“It’s all your fault. You will be held responsible”. 

Mrs Judge stood in front of me, arms on hips, blocking my way into a local cafe. It was lunch time and the cafe was full.  

“She has terminal cancer you know. You missed it.  It’s all your fault. I’ll see you in jail for this.”

It felt like everybody was looking at us, me.  

Mrs Judge was the mother of a thirty-five year old, married woman by the name of Maureen. Maureen came to see me, for the first time, about three years previously. 

“Doctor, can you examine my breasts please”. 

She had a family history of breast cancer and was very frightened. She lay on the examination couch and held the cover sheet close round her neck. I asked my nurse to join me. 

I examined her breasts, arm pits and neck. There were no lumps to be found. Her anxiety level was so high I referred her to a specialist. No cancer was detected. 

She kept coming to see me and asking for me to check her out.

“There is a lump in my right breast. I can feel it doctor”. Off to the specialists and again no cancer found. 

I suggested she see a colleague of mine, a psychotherapist and hypnotist. I sat in on their first session. This turned out to be the last time I saw Maureen professionally.  Once she was in a trance, the therapist asked her to focus in on her right breast and tell him what she could see. 

Well, blow me down! These early days of medical practice were full of surprises.     

“There’s a tennis ball in my right tit. My brother has just thrown it at me and it’s really hurting. He threw it at my tit on purpose.” 

The therapist asked her to imagine the tennis ball being removed. He gave her various ideas on how this could be done.

“I can’t get it out. It won’t move. It’s  stuck. It has penetrated me. It’s embedded. I cannot get it out”. I sat there stunned and fascinated.

The therapist asked her how old she was and her reply was, fifteen. He tried all the tricks of his trade to help her remove the ball. He worked with her for a couple of hours. It remained embedded.

“It’s no good. It won’t budge. It’s stuck for ever. I will get him  for this.”  The therapist looked at me, shrugged his shoulders. 

She came out of trance. He suggested she come and see him next week.  

The next I heard about her was a year later on the grape vine. She’d had a mastectomy and had secondary cancer in her spine. I knew this when Mrs Judge confronted me. 

She stood defying me and would not let me past. She smiled at me – some smile – hateful. I felt guilty and enraged. I could feel my right arm twitching. It felt like she wanted me to lose my temper, even wanted me to hit her.  I stormed out of the cafe. 

I had no lunch that day. I went for a walk on the beach. I remained highly disturbed for several days; and for ages every time I saw Mrs Judge in the street, she would give me a hate filled stare. 

I went to see a therapist. Within a minute I was into a pillow with a vengeance. I killed Mrs Judge many times in many ways – smashed her to pulp. It felt good. Suddenly I felt a pop in my head. I was free. I walked out of the therapist’s office with a light step. I  hadn’t had that for a while.

Commentary  2019

Anger directed at doctors is not uncommon. I attended a live-in week long psychodrama group. There were 25 participants. Four of them had major issues with their doctors and acted them out in front of us. 

A therapist I know helped run a seven day residential course for cancer patients. He found it necessary to put half a day aside for doctor bashing. That half day was seldom long enough.

I had anger for my wife’s breast cancer specialist. In therapy I was enraged by his advice to my wife not to listen to me. She’d asked me not to argue with him and so I didn’t. I wish I had.

Maureen had several visits to specialists and regular mammograms with no cancers detected. She had what is called an interval breast cancer. Meaning it developed between mammograms and visits to specialists. This indicates a rapidly growing tumour. 

Life is too often unfair  – random shit happens. Often there is no explanation and we humans are compelled to look for causation. We need explanations. A faulty one is better than none, it seems. It easier to think it’s someone’s fault, to rage and blame, rather than accept the brutal randomness of reality and our frailty. 

And yes errors and negligence occur, questions sometimes need to be asked. 

Cancer – what an ominous word to hear applied to oneself or a loved one. It’s terrifying.

However, it’s a term which covers a wide range of outlooks from the easily cured to the extremely lethal. If lethal, it can kill slowly over many years or rapidly over a couple of weeks. 

My wife was admitted to hospital with an internal bleed and was dead four weeks later from a rare form of cancer.  She’d had breast cancer 12 years before. Her prognosis back then was about the same as a woman of her age with no history of breast cancer. Her breast cancer was non lethal. Her sarcoma was brutally so. Maybe if she had not had a mammogram she would be alive today. I don’t know this but it’s a possibility. 

With all screening programmes for disease there is the potential for harm and benefit. 

Professor Baum who started the first breast screening clinic in London gave a lecture a few years back in which he claims that since the introduction of tamoxifen and other medical treatments no lives are saved with breast screening.  

This is an extraordinary statement and politically suicidal to suggest, let alone act on. He has been pilloried for making it. After all the ‘get it early and save lives’ catch cry makes so much sense and most of us believe it. Whether it makes sense or not, should not be the issue. Whether it is true or not, should be.  

It looks like screening 2 to 3 thousand women over ten years may prevent one person from dying of breast cancer during those ten years. But what about deaths from other causes.  Tamoxifen increases the incidence of uterine cancer and stroke by tiny amounts. Radiotherapy  increases risk of heart disease, lung cancer and other rare cancers by tiny amounts. 

Can breast cancer treatments cause enough deaths to eliminate the benefit of screening? Have a listen to Prof Baum.

Read this for pros and cons of breast cancer screening.

Watch this screening and over diagnosis .

Buy this book if you want more details on screening for cancer.

Are more tests and more information always better? Maybe not. So you have no symptoms are fit and well and you think might as well have a full body scan just to make sure I am okay.

They find a small tumour in your thyroid, kidney or elsewhere – now what! The numbers below are startling.