Sue Style:
The Theory and Practice of Brunnen
This year two of our English-speaking Support Group in Basel attended the Brunnen conference. All the usual culprits were there: inspiration, intellectual stimulus, friendship and fun, plus gorgeous views, great food – and a dip in the lake in front of the hotel.
We had an impressive line-up of speakers on various different subjects. Dr Eliane Sarasin sang the praises of phytoestrogens and gave the thumbs-down to stimulants, alcohol and cigarettes. A few people nobly gave coffee a miss at the next break, most were notably abstemious at dinner, the smokers fled outside for a quick puff behind the bike sheds, and we all vowed to eat tofu at least once a week because it’s Very Good For Us - some even claim it is good to eat.
On osteoporosis, Dr Marius Kraenzlin reminded us that one in three women will suffer a fracture due to this troublesome condition, but added cheerfully that cardiovascular disease is even more of a threat after a certain age. We vowed to keep up the gym classes and to have an annual cholesterol test after the age of 50.
Then came the agonizing decision about which workshops to attend: Water Wellness and Herbal Therapies, Confidence Building and Motivation for Group Leaders, Patients’ Rights and Duties, New Perspectives in Breast Cancer Treatment, or the opportunity not only to Look Good, but also to Feel Better in a makeup/makeover session offered by Bobbi Brown consultants. (A wonderful new word has entered my vocabulary: schminken. It sounds deliciously slinky and definitely naughty, like the cat who got the cream.)
From Dr Christoph Rageth of the Breast Centre in Zurich we heard about best practice in breast care, benchmarks, good Betreuung and lots of other words beginning with B. We watched (or averted our eyes, in my case) as he beamed close-up-and-personal shots of needle biopsies and sentinel nodes onto the screen, all in glorious technicolour. Eckard Klose of Roche Oncology brought us up to speed on the survival strategies of cancer cells and their wicked ways, while Professor Bettina Borisch, a pathologist from Geneva, spoke of the intellectual and emotional responses to cancer. She encouraged us to speak up for our rights and to close the circle between patients, doctors, politicians and all those engaged in improving health.
Perhaps the most inspiring speaker of all was Dr Gerd Nagel who declared that while the 19th and 20th centuries had been focused on disease, the 21st century was going to see the dawning of a new age of the patient. He introduced the concept of the ‘competent patient’, one who sees herself as a partner in the medical process, who informs herself about the situation, takes part in the decision process, develops her own self-help strategies and believes in the power of self-healing. He finished by quoting Karl Jaspers: Der Kranke braucht die Freiheit, die medizinische Ordnung zu brechen’ – the sick person should be free to break the rules of traditional medicine. It was classic Brunnen. We punched the air and set off for home fortified with this vision of a brave new world in which the patient is king (sorry, queen).
A few days afterwards, following some nagging back and shoulder pain, my oncologist suggested a bone scan. Anyone who has had breast cancer and is sent for a bone scan will know that this is when the imagination goes into overdrive. Bells rang, lights flashed, the non-rational side of my brain came up with all the worst-case scenarios. In 10 days I shed 2 kilos, barely slept, updated my will, pondered about the hymns for the funeral, considered cancelling my tennis abonnement and ditching some planned alterations to the kitchen. The rational side of my brain (such as it was) insisted that I’d just had a checkup and all was clear, that we’re lucky to live in a country where scans can be ordered at the drop of a hat, and that probably everything would be just fine. Besides, it reminded me, there was this brave new world out there, full of kind, thoughtful, sensitive people bent on putting the patient first.
By the time I arrived at my 10 o’clock appointment at the local hospital I was a nervous wreck. There was plenty of form-filling: mother’s maiden name, date of first period, husband’s day job, cat’s middle name, date of birth - and all in German. When, after a couple of wrong turns, I eventually found my way down to the radiology department, I was greeted by a furious young woman in a white coat. Where on earth had I been? Did I not realise my appointment was at 10 a.m.? Did I not know my way around the hospital’s nether regions? And how could she be expected to run a proper programme with people like me messing things up? (Where are you, Karl Jaspers?)
My German is improving all the time (viz. schminken) but it doesn’t stretch to swearing, otherwise I’d have given the young lady an earful. I confined myself to telling her, in German, that if half an hour was needed to fill in forms, she should say so, and that no, I didn’t know my way around the hospital as I’d never been there before. (Then I went home and swore loudly, in English.)
The long and short of it is that the bone scan was fine, the will and the hymns have gone into the file marked W.O.G (When I’m Gone), I’m back playing tennis again and the kitchen is bracing itself for its maintenance programme. What about the brave new world? I’m not convinced that the furious white-coated woman has heard of it yet. And Brunnen? Well OK, maybe theory is one thing and practice another. But thanks to what we learnt there, at least I know how things could be. Meanwhile I’ve written to the hospital suggesting how admittance procedures might usefully be improved and how staff might be better trained to deal with people who are half dead with anxiety. I’ll let you know the answer when it comes in.
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