Jennifer Lycette, MD
A perspective essay in the Art of Oncology section of The Journal of Clinical Oncology.
The Art of Oncology features narratives, poetry, and photo essays that explore the experience of suffering from cancer or caring for people with cancer.
Jennifer Lycette, M.D.
A perspective essay on the challenges of providing cancer care in the setting of mental illness, when the resources to treat the mental illness are lacking.
Greetings Readers. I thought I would try something new and start somewhat of a series. If you didn’t see my original post on prior authorizations, this link will take you right to it. Last week I found myself on the phone, yet again arguing on behalf of a patient, to overturn the denial of the insurance company to pre-authorize a PET/CT scan. The conversation was as usual, frustrating and, a waste of 15 minutes of my clinic time where I had to keep another patient waiting in the exam room. (Because the insurance physician is only available during clinic ...read more →
“My mom is a doctor, my dad is a Dad.” So stated one of our children in their autobiography assignment for school. I kept reading, curious what would come next. “My dad usually stays home and cleans up, and takes care of the pets.” I thought for a moment. “That’s very good, honey, but do you think you could write something else about Dad?” I suggested. “He does other stuff too, add some more nice things.” “Ok, how about … ‘And he takes care of us, because my mom works all the time.’” Ugh, not exactly what I was ...read more →
I am pleased to share the link to my newest published narrative essay, entitled The Puzzle Table, published online 10/2/17 in the Art of Oncology section of the Journal of Clinical Oncology.
Recently I was enjoying a “mom day” running errands with the kids, you know, the usual essentials — groceries, school supplies, and espresso coffee drive-through. At this last stop, the barista made small talk and, seeing the kids in the back seat, joked about school starting soon and how I must be looking forward to that — “You’ll get your Mom time back!” To which I laughed and relished the rare moment of just being a Mom. Until one of my kids yelled up, “But, Mom, you work all the time!” The previous week, sitting around the dinner table, ...read more →
I am not the first physician blogger to write about the difficulties of prior authorizations, denials, and appeals, but recent occurrences in my own practice have been so convoluted that I feel they must be shared. The nonsensical denials would almost cause one to laugh, if not for the reality that each denial represents potential delay in care for the patient and redundant work for the physician — work that expands exponentially from the initial time taken to submit a carefully-worded request (in the futile hope that one might receive an approval on the first try). The incredulous laughter ...read more →
The following post is an edited transcript of my speech given on 7/8/17 at the Relay for Life 2017, Clatsop County, OR. I am very excited by this year’s Relay for Life theme, “Who is your superhero?” I am excited because I get to work with real-life superheroes every day. And this morning I get to tell you about some of them. If I had to pick just one group of people who are my superheroes, there is no question, it would be my patients. A hero is an ordinary individual who finds the strength to persevere and endure ...read more →
My smile freezes on my face as my patient says to me, “I’m so glad you’re back – that I get to see Mrs. Lycette today!” He has been my patient for several years, and I am perplexed to hear him address me as “Mrs.” rather than “Doctor.” At the same time, I really do not think he means an intentional insult, so I keep my face neutral and continue with the visit, without saying anything to correct him. But it sticks in my mind. It is not the first time one of my patients has referred to me ...read more →
I recently read a post by oncologist Dr. Stephanie Graff on the experience of blame, from self and others, that people with cancer are subjected to. The talk about risk factors and early detection makes us think we can achieve perfection, and that cancer is somehow a personal fault…let us stop making accusations and blaming persons diagnosed with cancer. They are blameless. Her post, The only perfect cancer statistic is an imperfect one, is a great resource for any of our patients who have experienced or are struggling with this. Another type of blame we can see in oncology practice is ...read more →
Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door. I didn’t want to head in to the clinic that morning. Instead I was filled with despair; overwhelmed with the events of the world. How can I do it? I thought. How can I walk in there and summon the energy to see my patients? An even worse thought: Why should I do it? What is the point in trying to heal the sick, in a broken world? In addition to world events, I had ...read more →
In recognition of National Nurses Week: Thank you to nurses for: staying behind in the room with patients and families after we deliver difficult news, not letting us shirk the tough questions, professionalism in the most difficult of circumstances, being partners in care, remembering what size gloves we wear, the phrase, “Doctor, I think you meant to order …”, making sure we eat, triaging phone calls, listening, telling us what the patient is really worried about but too afraid to ask, a calming presence, working 12-hour shifts, working over-time, knowing when to page and when it is ok to ...read more →
For many physicians, the term “compassion fatigue” may imply, as the words describe, that fatigue leads to the loss of ability to feel compassion for others. After all, what physician doesn’t have a day when s/he is too tired, running on too little reserve, and feeling some degree of emotional numbness? Many physicians may not realize, however, that compassion fatigue can go much deeper. According to the Compassion Fatigue Awareness Project, physicians and other health caregivers suffering from compassion fatigue may actually develop a secondary traumatic stress disorder. According to their website: When caregivers focus on others without practicing ...read more →
(A facetious piece. Inspired my my kids’ love of Mad Libs) Directions (in case you’ve never played Mad Libs): Play with a friend or colleague. Ask them to say a word for each type of word specified. Read the story using their words to fill in the blanks. Or play on your own, skip down without reading the story and fill in the blanks in the list before you read the story. Then read the story using your words to fill in the blanks. Why Your Doctor is Running Late “I apologize, Mrs. (person’s surname), to keep you waiting. ...read more →