A medical oncologist sees patients with a wide variety of cancers and blood diseases. It will necessarily have taken him much longer to accumulate respectable clinical experience with brain tumors than would a neuro-oncologist, who sees brain tumor patients exclusively and on a daily basis. What a neuro-oncologist would learn in a single year of practice might take a medical oncologist a decade to grasp. When a situation arises, you want the doctor who calls to mind a hundred similar cases he has seen recently, not the doctor who will rack his brain trying to remember the dozen cases he may have seen or merely read about long ago.

A neuro-oncologist, because of his understanding of the entire brain tumor experience (not just the chemo part), can address questions related to cognitive changes, family tensions, etc., and will have a better handle on interactions among drugs the brain tumor patient is likely to be taking simultaneously. He is also more likely to have the tact and sensitivity needed to deal with the very specific needs of the brain tumor patient and family. The difference between our oncologist and neurooncologist was amazing. We considered the original guy fine (and he was), but then someone came in and turned on the light. It was like that moment when Dorothy from The Wizard of Oz steps out of the house and the world’s in color.

The neurosurgeon told us that everything looked great on Janet’s MRI and to come back and see him in 3 months. He also gave me $10.00 and said if we get down to Biloxi again to play #22 on roulette for him. I asked, “Why 22?” and he said that was the date that he met an individual that helped change his perspective on life, which in turn has allowed him to treat his patients better. He then handed me Janet’s chart and pointed to our first appointment date: Sept. 22, 2000.

For 2 months, we were dealing with a doctor who said there was only a “vanishingly small” chance at a cure—NO clinical trials, NO other options, NO, NO, NO. I did my own research, and ended up with a doctor new to our hospital, who gives Danny a “real chance.” Not only does his attitude make a difference to my own attitude (it’s actually pleasant to be in the same room and talk to him), but I believe he is actively searching out treatment options and in fact has a whole list of things to try. The first doctor came at it from a much more conservative vantage point—if something didn’t have a tried and true track record he wouldn’t recommend it. The problem in our case was that Danny has an incredibly rare brain tumor so there is no track record. One final note: every doctor I spoke with, except, of course, our first one, said that there are always exceptions. They’ve seen patients 10 years ago who they said would never make it, and they’re doing great. I need a doctor who helps me keep my head attuned to the positive.