Natividad’s last consultation in Oncology at the El Bierzo Hospital lasted just “half a minute.” It was Monday the 20th and only one oncologist supported the service until it collapsed, leaving Tuesday’s patients without any care. That last day before going on sick leave, the only active specialist – his partner no longer worked that morning – had to prescribe 40 chemotherapy treatments and care for the 19 hospitalized in the plant, according to union sources consulted by this newspaper. Something unaffordable for a single professional, who until a few weeks ago was part of a group of four oncologists and who on the last day of his consultation “was completely overwhelmed, out of his mind due to the amount of work,” Natividad acknowledges.
She has breast cancer and is awaiting surgery. She should have already had surgery, but when it had to be done “they told me that there was no operating room available, so they scheduled me for a new phase of preventive chemotherapy until they can operate on me,” she explains. She has her next medical appointment on June 10 and she lives in a sea of uncertainty because she does not know if her doctor will be there when she returns and if, if she is seen by a backup oncologist, there may be a new change of plans. Like all cancer patients, Natividad needs to feel safe and, right now, what she feels is “anxiety” about the situation generated.
«We are so sensitive and so scared and we are so ignorant on this issue that we need to be informed and shown empathy. Right now, we are receiving all kinds of information, we talk to other patients and they tell us that other doctors give them other diagnoses and that generates a lot of anxiety,” says a woman who has to go to the consultation with a list of written questions in order to be Quick in resolving your doubts given the short time the appointment lasts. “I always have a sheet of paper prepared with some questions, because sometimes you are so blocked and everything goes so fast that you forget,” she says.
“I feel unprotected as a patient and forgotten compared to patients from other areas of the community”
The day there were no oncologists at the El Bierzo Hospital was Ana’s first chemotherapy session. Her son lives abroad, but he had taken a week’s vacation to be able to accompany her during the first days of the process. In vain. At 7:45, they were already sitting in front of the door of the Oncology consultation. One hour before the scheduled time. “We arrived early because we were nervous,” says the son. They left home early because Ana lives in Villablino and the road that connects with Ponferrada is closed by a serious landslide, but they had to return home without having been attended to.
The next day, a phone call informed his mother that he would receive the treatment on May 31. “How do we know that by then she hasn’t moved on?” she questions. Another normal question among patients fighting cancer. “Furious and scared.” That’s how Ana felt.
Oncology Patients at El Bierzo Hospital.
Anxiety, anguish, uncertainty, helplessness, rage and fear are emotions typical of cancer patients when faced with a setback like the one they are experiencing at the El Bierzo Hospital. Ana has even considered registering in Oviedo, where one of her children lives, to be treated there due to the void left in her reference hospital and the doubts that invade her and her family. “This situation does not give you any confidence,” criticizes her son, who also explains that his mother’s first chemotherapy session (the one that was suspended) was already arriving “a month late, because they told us that there were no places in the hospital before.” at daytime”.
A debilitating disease on a psychological level
«We are talking about a particularly draining disease on a psychological level. From the moment of diagnosis, which is never easy to assimilate, to the dozens of doubts that invade the patient about the treatment, the course of the disease, the care required and the changes they have to make in their life. When a consultation is suspended and treatment is postponed, uncertainty and fear must be added to those previous points.
Emotions that “can negatively affect the course of the disease and the patient’s quality of life,” explains psycho-oncologist Gerardo Luna. “We must not forget that around cancer there are social stigmas, prejudices and taboos that still persist due, mainly, to lack of knowledge about the disease, its origin, its course and the prognosis of each particular case,” adds the psychologist specialized in oncology. .
“We are talking about a particularly exhausting disease on a psychological level and emotions can negatively affect the course of the disease and the patient’s quality of life”
Nélida was diagnosed with breast cancer in November and began chemotherapy treatment in January. Since then, she has been seen by three different oncologists. Not always being treated by the same specialist also increases insecurity. That is why now doctors from other hospitals in Castilla y León are going to be in charge of her case, which undermines her confidence. “You don’t know who is going to play you each week and although it may seem silly, it isn’t,” Susana also says. She has been another of those affected by the suspension of the service last Tuesday.
