I appreciated the psychologist’s approach to an extremely awkward discussion. I believe there is value in using humor to a certain extent in situations like this but I also appreciated how he tried to move the topic from a sexual one to one that categorized fertility as part of his overall treatment and health plan. I’m still not quite sure though I agree with how far to continue to push the subject when it seemed like the parents and the patient were all kind of against talking much about it.
I was asked to discuss sperm collection with an adolescent recently diagnosed with T cell leukemia. There was a language barrier, and an interpreter was provided. The use of an interpreter brought a whole new level of awkward to the equation. And, before I a entered the room to meet the patient, the interpreter pulled me aside to say “The father does not want you say anything inappropriate.” During my conversation with the adolescent, the father paced back and forth and occasionally spoke to the interpreter, but it was not relayed to me what the comments were. Tough situation. Ultimately, we weren’t able to collect a specimen before treatment commenced.
I also liked the approach used by the psychologist making fertility a part of the overall treatment plan. I feel that this may be the best way to begin the discussion, especially with the age of this population, thus ensuring that everyone being treated has at least gained some information about fertility preservation. My experience has always been with young adults, mostly young women with breast cancer, which makes fertility preservation an easier topic to discuss, so I appreciate the knowledge of this technique in case I am ever in this situation.