
Serious she would have been right in calling the police on me. But instead she talked me down and gave me hope.
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Londongirl99- wow! I am glad that you posted this and I hope you have gotten some better news since then.
I was afraid if I told my oncologist that I didn't want anymore IV chemo- (don't think it has been shown to work on my cancer and it has so many SEs) anyway- I thought if I said THAT she would sic the entire psychology department on me. It is a real disconnect between their duty to report and what happens to you and whether it is helpful.
I was recently asked to be in a study about the family effects etc re cancer and when they said they would share the results with my doctor- I declined. anonymously I would be happy to contribute- but, what is the point of not being able to be truthful due to fear of health professionals duty to report? I once got a little teary in an appointment re bad results and the palliative care folks hounded me for months due to her request for them. My doctor Is a good person-
Hugs to everyone
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