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Research, Theory and Reality

Baldwin

For the past five years, I have spent my time studying the intersection of health and communication. I have used theory as the lens with which to examine patient-provider interaction, medical adherence, breaking bad news, grief and end-of-life issues. I have read hundreds of journal articles based on studies done on a variety of populations with all different types of diseases: cancers, diabetes, Parkinson's, Alzheimer's, hypertension and more. Interactions are examined from the point of view of the patient, the family, the caregiver, the organization or the healthcare professionals. Populations range from multiple age groups, from young children to seniors. In my own studies, I have interviewed people whose loved one was dying, children who had lost a loved one, and women with breast cancer currently on Tamoxifen regimens.

Beginning on September 26, 2011, my research paradigm changed when I went for my annual mammogram. The mammogram went as usual and I thought nothing about it as I focused on my semester of preparing for my dissertation prospectus defense and teaching a couple of Communication classes.

The first frisson of alarm occurred when my doctor called me the day after my mammogram; getting a call that soon after a test is never a good sign. She told me they had spotted something and that I needed a follow-up mammogram. Still calm, I made another appointment two weeks later.

This appointment was almost the same as the first except the radiologist explained that this was a much higher magnification in order to look at the calcifications. She also said I would be getting the results today. After the test, she directed me to dress and take my things to a room down the hall. It was all the way at the end of the hall and once I stood in the doorway and looked in the room, it hit me. This room, with its two chairs carefully angled at 45 degrees towards each other, its blank walls, and its two end tables with brochures on them, this was a bad news room!

The doctor came in and told me the news, in this case, the bad news. I would need a biopsy to see just how bad. A nurse came and walked me to an isolated part of the reception area. She explained what the procedure involved. I made an appointment for the procedure and left. Once in my car, I spoke to my primary care physician and she recommended a breast surgeon. I spent the next three days of my fall break switching the testing over to the new doctor, having blood drawn, running back and forth between appointments, picking up x-rays and filling prescriptions.

In the middle of my very busy school schedule, I stepped aboard the breast cancer diagnosis train. In the space of about three weeks, I had two mammograms. Filled several prescriptions. Underwent two MRIs. Taught six classes. Went to one out of town conference. Interviewed at the National Cancer Institute as a finalist for their Cancer Prevention Fellowship (yes, I know. Ironic.). Underwent one needle biopsy and finally, one lumpectomy.

I'm not going to dissemble; this process was difficult. And I am one of the lucky ones. I do not have breast cancer. I have atypical lobular dysplasia meaning that on a cellular spectrum with normal cells on one end and cancer cells on the other, I have some abnormal cells. The upshot of this is that my likelihood of getting breast cancer is twice that of another woman and that my medical oncologist wants me to start a five year regimen of Tamoxifen in order to reduce my chances of getting cancer by 50%. It also means that I have had or will have the opportunity to experience patient-provider interactions, breaking bad news, and medical adherence on a very personal level.

Reflecting on this experience reminds me that the patient populations in those studies are based on the real-life experiences of human beings, not just dry statistics laid out into neat tables and figures on a page.

Now more than ever, I see the importance of what we as researchers do. We have the power to find better information for people going through the trajectory of a disease, whether it's during the diagnosis testing or at the end when the disease has run its course. What we do can make a difference. What we do matters.

Paula Baldwin
2011 CCRC Doctoral Fellow
George Mason University

Written by CCRC at 12:46

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