Profile by ann suzuki

The tiny-framed fighter

he couldn’t afford to cry.

She had her son to think about.

After seeing blood in the tissue she had coughed into, Sanae Lash suspected something was seriously wrong. She brought the tissue to her new doctor, and was soon diagnosed with an advanced stage of cancer.

However, Sanae didn’t want her son, who was still in college, to be worried about her. Patrick had already lost his dad several years earlier to liver problems, so she couldn’t bring herself to show any weakness. She had to keep her emotions in check.

She said stoically, “what happened, happened. I may have bad genes, who knows? I didn’t smoke or drink, so what can I say? What’s done is done” (S. Lash). In that moment I realized how strong she was. Seeing how active and lively Sanae was, it was hard to figure out that she had suffered through a tremendous cancer journey. Despite the situation she was dealt, Sanae never complained or used her cancer as an excuse to stop her from doing anything she wants.

Even before severe cancer symptoms appeared, Sanae felt tightness in her throat as she swal lowed her

By Ann Suzuki

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food. For months, her first doctor disregarded her pain.

He just misdiagnosed her with thy roid itis a nd gave her pain relievers to sooth the inf lammation. Actually, she was misdiagnosed several times despite strongly voicing her concern to the doctor that something was wrong with her. A lthough Sa nae was eventually lucky enough to survive her cancer, this tragic mistake is still a very common problem today. In fact, “one out of every 20 U.S. adults could be misdiagnosed during outpatient visits, and about half of those errors could prove to be harmful.” It has resulted in “12 million U.S. adults every year to experience a diagnostic mistake (Rice). Sanae almost lost her life because of the hectic health care system that often produces misdiagnoses.

“She’s

just

However, this delicate, tinyframed fighter exemplifies the need to battle for life and to strive towards an active life.

Around 20 years ago when Sanae’s cancer progressively got worse, she k new she needed to act quickly. She was determined to make all the necessary arrangements she needed to go to Japan to treat her throat cancer.

But before Sanae knew she had throat cancer, she started to research her own illness after she was misdiagnosed.

Since her doctor kept saying that her supposed thyroiditis would eventually go away, but never did, Sanae took matters in her own hands. She went to a medical library to read as many books as possible. Even doctor Jerome E..Groopman, author of How Doctors Think, states the importance of selfdiagnosis: “such self-diagnosis is a reality that neither patients nor physicians should ignore” (261). Not only did she perform

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a self-diagnosis, she also knew perfectly what actions to take in order to survive. She demanded for I V liq uids as she was losing weight quickly and was struggling to eat. After months of fighting to stay alive, it was suddenly unacceptable for her to give up after the new doctor she went to said that surgery was too late for her. Since she was told that she had one year left to live, Sanae became further determined to battle cancer for her son. In desperation, she went from demanding results to her experimental treatment to asking for a second opinion in Japan. However, since the hospital she contacted was a very famous hospital in Japan, Sanae had trouble getting an available room. With the help from her CEO, Tom Funaki, who she was a secretary for in a company called IDEC, she was eventually able to find a doctor was willing to perform surgery on her as he had connections with the hospital. It was the final beacon of hope that Sanae had to fight cancer.

However, before she could go to Japan, Sanae needed to

strong person.”

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make a few preparation. She first marched herself to the lawyer’s office to make a will. She said, “I didn’t want to tell my son how serious I was. I didn’t know if I was coming back alive or not, that’s why I made a will.” It was only after the will was faxed that Patrick realized how serious her condition really was. He elaborated, “I mean she told me she had cancer but not to worry about it. She didn’t really make a big deal about it, but when I received that, I knew that this was a life or death situation...I didn’t know how close I was to losing my mother” (P. Lash).

Not only was she busy with preparation with the will, but she made deals with her real estate friend about the future of her house. She then proceeded to go to the doctor’s office to demand for all her medical records. She insisted on getting them to take with her to Japan. However, since they don’t normally give records to patients, Sanae had to demand and argue for them. She said, “I didn’t have any strength left but I couldn’t think about anything else. I had to keep going and going” (S. Lash). And she did. She eventually won the battle and was now ready to go to Japan.

