They warn you about many things when you rotate through the Veterans Administration (VA) hospital. The health records system is bare-bones, the staffing is unpredictable, and the cafeteria hours leave much to be desired. What they don’t prepare you for is the stoicism of some patients.
When a middle-aged father of three learned he had glioblastoma, a rare and deadly cancer of the brain, he soldiered on silently. I had seen tears, prayers, even wails from patients before, but his silence was harrowing. While “oncology” means the arm of medicine concerned with cancer, “onc” means “mass” in ancient Greek, but it also translates as “burden.” My patient’s glioblastoma was a burden that he could shoulder in silence, but it was not his to shoulder alone. His wife, rejecting the silence, demanded answers. I knew all about the limited treatment options and dismal prognosis (predicted outcome; one common statistic gives a five-year survival rate of less than 5%) because I published research on glioblastoma management. What I couldn’t answer was why it had to be her husband.
Later that night, I started sifting through a different kind of oncologic research, not on the mechanisms or treatments of glioblastoma, but on risk factors. I learned that countless young veterans of wars in Iraq and Afghanistan, like my patient, have been recently diagnosed with brain cancer, and only now had we uncovered a likely culprit: burn pits. For decades, the US military had disposed of its trash on bases by incinerating it at high temperatures, releasing cancer-causing agents (carcinogens) straight into the lungs of their soldiers. At bases like Camp Lejeune, they dumped toxic waste into the water our soldiers and their families drank. Veterans returned from war carrying indelible trauma in their psyche (or “flak happiness” as the airmen called it) and the harbingers of cancer deep within their cells.
My patient had risked his life for a country that failed him because it didn’t care to put more thought into something as simple as disposing of trash. If the medical community didn’t do everything in our power to prevent deadly cancers like his, we would be failing him, too.
