A Disappointing Tumor
by Mike Litrel, M.D.

Another patient, Pamela, visited that day and also wanted a pill to make her feel better. Her pain was even worse. But unfortunately, there was no tumor to account for it. In the end, it's the lucky patient who has a tumor. Once the tumor is removed, the pain comes to an end.

Since having her children over the past ten years, my patient Pamela had become increasingly depressed. She found herself turning forty, with a weight problem, low sex drive, and a profound sense of disappointment. Somehow life had not turned out as she once had imagined it. The long stretch of middle age ahead seemed barren of hope. Over the years, she had received treatment from several different physicians. Antidepressants had once helped her improve her mood, forget her suffering, and feel better about her life. But by and large, the years had brought no change, no new purpose, and finally, no hope of ever feeling really good. She had just seen a television commercial featuring a vibrant woman advocating the latest and greatest antidepressant. Maybe that was the pill for her, she said to me.

Nowhere in the anatomy textbooks I studied in medical school will you find a description of the soul. Yet the soul exists, just the same. And as the years go by, I see in my patients with more and more certainty: the process of life is biological - but its purpose is spiritual. We are not human beings with spiritual problems - we are spiritual beings with human problems.

The disappointing tumor is the one that cannot be seen, cannot be cut out. I suspect that Pamela has a tumor on her soul. She can cover up the pain with medication, just as my first patient was masking the evidence of her tumor with stronger medicine. But this will not mean the tumor is not there. For Pamela I can prescribe pain medication, sleeping pills, or antidepressants. Or she can self prescribe in the usual ways - overeating or drinking.

The more difficult but effective task is to locate the tumor on her soul. God puts suffering in our lives for a reason. Just as He has given us pain to signal a physical problem, depression can signal that there is dire spiritual work that needs to be done.

My own drug of choice has always been food - sweets, in particular. In times of stress or upset, I have been guilty of imbibing a box of chocolate glazed or cream filled delights, a half dozen at a time. I quote one of my all time idols, Homer Simpson, when I say: "Mmmmmm... dohhhhnuts... Is there ANYTHING they can't do?"

In the end, though, that box of delights with ten thousand calories actually contributes more to my problems than it solves. And the source of my suffering remains unexamined, untreated.

Not all suffering is in vain. God has created us with the capacity to suffer, so that we will know when there is sickness in our spiritual lives. What is the spiritual work that Pamela needs? Only she can figure that out for herself. Prayer and counseling can be part of the surgery to remove it.

But if she does not examine the source of that pain, she risks its growing presence for the rest of her life. She will continue to find her life disappointing.

And who wants to be disappointed?

Dr. Litrel is a surgeon in private practice with Cherokee Women's Health Specialists in Woodstock and Canton. He is a Clinical Professor at Emory Medical School and the Medical College of Georgia. Dr. Litrel lives in Towne Lake with his wife Ann and their two sons, Tyler and Joseph. (mikelitrel@attbi.com)

I once removed a tumor that weighed nine pounds and twelve ounces. Before the operation I had told my patient that the mass on her ovary was at least ten pounds. So I was four ounces shy - and very disappointed.

I asked Diane, the operating room nurse, to weigh it again, stressing to her that my expectation had been that the tumor be at least a ten pounder.

"I'm sorry, Dr. Litrel it weighs the exact same," Diane assured me in her sweet southern voice. Diane is quiet and competent, one of my favorites, but her answer was annoying and I told her so.

"Why couldn't you just have said it was ten pounds!?" I asked incredulously. "It wouldn't make any difference and I'd feel so much better!"

Diane laughed like I was joking, and I joined in. But maybe I was serious. You see, surgeons can be megalomaniacs. Or at least this one can. And occasionally they don't mind saying things like, "you should have seen the size of that incision," or, "this morning I took out a ten pounder." It's a chest beating thing.

But despite the four ounce shortfall, there was wonderful news too, and much more important. Not a drop of cancer. The capsule of the tumor was smooth and glistening, unlike the surface of a malignant mass. In a few places it had become stuck to my patient's intestines. But once the scar tissue had been cut, the large mass lifted easily and cleanly out of her body. And the patient was ten pounds lighter.

Well, almost.

The incision was more than a foot long, spread wide open by the retractor. Anywhere but in the operating room, this would have been a mortal wound. But here it was bloodless, opened layer by layer in a clean surgery. We had entered her abdominal cavity and removed the source of her pain. My patient would quickly recover. And she would no longer suffer from this tumor.

Pain was the reason she had first come to my office. Her family practitioner had been treating her "menstrual pain" with stronger and stronger medications. She had finally appeared in my office because the medication wasn't "holding her," and she wanted a stronger pill.

She hadn't known about the tumor.