RUNNING HEAD: The Doctor

Scholarly Assignment of Case Study: The Doctor

Urmila Singh Nandy

823636915
NURS 209 Practical Nursing Theory 3
Professor Eva Hearn
November 18th, 2014

The Doctor

The Doctor is a movie directed by Randa Hanies from 1991 and is about a successful
surgeon who is a monster until a devastating event forces him to reshape his personality. In his
lectures to the interns at the hospital, the Doctor warns that personal feelings have nothing to do
with the science of medicine. His problem starts as a small, nagging cough. He ignores it until
one day he coughs up blood. Ear Nose and Throat expert reveals he has a malignant tumor in
his throat. Depression and anxiety threatens the doctor. With his own mortality during the
treatment, he turns to a patient, June not for romantic reasons but as a fellow traveler in the same
path. The doctor was unable to connect to his family during recovery but after Junes death, he
ends up having friend and family support. He continues working with patients but with a more
personal touch. I believe this movie is an eye opener for many cancer patients who can see a
positive outcome as in this movie. This movie also allows professional people like specialized
doctors and surgeons to treat their patients with dignity.
There are a variety of health challenges that are faced by patients going through cancer
treatment. However, I am going to focus on three physical events faced by the doctor in this
movie. Nausea and vomiting are side effects of chemotherapy. This challenge is faced by both
the client as well as the family. The family has to be prepared in every situation when this occurs
and it can cause uneasiness and tiredness amongst the members as they have to be ready to clean
up. In this movie, the doctor did not project this on an ongoing basis. I think if it was a real life
situation and not a movie, then we may have seen more of these effects. In addition to the
uneasiness faced by the first challenge, cancer patients also suffer swallowing problems, or
Dysphagia. This can result in the temporary insertion of a nasogastric tube to help in feeding.
The tube can cause discomfort to the patient who has to restrict his head and neck movement as
the tube is fixed to his nose and throat. Finally, patients with ENT-related cancers experience

The Doctor

hoarseness and speech problems because of surgery.. In this movie, I could see that there was a
problem with hoarseness, and thus communication was impaired for a short duration of time.
This affects the family in that they are not able to comprehend what their loved one is trying to
say and they feel helpless in providing the patients needs. One of the most common effects is
cancer related fatigue and is caused by the presence of cancer itself along with the chemotherapy
and radiation therapy and other therapies of this nature (Berger A .M. et.al 2010).
While the debilitating physical effects of head and neck cancer patients are very harsh,
they must also face many psychological, social and personal challenges. This is mainly because
cancer treatment affects some of the most basic human functions, including breathing,
eating, communication, and social interaction. In this movie, there are three psychosocial effects
which I strongly identified with the Doctor. This includes depression, anxiety and fear of
recurrence and finally, interaction with spouse, family, friends, and co-workers. Being unable to
speak, or even having difficulties with speaking, make it harder to express emotions and can lead
to isolation which in turn results in depression (Gate R.A. and Fink R.M, 2008). In the movie,
there was an episode of the doctors depression but he overcomes it by confiding in June, another
patient with inoperable brain tumor. Paradoxically, feeling depressed after learning about the
diagnosis allows him, as the patient to accept the new reality. The fast spreading action of cancer
is well known to the doctor and obviously he has his moments of anxiety and he does fear that if
all the malignant cells are not removed there is the chance of it recurring. This fear exists in
many patients undergoing therapy. Interestingly, I noticed that with cancer patients, many a
times they do not want to be with their family member but they find solace in a strangers
company. For instance, the doctor did not want to communicate with his wife but found it
peaceful being with June.

The Doctor

From a holistic perspective, caring-healing practices include basic and advanced use of
sensory and mental-cognitive modalities (Watson, 2002). The quality of therapeutic presence is
also a caring-healing practice, as well as a fundamental aspect of nursing as a relational practice.
For example, promoting positive nutrition and lifestyle change or use of touch, imagery, music,
humor, or meditation are considered part of holistic nursing practice .In the caring-healing
inquiry model, quality care and human wholeness are the outcomes of caring. In the movie, the
doctors lifestyle had to be adjusted according to his treatment and his wife and son worked as a
team to help him. The family also changed over to positive nutrition as nutrition is the key for
many recoveries.
Keeping in mind the holistic approach to healing and caring, I put forward the following
intervention strategies. Biofeedback can be used as a relaxation technique involving careful
monitoring of vital functions. Relaxation is a technique for reducing anxiety and stress , as the
doctor is experiencing. Additionally, the use of diet and supplementation therapeutically in
Nutritional Counseling can greatly aid the recovery. In this case since the doctor suffering
involves the throat, diet choices should be a priority as the type of food ingested can greatly
impact the healing process. Too much spicy or abrasive food material will have a negative effect.
Finally, mental health nursing involving family, friends, and society to help recover the patient
from the shock of surgery, irradiation and chemotherapy will help immerse the patient back to
their normal lifestyles. If the doctor was isolated then he would face advance stages of
depression, but socialisation helps in healing. So the mental health nurse will encourage patients
in the right direction.
Based on the aforementioned mentioned interventions, I also would like to suggest the
following interprofessional collaborative care strategies. Speech language therapy is usually

