A patient's letter: I chose DHMC for my cancer treatment. Was it the right choice?

A patient's own letter

I’ve tried to avoid Western Medicine most of my adult life, but orthopedics, cataract surgery, and lip and jaw cancer kept me tied to a range of physicians in coastal Oregon where I lived from 1983 – 2014. During this time, I was further disheartened by my former wife’s experience. I felt she was a pawn in a system beyond our control. I felt jaded, skeptical, and cynical.

Fast forward to a new marriage in 2014 and an eventual relocation to Vermont. In the summer of 2022, I received  a diagnosis of prostate cancer.

Dartmouth Hitchcock Medical Center (DHMC) wasn’t the first choice provided for me. Our GP, a warm and engaging doctor, referred me to a urologist in his system. Within the first three minutes of my initial visit with the urologist, our personalities clashed. After our second visit, I asked my wife, Cathy, to help me search for alternatives. Cathy began researching options, centering on DHMC, and reading the profiles of the urologists there. From our vantage point in Windham, VT, the drive to Lebanon seemed farther away than other options but it was just 20 minutes more than our other choices.

Cathy called Dr. John Seigne at DHMC to see if he was taking patients and schedule an appointment. His profile indicated a patient-first approach in his practice. Prior to our visit, blood was drawn. After appearing at the exam room door very close to the scheduled time, Dr. Seigne integrated his analysis with active listening without judgement. There was even room for a little meandering as we got to know each other. An MRI and a follow-up appointment were scheduled.

My first and only experience with MRIs, was for imagery focused on my jaw and throat. There in Oregon, shortly after being strapped into a helmet and slid into the tube, I said, “Get me out of here.” In the control room, the tech was busy and didn’t respond. My voice increased in decibels until shouting, “Get me out of here!” He apologized.

I was not looking forward to any MRI. I arrived early at DHMC for my appointment feeling extremely stressed.  I had been prescribed a sedative to take an hour before the scheduled time. As soon as the tech introduced himself, I declared my concerns. I was dreading being encased in this machine. Even with all the resistance I was feeling, I could detect empathy in his voice: “You might be tall enough that your head will be just outside the tube. We’re imaging your groin. I don’t think you will have to be completely inside the tube. Let’s do a test and find out.”

I felt seen. I was heard. From the receptionist signing me in, to the tech leading me to the changing room, each person revealed something of themselves. Nothing sounded repetitive like someone who didn’t care or wasn’t invested in their job. In the weeks and months that followed I was scanned, poked, examined, and scanned some more. I had two 24-carat gold coils inserted into my prostate, an injection into my penis that lifted my hips off the table and three locational tattoos to consistently position me on the radiation treatment table.

During all this, I continuously felt seen and heard. My cynicism dissolved. Even my skepticism softened. How could it not!

On a good day, our drive door-to-door took one hour 18 minutes. The DHMC campus sits on an expansive parcel with preserved forest and walking paths traversing the grounds. I chuckle when talking with a friend back in Oregon who’s familiar with the gridlock around Portland as he asks about my schedule: “Why’d you pick those times, isn’t the traffic terrible?”

A teaching hospital has a far different aura to it. There is a sense of shared curiosity. This same energy infuses my radiation tech team as I come to know them. The counselor, either Alicia or Rex, of the tech team usually greets me with, “Hi Hunt, how was your weekend?” Or “How do you feel today?” They'd greet me with their eyes and connect with me as I’d explain in some detail if the side effects activated a worrisome response. It took less than a week for this team of rotating five to develop an authentic relationship with me, and I with each of them.

I’m terrible at remembering names, even after a second contact. It’s plagued me all my life, and I need to carry a pad to remind me. But their warm and consistent, “Hi Hunt,” embraced me as I entered the treatment room, and motivated me to learn their names.

When the Barbie movie came out and I declared that Cathy and I were going to see it, Eliza, one of the radiation techs, animatedly said, “I’m interested to hear your take on it. I loved it.” I learned about each of their lives as they learned about my journey.

Duke is the senior radiation technician. I may have not learned as much about his personal life, as I did with others, yet he listened intently to our short conversations, adding his own thoughts. Abby was there in the beginning and the end. The technicians rotate between two treatment rooms. Everyone devotes their full attention on me when I enter their space. What a gift for me to experience this awareness and consideration after being so resistant to entering any treatment program that involves a hospital. I was jaded by my own experiences that felt impenetrable, as well as in my role as the caregiver for my wife. She had unanswered questions, both of us feeling that we never were given all the facts and options. The opposite is true with my experience at DHMC.

What makes this place so special? Is it because DHMC is a teaching hospital or its setting in the woods or the intersection with the university and community surrounding it? Is it the architecture and the consistent care? Or is it this patient-first approach that drew me here in the first place?

As my radiation time is receding into the rear-view mirror, what stays with me even now is the feeling I experienced when I first set foot in DHMC for my MRI. On the way home, I exclaimed to Cathy who was driving, “Everyone from the receptionist to the five people who interacted with me in the MRI and treatment areas were engaging and compassionate. They understood me.” 

Now I am the one who is honored to say I am part of Dartmouth Cancer Center's Radiation Oncology team - an advocate.

Sincerely,
Hunt Fales
Windham, VT