Even though Sanae was lucky enough to make it in time to go to Japan, her misdiagnosis prolonged her symptoms and resulted in severe side effects.

Like Sanae, quite a few patients gets misdiagnosed. In the article Is your doc tor missing the mark?, it states someone with a very similar situation as Sanae.

Tara McCarthy, 28, also started hacking intensely but her doctor would only prescribe with her medicine. Like Sanae, she strongly believed in the possibility of cancer

but was laughed at when she voiced her concern. She stated that the misdiagnosis intensified her cancer as she ended up getting “radiation, 12 rounds of chemotherapy, and a painful procedure that drained 10 ounces of fluid from around her heart”; treatments she wouldn’t have needed if it hadn’t taken seven months to get a proper diagnosis.

Dr. Groopman explains that misdiagnosis can stem from many different factor. He states that doctors use a shortcut called as heuristics, which are ‘fast and frugal,’ the core of f lesh and blood decision making” (35). Authors Dr.Wen and Dr. Kosowsky from When Doctors Don’t Listen add that doctors also uses a cookbook medicine which is efficient but can skew doctor’s th i n k i ng. It is a for mulaic approach that became common when, “medicine ... morphed from thoughtful engagement between doctors and patients to cookie cutter recipes that regards all individuals alike... they reduced each person’s u n iq ue stor y to si mpl istic recipes”(3). Once doctors identify potential diagnoses, they narrow their thinking until only one imperative diagnosis remains.

It was likely that Sanae’s first doctor was “not able to adjust to change”(82). However, it is almost as if doctors have to use these thinking methods to make quick and efficient diagnoses in the limited time they have. In Is

state that “a primar y care physician might see 30 to 60 patients in a given day,” leaving doctors the need to hurry on to move on to the next person. Also, “the average is less than 20 minutes and today doctors spend only about half that time focused on the patient...the rest is spent filling out paperwork” (Asp).

Despite the frustrating misdiagnoses that lead to a more severe cancer, Sanae holds no grudges against doctors. Though at some point, she did find a lawyer to take her case, Sanae decided to let it go and enjoy life instead like she did before. She instead thought “why don’t I look at the future for myself and do what I can do other than what I cannot do?”

After Sanae went through a successful surgery in Japan, she stayed in the hospital for a while. During Sanae’s stay in the hospital in Japan, she noticed several differences between the American and Japanese medical system. Sanae stated her disappointment in the American medical system.

In

your doctor missing the mark? they

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Japan, she was able to stay in the hospital for a few months until she got better, but the US’s system only allowed her to stay only a week as her insurance only covered that amount. Evan Falchuk, vice chairman of the Boston-based Best Doctors in Is your doctor missing the mark? states, “Misdiagnosis is a symptom of a deeper problem in the hea lthcare system.

There aren’t enough doctors, information, or time” (Karen).

Doctors aren’t only the ones to blame for misdiagnosis. The US medical system can be chaotic due to its large population size. Though it is fast, it is certainly not the best. Doctors Wen and Kosowsky state that “our healthcare system has become morbidly obese: there are too many tests done too often without justification, and our system has become too expensive and too

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inefficient...What America needs right now is the right medica l care, care that is lea ner a nd more patientcentered, starting with the right diagnosis and leading to the right treatment” (254).

After her stay in Japan, Sanae attended speech therapy because she lost her voice after the surgery. She struggled to talk, so she eventually had to use an electrolarynx (voice machine) to communicate. Due to this, she changed careers and became less talkative. She said that what she misses the most is having small talks with strangers. She also have difficulty talking on the phone with them so she uses the fax machine instead. However, she still learns to smile through it.

She humorously said, “in a way it’s good. I got to learn how to use the internet” (S. Lash).

Patrick, who also recognized his mom’s strength, could only remember one time where his mom talked about losing her voice. He recalled it being on the answering machine. She had said so bittersweetly “I can’t believe I lost my beautiful voice” (P. Lash).

However, Sanae still copes with losing her voice. She still manages to remain

very active like she d id before. Her c u r rent pa r tner, Dave, said “she is a very hardworking and dedicated individual.

She a lways got a million things running through her mind, jumping from one idea to a nother” (Welch). Sanae even says that the cancer has helped her slow down and not run around wanting to do everything at once.