The Doctor

employed when the patient has lost either the ability to speak or he may be too hoarse to speak.
The importance of psychological counsellors in approaching these cancer patient to pour out
their feelings. In the movie, the doctor needed someone to talk to so he turned to June but he
could have approached a psychological counsellor. These counsellors have the innate ability to
help people go in a positive direction and help in healing.And lastly the nutritionist will help the
patient realise the benefit of proper nutritionI can de. I definitely agree that the intercollaboration
of these three therapies will make the recovery process a lot easier.
In Canada, there are various resources in communities to help individuals who have
cancer. Two of them that I know of include Canadian Cancer Society (2014), a volunteer based
organization that is working towards eradication of cancer and they also enhance the lives of
people living with cancer. This society connects people suffering from similar types of cancer so
as to encourage each other and give hope to them and their family. Additionally, the Canadian
Cancer Survivor Network (2014) ensures the education of patients, advocates for them, helps
them collaborate so as to remove any barriers to patient care.
The consequences of cancer and its treatment extend far beyond a physical impact.
Cancer patients have described the information of communication (DallArmi et. Al. 2013) and
support in dealing effectively with these consequences clearly having relevant information is
important to cancer patients. Cancer programs need to know how well they are performing in the
dimension of quality care around the provision of information to patients.
This movie has been a great learning experience for me as I saw the transformation of a greatly
knowledgeable surgeon from a mechanical human being to a passionate caring doctor. I also saw
the stigma attached to cancer, On an another note, I also came to know of my Professors
husband being diagnosed with oesophageal cancer. Symptoms of dysphagia, ,cough and

The Doctor

irritation led him to go and seek medical advice. I learned that initially he was scare and nervous
about it spreading. Normally an outgoing witty person, he became withdrawn and quiet. He
started thinking negatively and kept repeating that he was not ready to die yet and God is not
finished with yet. Professor Eva is a very supportive and encouraging wife. Initially she was
scared mentally, started making funeral arrangement, selling the house and how she was going
to manage without him etc. In other words all negative extreme thoughts. Yet she was hopeful
about the diagnostic tests saying they caught it early and times have changed, technology has
changed and people survive .She gave hope to her husband as well as to herself. Started praying
a lot and asked friends and relatives to pray also. I believe their positive attitude will get them
through this, just like in the present case study.
This incidence has made me realize the stigmatization with cancer. In the modern industrialized
world, where feminism and pestilence are things of the past, cancer has become the most feared
of all diseases. It may not be the commonest cause of death (Canadian CancerSociety,2014)
occurring much less frequently than heart disease, both diseases have similar cause related
factors namely smoking and alcohol consumption (Hashibe,M.,2007).Yet cancer has the
reputation of being usually a progressive fatal condition for which no treatment has been
discovered .Cancer is seen as something that originates in one localised area and then spreads so
that the rest of the body is eaten away by the disease. In spite of this, I saw the positive outcome
in this movie. The doctor does combat this disease and his positive attitude could be a reason
for his survival.

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7
References

Berger, A.M,, Abernethy, A.P., Atkinson, A., Barsevick, A.M., Breitbart, W.S., Cella, D.,
Wagner, L.I. (2010) Cancer-related fatigue. Journal of the National Comprehensive
Cancer Network, 8(8), 904-931.
Canadian Cancer Society. (2014). Support and Services. Retrieved from:
http://www.cancer.ca/en/support-and-services/
Canadian Cancer Survivor Network. (2014). About CCSN. Retrieved from:
http://survivornet.ca/en/about
DallArmi, L, Simpson, G.K., Forstner, D., Simpson,T., Roydhuse, J.K., & White, K.J.
(2013). The information needs of patients with head and neck cancer and their
caregivers: A short report of instrument development and testing. Applied Nursing
Research 26(1), 40-44.
Frank-Stromborg, M. & Johnson, J. (2008). Oncology Nursing: Past, Present and Future. The
Nursing Clinics of North America, 43(2), 179-241.
Gates, R.A., & Fink, R.M. (2008) Oncology Nursing Secrets, 3rd Edition. Toronto: Mosby
Canada.
Hanies,Randa dir The Doctor, 1991 DVD
Hashibe, M., Brennan, P., Benhamou. S., Castellsague, X., Chen, C., Curado, M.P.,
Boffetta, P. (2007). Alcohol drinking in never users of tobacco, cigarette smoking in
never drinkers, and the risk of head and neck cancer: pooled analysis in the
International Head and Neck Cancer Epidemiology Consortium. Journal of the
National Cancer Institute, 99(10), 777-789.

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Lewis, S.L., Heitkemper, M.M., & Dirksen, S.R. (2013). Medical-Surgical Nursing in
Canada, 3rd Edition. Toronto: Mosby Canada.
Watson, J. (2002). Intentionality and care healing consciousness: A practice of transpersonal
nursing. Holistic Nursing Practice, 16(4), 12-19.
The Doctor is a movie directed by Randa Hanies from 1991 and is written by Ed Rosen
Baum and Robert Caswell.