A doctor's view point of being a new Laryngectomee

A physician as a cancer of the neck patient: experiences in

the otolaryngology ward after laryngectomy

18 October 2010

Sir,

I am a physician who had undergone pharyngo-laryngectomy

for the removal of pyriform sinus squamous cell

carcinoma. Since most patients after total laryngectomy

are unable to speak during their hospitalisation, sharing

my experiences can shed light on their personal feelings,

anxieties and needs. A detailed description of my experiences

can be found in my book entitled ‘My Voice-

A Physician Personal Experiences with Throat Cancer’

which can also be read on my Blog: http://dribrook.

blogspot.com

The new reality of having no voice was difficult for me

to adjust to. I was unable to express myself fully and

could not show my emotions. I had to completely depend

on the slow process of writing everything.

Although the medical care I received was overall very

good, I realised that mistakes were being made at all

levels of my care. Fortunately, I was able to prevent many

of them, but not all.

Some of the errors I experienced by the medical

personal included feeding me by mouth when I was still

tube fed, not rinsing away the hydrogen peroxide used

for cleaning the tracheal tube, not washing hands and not

using gloves when indicated, connecting the suction

machine directly into the suction port in the wall, taking

my temperature without placing the thermometer in a

plastic sheath, attempting to deliver viscous medications

through the feeding tube, dissolving pills in hot water

and feeding them through the feeding tube, not

connecting the CALL button, and not responding to an

urgent call when I was bedridden and unable to speak,

and forgetting to write down verbal orders.

All of these events made me wonder what happens to

patients without medical education who cannot recognise

and prevent an error. Fortunately, despite these errors,

I did not suffer any long-term consequences. However,

I had to be constantly on guard and stay vigilant, which

was exhausting, especially during the difficult recovery

process.

My post-surgical stay was one of the most challenging

periods in my life. As I look back to my hospitalisation,

I feel great gratitude to the nurses, physicians, and other

health care providers who supported and cared for me. It

is my hope that by reading what I felt and experienced,

they will gain insight into the mind of their speechless

patients who are very vulnerable and depend on their

care. A compassionate and diligent care is the key to their

mental and physical recovery.

Conflict of interest

None to declare.

Brook, Itzhak

Professor of Pediatrics,

Georgetown University School of Medicine,

Washington, DC, USA.

E-mail: ib6@georgetown.edu

C O R R E S P O N D E N C E : L E T T E R S

514 Correspondence

2010 Blackwell Publishing Ltd • Clinical Otolaryngology 35, 507–514