Currently, Sanae freelances at IDEC. After resigning due to her cancer, she was invited back to translate documents since she had to change her career from being a secretary.

In her free time, she will drive her RV with Dave to go camping so her dog, Toppy, can run around after remodeling her house. She is also involved as a treasurer in her church and is a part of a stock group. As a hobby, she mastered to play the violin after being unable to play the flute. In addition, she travels and garden. And the list goes on and she doesn’t plan on stopping there. She still plans to remains active with a curiosity for life.

Sanae’s curiosity eventually led her to help a fellow laryngectomy friend

with a life cha ng i ng decision.

When she attended a laryngectomy p a t ie n t support group, she met a lot of people who were misdiagnosed just like her. At the group, Sanae made a friend who had also lost her voice.

After coming back from the successful surgery in Japan, Sanae was curious to see if there was any new equipment, treatment or device that could help her regain her voice. Her curiosity led her to find a laryngectomy association.

T h r o ug h t h e r e , s h e discovered that there was a voice restoration technique surgery. When she decided to check with the doctor who developed the method, she dragged her friend who also had laryngectomy to come with her. But before the doctor could do any operations, he needed to see if Sanae was a good ca nd idate for the voice restoration surgery.

Just as she took the test, her friend sat there with her.

Unfortunately, the doctor reported back that since she had her surgery in Japan, where they use a different method, she was not a good candidate for the surgery. If she was to do the surgery, there was only a fifty percent chance that she could get her voice back. However, Sanae affirmed, “ I would still like to take it” (S. Lash). Since Sanae likes trying new things, she was fully ready for the surgery despite not being

a good candidate. Sanae also told the doctor, “Well my laryngectomy friend is here. Maybe she would like to take a test” (S. Lash). She immediately switched chairs with her friend and waited as her friend took the test. The doctor then notified that her friend was, in fact, an excellent candidate for the procedure. However, her friend was skeptical in doing the surgery. Sanae being an optimist, knew that this was a

good opportunity. She pushed her friend in doing the procedure.

After much hesitance, her friend reluctantly decided to try the surgery. Before long, her friend was eternally grateful. She was able to regain her voice.

However, Sanae’s surgery wasn’t as successful.

Despite that, Sanae holds no bitter feelings.

Through it all, she tells

the story with much joy and excitement for her friend.

As Sanae slowly approaches 70, she continues to live a strong and hea lthy life. Sanae wil l probably continue to live in the same house I have visited since I was eight. She will continue to live a long and strong life like the lemon tree that she has been gardening for 25 years. She will still supply my family with a bag of lemons, volunteer at church, take care of her dog Toppy and so on. She will still freelance at IDEC but once she decides to retire, she says that vshe might want to slow down. Until then, Sanae will look for things to do. She says that she dreams of going to national parks throughout the country but she states that, “...one of the things I’m daydreaming about everyday is what can I do? What should I do?” No matter what Sanae decides to do, she will always look at the positive. As she she ref lec ts on her li fe, she smiles and says “I think it was a good thing I had cancer because that slowed me down. I will be running around like crazy so maybe that was God’s way of saying “calm down, have your own time” (S. Lash).

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Works Cited Asp, Karen. “Is your doctor missing the mark? The experts aren’t always right about what’s wrong with you. And those errors can endanger your health--and even your life. Shape investigates why a growing number of people are being misdiagnosed and uncovers what you can do to stay safe.” Shape Mar. 2013: 160+. Student Resources in Context. Web. 12 Oct.2015.

Groopman, Jerome E. How Doctors Think. Boston: Houghton Mifflin, 2007. Print.

Lash, Patrick. Personal interview. 28 Sept. 2015.

Lash, Sanae. Personal interview. 14 Sept. 2015.

“TIME TO TACKLE DIAGNOSTIC ERRORS; Physicians blame patient ‘treadmill’ for missed calls.” Modern Healthcare 19 Jan. 2015: 0018.

Student Resources in Context. Web. 12 Oct. 2015.

Welch, Dave. Personal interview. 21 Sept.

2015.

Wen, Leana S., and Joshua M. Kosowsky.

When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests. N.p.: n.p., n.d. Print.