Overall, the five-year survival rate for pediatric cancer patients has surpassed 80 percent. You change lives by saving lives. How does that change you?
There are not many better things in the world than being told that you’ve saved somebody’s life. On the other hand, 80 percent is a useless number. Whenever we lose a patient, it’s even more of a reminder that we need to do better.
One hundred percent is possible?
It has to be. Nobody would have guessed 200 years ago that diphtheria, pertussis, measles, cholera wouldn’t be killing everybody. So, we’re just a little behind in cancer. But we should be able to get to 100 percent. Eventually, everyone is going to have to die from something, but we like it to be old age. We don’t want kids dying from cancer. Period. End of story.
Childhood cancer is actually rare.
It is. When you look at what kills kids, it still is, unfortunately, high trauma. Violence is a public health problem. I wish there was a MACC Fund for the community. The gun deaths, it’s horrible. Mother Nature does enough bad things to our kids. We’ve got kids with congenital heart disease, with cancer, lung problems, kidney problems. It can be kind of depressing on rounds in the intensive care unit when you’ve got more than one patient in there because of violence. Sometimes, I think we need to improve what we do as a society.
How has the Affordable Care Act – “Obamacare” – affected your work?
It’s better for our patients. We have a young man who’s 18, has leukemia, and he was able to get insurance on an exchange. Instead of being not insured, he is still getting taken care of, and he’s alive. I am one of those physicians that truly believes this is what’s best for patients. It may not be best for a physician’s pocketbook, but you want your most fragile taken care of, and the Affordable Care Act has helped that.
What is your experience with children’s inner strength?
Life on a cancer ward, kids know everything. Let’s not tell them they have cancer? They know. Kids are much less likely to have denial and much more likely to attack things head-on, ’cause that’s all they know. This is the life they have to lead, and so they lead it. And they’re very strong, and resilient, and they fight hard, so how can you not fight with them?
What makes healing happen and recovery possible?
Attitude. It’s one of the reasons I like to get to know my patients as well as I do. I want to know what keeps them in the game. I test the residents: What’s on the kid’s iPod? What’s his favorite sport? What’s his favorite movie? You want kids to stay in the game, and so part of that is attitude and engagement. Attitude is everything.
There are extraordinary highs and lows. How do you balance that?
Growing up, I never missed “M*A*S*H.” There was a great line. Hawkeye is down, and Col. Blake says that in war, “Rule No. 1 is young men die, and rule No. 2 is, doctors can’t change rule No. 1.” And that is somewhat similar to cancer. There are days when you break down. But you exercise and pick yourself up the next day.
‘Point of View: Dr. David Margolis’ appears in Milwaukee Health, a brand new addition to the Milwaukee Magazine family.
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