I’m a doctor who deals with the c-word daily. Yet a brief encounter on a busy day floored me

It was a routine, busy day in my skin cancer clinic in Caroline Springs. There were footy and weather discussions, laughs, some tears. There were wound reviews, patients with concerns about a possible melanoma, other anxious patients waiting for results with a fear of the “C” word. The day was going as smoothly as one can expect.

I was, as usual, running behind when I looked at my patient list. A big smile spread across my face - the next name was a very familiar one, someone I hadn’t seen in over a year. I went to call him from the waiting room with an apology for running late.

More than two-thirds of Australians will be diagnosed with a skin cancer during their lives.

It was a patient who I had diagnosed six years ago with an invasive skin malignancy and had treated in liaison with the local cancer hospital. He had undergone surgeries, chemotherapy and radiotherapy. I had been regularly monitoring him and excising skin cancers to the point that he would often come in the room and say, “Doc I have this skin cancer and would appreciate it if you excised it today.” I always laughed at his accurate diagnosis and called him “Sir Doc”. His routine was to tell me a dad joke before leaving the room.

He entered my room, smiled and sat on the chair. I waited for him to start the conversation while I went through his file, but this time he didn’t start the conversation with his routine line. “Doc,” he said, “today I am here to say my last goodbye to you and thank you for everything you have done for me.” I suddenly stopped and looked over at him.

He continued: “My cancer has spread everywhere, and I have only three months to go. I am on my end-of-life pathway. I have sorted everything out and chose voluntary assisted dying. I asked the hospital to give me a few days to see five important people in my life and you are one of them. You are the reason I am still alive.” He stood up, shook my hand and left the room.

Dr Farrukh Tufail

I was in shock and wanted to say something, but words were not coming out of my mouth. It took me a few minutes to come back to reality. I ran out to the reception, but he had already left.

I sat on the floor for some time to get my emotions under control. They were mixed feelings, of grief and pride.

There is a line from Spider-Man that has since continuously echoed in my mind. “With great power comes great responsibility.” This is my gift, my curse. Who am I?

I have been working as a skin cancer practitioner since completing my masters degree in the field at the University of Queensland. I fell in love with this area of medicine during my training rotation in the Victorian town of Kerang, when I realised how dangerous these can be when left undiagnosed. It has become my passion.

I have since managed more than 5000 skin cancers. This cancer is a risk all Australians need to acknowledge – more than two-thirds of us will receive a skin cancer diagnosis in their lifetimes and 2000 die from it each year.

Yet, of all the cancers, skin cancer is one of the most preventable. It’s UV rays from the sun that cause the vast majority of cases. As we enter the warmer months we can all be smarter about covering up and preventing overexposure from the sun’s radiation.

The youngest patient I have ever diagnosed with skin cancer was a year 10 student who first presented with a lump on his abdomen that was life-threatening. This diagnosis initially affected his studies and mental health but began treatment and was ultimately cured. He has since turned this unfortunate event into a life-changing moment.

This young man was so inspired by the doctors at the Peter MacCallum Cancer Centre that he chose to pursue a career in medicine. He recently achieved a near-perfect ATAR score and will start studying medicine with hopes of one day becoming an oncologist.

I share my message with all my fellow doctors, nurses, paramedics. As healthcare providers in Victoria, we are under extreme pressure, especially during the winter flu season. I can tell that many of my colleagues are feeling exhausted.

The expression of emotions in medical practice is often perceived as unprofessional and many doctors learn to suppress and ignore their feelings. When facing stressful situations, these physicians are more likely to suffer from depression and burnout than those who engage with and reflect on their feelings. For empathy to flourish in the medical profession, doctors should feel able to deal with their emotions without the fear of being criticised or stigmatised as weak.

Yes, we are tired, maybe even burnt out. We sometimes suffer abuse and are underappreciated, we are struggling with work-life balance. But always remember who we are. Our hard work and dedication can make us the unsung hero in someone’s life.

Dr Farrukh Tufail is a skin cancer doctor based in Melbourne.

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