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Interview: Jonathan Waxman

Cancer: facing the facts in fiction

    Jonathan Waxman: in perspective
    Jonathan Waxman: in perspective

    Jonathan Waxman's consulting room is a relaxing place - armchairs for the patients, a couch of the kind you might expect to see in a psychiatrists office… and a tropical fish-tank.

    Waxman, professor of oncology at Imperial College, sees me glance over at his collection of tropical fish. "The fish won't eat the cancer, you know," he says. This is a reference to a tale in his new book (he has previously published a novel and several books about his specialism), a collection of short stories which neatly combines his work as a doctor with his literary ambitions.

    Each story in The Elephant in the Room is a case study of a cancer patient, based on real cases but fictionalised. One concerns a man with testicular cancer who decides he can cure himself through diet, enemas and meditation. Waxman explains: "When you meditate you are taught to imagine tiny fish in your bloodstream. And when these fish find some cancer they nibble away at it."

    He does not deny the importance of meditation but puts it in perspective. "It can help because you are able to become calmer through meditation. But it won't cure your cancer."

    Waxman hopes the book will be of help to both sufferers and their families and friends: "The one thing patients don't usually have is access to the thoughts of doctors. I thought it might help people. And after all, the job of a doctor is in trying to help people."

    Whereas some doctors see communication with the patient as a necessary evil, for Waxman it is a crucial part of the job. And this book is part of the process of illuminating his work and demystifying the many diseases that are collectively known as cancer.

    The idea came from a book Waxman wrote about the condition he specialises in - prostate cancer. "It contained standard explanations for patients about the illness and the treatments. At the end of it, I wrote three or four case studies - about a page-and-a-half each. After this, people in my clinic would ask: "so what did happen to Ron in the end?"

    The way a doctor explains the symptoms, treatment and prognosis to a patient is, he feels, crucial. "It is down to the doctor's sensitivity. You should be trying hard to sense exactly how much the patient wants to know. You need to take things at the pace your patient is comfortable with.

    "Of course we get it wrong sometimes. I have a catalogue of stories about surgeons who deliver news in a very matter-of-fact way and then leave the room. I don't think surgeons can be trusted with sensitive things like that. They need to leave the oncologist to deal with it."

    Waxman doesn't see writing superseding his medical work. "Those who have made a living from writing are very few - and I love medicine."

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