Summary of thesis
The core of medicine, even specialized and high-tech medicine, is a meeting, a consultation, between a human being asking for advice and another human being, whose knowledge and experience is expected to be helpful. This thesis explores how the suspicion of cancer can arise in such a consultation, how general practitioners (GPs) can contribute to cancer care and how GPs might accompany people with cancer towards the end of life.
25 qualitative interviews with Norwegian GPs about diagnosing and attending people with cancer through the course of illness were analyzed. Besides clinical assessments and paperwork, the GPs often acted as intermediaries between the patient and the hospital. They pushed for quick hospital appointments, interpreted and translated discharge letters and were asked for second opinions. In rural areas some GPs offered cytostatic treatments. Knowing the patient and preferably also the family was seen as a premise for being a good GP. In the researcher’s interpretation, the GPs were well acquainted both with the patients’ world and with the clinical world. They could act as guides for their patients, but their personal knowledge of patients could, even if it was clinically relevant, be given less weight when confronted with hospital routines and criteria. This could lead to conflicting loyalties for the GPs. During end-of-life care in the patients’ homes, existential conversations were seen as demanding but rewarding. Palliation of pain was an easy task compared to being a fellow human being, listening and attempting to comfort a person who is afraid to die
