In the Basement at the Va: Stories from a Cancer Doctor

"Clear-eyed and deeply human, In the Basement at the VA shows that medicine is as much about communication as it is about treatment--and that small choices can carry life-changing weight."
--Danielle Ofri, MD, editor of Bellevue Literary Review, author of What Doctors Feel: How Emotions Affect the Practice of Medicine

"In the cancer ward of a VA hospital, where prognoses are often grim and time is scarce, Dr. Tripp practices a form of medicine that resists detachment, in the tradition of great doctors turned authors Atul Gawande and Siddhartha Mukherjee . . . His conversations reveal the delicate balance between empathy and honesty, reassurance and realism, that defines medicine at its most human."
--Laura Landro, author of Survivor: Taking Control of Your Fight Against Cancer

When a doctor speaks with a patient, there is nearly always an information imbalance. Patrick Tripp has spent his career treating cancer patients at Veterans Affairs hospitals where the difference in their life experiences--not to mention education, age, income level, and race--adds to the challenge. Tripp's writing reveals a caring and careful doctor actively working out the best way to share information and make decisions with his patients. The reader is brought into the intimate spaces of the clinic to witness discussions with patients, with their family members, and with specialists conferring on the best path forward.

These conversations are not only about disease and treatment, but about family matters and personal history. Patients recount harrowing experiences fighting in Vietnam, struggles with alcohol and drugs, and previous health crises. A veteran with PTSD tells of roaming his house with a machete in hand. Men dealing with prostate cancer find surprising and humorous ways to discuss sexual function. Brief lessons on the history of cancer treatment and the science behind today's technology are woven throughout.

Full of compassion and candor, these essays provide examples to aspiring doctors, to cancer patients and their family members, and to all who are interested in how to communicate and connect under difficult circumstances.