María Jesús says the same thing: «Since there are so few professionals, every time you go you see a different doctor, who is not yours, who does not know your history and who I understand has little material time to study each case. Oncology follow-up should be more personalized.
Nélida went for a consultation on Wednesday, when the Oncology service was already being covered by two doctors displaced from León. “I entered four hours later because it looked like the subway at rush hour,” she describes. She came out bewildered. «The oncologist who treated me gave me different information than what they had given me. I had more cycles of chemotherapy scheduled because the doctors here had decided, but the specialist in León said that there was no point in continuing,” she says. She is already waiting for surgery. “I left with a feeling of absolute insecurity, having to assimilate the change,” she says.
The “panic” that this patient claims to feel is related, precisely, to her upcoming operation: “Oncology patients go through many services (Cardiology, Surgery, Pharmacy…) and in all of them I have encountered the same situation of overloaded professionals.” , especially in Cardiology, where the last cardiologist who treated me was exhausted and even apologized for the poor care. Now, I am terrified that when I have surgery my surgeon will not be there because she is on sick leave or has requested a transfer.
“I have had a very short process and I have already been seen by three different oncologists. The staff is overloaded and now I am terrified that when I have surgery my surgeon will not be there because she has signed off or requested a transfer”
María Jesús feels “forgotten” as a patient. «You cannot suspend a service in the hospital. This is an absolute lack of foresight on the part of management. “We are unprotected as patients compared to other areas of the autonomous community,” she criticizes, recalling that chemotherapy is “the only weapon we have against the disease.” Therefore, delaying any cycle has an important psychological impact. “We can not do anything else”.
Internal Medicine takes care of the hospitalized
The number of hospitalized patients dependent on Oncology ranges between 15 and 19. Patients who are also suffering the consequences of the lack of specialists and who are currently being cared for by internists, explains the representative of the Singefe union, Carlos Javier Reguera. “It is Internal Medicine that is seeing these patients on a provisional basis,” he says. For Reguera, this serves to once again point out the need to have five oncologists on the organic staff, given the volume of oncology patients and the prevalence of the disease in this health area.
The Soria Hospital, for example, has four oncologists. They are the same as the organic staff of the El Bierzo Hospital, but for “half or a third of the population,” emphasizes the representative of Singefe. In Ávila, the Medical Oncology staff is made up of five specialists and in Palencia there are six. The Zamora Hospital also has five oncologists, in addition to three specialists in Radiation Oncology. The Health Care Management of Segovia, for its part, has six oncologists and, among the largest hospital centers, those of Salamanca (14 specialists in Medical Oncology and 8 in Radiation Oncology) and León (10 in Medical Oncology and 7 in Radiation Oncology).
“Cancer is a very screwed up disease and what I’m seeing seems like a total lack of humanity”
One of the two doctors who will travel to Bierzo next week to cover the service will do so from the Clinical Hospital of Valladolid. Here, the organic Oncology staff is made up of 19 specialists (9 from Medical Oncology and 10 from Radiation Therapy). Also in Valladolid, Río Hortega has 7 oncologists. The hospitals with the least organic staff are Santos Reyes de Aranda de Duero and Santiago Apóstol de Miranda de Ebro, with two each.
«In Bierzo there have been four positions filled and a fifth due to accumulation of tasks. Having five oncologists would allow us to have more margin in case of sick leave and to open the day hospital in the afternoons to be able to see more patients,” stressed Carlos Javier Reguera. In any case, right now the counter is very far from five. Zero is the brand of specialists of a service that once again operates exclusively with professionals from other hospitals and with an eye toward the reinstatement of the two who are on sick leave. Two who, in addition, have just obtained a permanent place in the stabilization process. A third has also been closed, but we will have to see if it is incorporated.
«Cancer is a very screwed up disease, you organize your life around the treatment. You live for that, it’s the only thing you think about, and what I see is a total lack of humanity,” says Susana.