How To Live Between Office Visits by Bernie S. Siegel, M.D., HarperCollins, 1993, $22. Harper Audio Tape, 1993, $17. Love, Medicine & Miracles by Bernie S. Siegel, M.D., HarperPerennial, 1986, $12. Caedmon Audio Cassettes, 1988, $15.95. Peace, Love & Healing by Bernie S. Siegel, M.D., HarperPerennial, 1989, $12. Caedmon Audio Cassettes, 1989, $16.

Dr. Bernie Siegel, a retired (1989) pediatric and general surgeon who was an assistant clinical professor at Yale has a new volume on the local bookstore shelves. His previous volumes have been re-issued in paper back and all three have been issued in Audio Tapes. His Love, Medicine & Miracles was on the New York Times Best Sellers List for 130 weeks! He may be better known to our nursing colleagues and to our patients than to many of us. I'm told that he spoke at the Sacramento Convention Center on two occasions.

Dr. Siegel opens the current volume, How to Live Between Office Visits with a comment from one of his patients who said, "You know what I need to know? How to live between office visits." Bernie in typical physician fashion assumed the superior role and said, "I'll teach you." He thought that they could work this out together over eight sessions and in two months "we" would know how to live. But that short course extended over fifteen years, and Siegel states, "I am still working on the same problem: living."

As a cancer surgeon, Siegel was constantly faced with death. He gives the credit for becoming more sensitive to his patients that were the least compliant. They were the most tenacious in asking questions, wanting answers and explanations, and wouldn't let him proceed until they were satisfied or convinced. Nowadays, more patients don't ask. They are intimidated by their physicians. Bernie's wife Bobby states it's like the Tribes of Israel. They wandered around the desert for forty years because people even then could not ask for directions.

Siegel recalls one patient with a breast mass which remained unchanged for years. One day she walked in and said, "Something's different. It has to come out." He listened and removed the cancer. He speaks of the tragedies of the patients who listened to their doctors without asking questions. A young woman who developed a breast mass was told, "You're too young to have cancer." After graduation from college, she went for a pre-employment examination and was asked why she neglected herself. She stated, "My doctor said I'm too young to have cancer." Siegel tried to get her to write the former doctor hoping that he could say, "I will never let this happen again," so something good could come from her pain. Siegel states, "A malpractice suit does not heal that kind of rage and resentment."

Bernie, as he prefers to be called, speaks of the adventure of death with numerous anecdotal patient stories. He recites the sad situation of the many people who have died to stay alive and of others who began living when told they would die. The lawyer who always wanted to be a violinist except his parents wanted him to be an attorney, when told he had a brain tumor with one year to live, closed his practice and began playing his violin. A year later he was playing with a symphony with no signs of a tumor... Siegel told the woman who dreamed of dying on Thursday to cancel her Thursday surgery... When he saw a patient in the hospital in consultation who was crying because she had a short time to live, he asked her "Why don't you leave the hospital and do the things you really want to do while you can." He had a wager with any physician who referred patients to him that if they were accurate within six months as to when a patient would die, he would exchange that years income with that doctor. He never had anyone take him up on the bet.

Bernie advises patients to choose their doctors by calling the oncology (or cardiology etc) ward and talking to the nurses about which doctors they prefer. He tells his own children, when they go to an emergency room, to first ask the nurse about the doctor they are about to see. If they have a doctor they don't like or can't relate to, he advises them to find a new doctor. If that's the only doctor in that specialty in their health plan, he recites the following true story. A woman showed up at her health facility with her lawyer beside her, sat down in front of her doctor, and said, "You and I do not have a good relationship. It is destructive for me when I am trying to battle cancer. I'm going to get another doctor, and the health plan will continue to pay. My lawyer is here to work that out. Goodby."

As the founder of ECaP (Exceptional Cancer Patients), former president of the American Holistic Medical Association, and an active speaker to our patients and nurses, his management of cancer patients certainly warrants our awareness. He relates well to patients and their care givers, including nurses. His spiritual references run smoothly between the Hebrew and Greek testaments. He feels the absence of love is the only true disease. True healing is of the heart and mind, not of the body. Before we label that as alternative care, we should make the effort to listen to one of his three hour audio tape abridgements which he personally reads, or get a copy of one of his books and pass it on to our families. Let's keep aware of what our patients may expect of us.