Dr. Stanley Goldstein - Author and Psychologist

An article in The Wall Street Journal (August 25, 2023), "Are You Sure You Have Cancer? ...Misdiagnoses are all too common..." aroused several thoughts. An excellent older book, Should I Be Tested For Cancer? Maybe Not and Here's Why, by H. Gilbert Welch, M.D., M.P.H. is well worth reading. And regarding misdiagnoses: years ago I was diagnosed with glaucoma by a local ophthalmologist/glaucoma specialist ("You have a little glaucoma in both eyes. Do you want laser or drug treatment?"). Distrusting him because of his personality and office staff's unprofessionalism (the receptionist being on the phone with her boyfriend), I went for a second opinion to a world famous glaucoma expert in NYC. After examination he said that not only did I not have glaucoma but that in his entire career he had never seen glaucoma in eyes like mine (I have unusually thick cornea in both eyes). Had I stayed with the first doctor I might have wound up blind and you can imagine the unneeded stress he caused me. For something serious in a non-emergency situation, ALWAYS get a second opinion from a noted authority in another town. It's well worth traveling for.

 

 

 

 

 

 

 

 

Thirty-years ago I was asked to treat an eight-year-old child who, stricken with leukemia, had been discharged from the hospital to die at home. Though fearing the emotional turmoil, I felt unable to refuse the request, feeling that he needed someone.

 

The boy looked terrible at our first meeting, holding a white enamel tray lest he vomit. I introduced him to "our friends," the stuffed animals in my office (Bertram Bear and Darrell Dog and Barry Bird and Gregory Gorilla) while we played a board game. He looked healthy at the following sessions, not bringing a tray, and playing and interacting with our friends comparably to my other young patients. He seemed so normal that I embraced the frequent delusion that his doctors were wrong and he wasn't dying. Then one day, when he became too ill to travel, I went to his home and spoke with his parents in the kitchen while he lay in bed.

 

Despite my heavy work schedule and preoccupation with him since we met, I felt nothing when he died but my body reacted differently. Though continually healthy, I immediately developed an unpredictable explosive diarrhea which made me unable to perform my duty as expert witness in court. Medical tests found nothing wrong and when the diarrhea ended two months later, I sensed it was gone forever and it never returned. Had my body tried to expel the poisoning stress through diarrhea? I wondered. A primitive reaction explained by psychosomatic medicine which holds that what cannot be spoken will be expressed through the body.

 

Twenty-six-years later I was referred for treatment an adult who, after extensive surgery, was being heavily medicated by his doctor for pain and self-medicating himself with forbidden alcohol and cigarettes. Having become a troublesome hanger-out in her office, she referred him to me "for therapy." A first glance told me he was dying. He had no interest in therapy, I didn't see him for long, and my increased blood pressure lasted as briefly. A week later, without conscious intent, I spontaneously spoke of the boy who departed life too soon, leaving his parents and me and our friends to grieve. Then I did cry.

A TV celebrity recently spoke of the anxiety and depression he felt upon learning his diagnosis of pancreatic cancer. These normally occur when serious illness threatens. And also, for that matter, following a cognitive or physical disability for either can reduce a person's normal functioning ability.

The diagnosis of cancer may well have a unique anxiety-bearing capacity for it possesses similarities to those of the unconscious mind, which are widely feared: its occurrence is unexpected and arising from nowhere; seemingly irrational; and experienced as all-powerful. But this is false since every unconsciously-derived act has a valid reason, even those which appear senseless. In one published case a surgeon felt compelled to repeatedly, publicly expose himself despite the legal and reputation risk until psychotherapy revealed that, by doing so, he was boasting to his mother how powerful he was, as he had wished to do when a toddler.

One member of the clergy, a three-time survivor of cancer, advised the following: that, when afflicted by serious illness, pray, but also get the best medical advice possible.

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