Tuesday, April 29, 2008

Bad news

Yesterday was a bad news day. Every now and then the stars align to allow me to ruin more than one day at a time. It is not my favorite part of the job. I see some of the best and sweetest and most genuine patients with life threatening issues and my heart hurts to tell them the news. Somehow, it almost seems as if I could protect them from their cancer by just not telling them and letting them live their happy life.

The first case was a woman 12 years out from her bad breast cancer who had been having back pain. When she wasn't getting better with the care of her chiropractor, he sent her to me to get further testing. We did a CT and found numerous cancer spots in the bones of her pelvis and spine. BAD BAD BAD......She didn't cry. Her husband held her hand and she asked the right questions about where to go next and if her oncologist could be alerted. Amazingly, she was most concerned about how long she could wait to tell her daughters. The younger is graduating from high school in a few weeks and has prom coming up and she didn't want to ruin those experiences for her. I know in her head she is thinking " I may not be there for her wedding or to see her graduate from college, at least I can enjoy one more prom and high school graduation before I become the center of the world of worry in my family."

We decide she may be able to wait a while but her daughters will likely know that something is wrong.

After lunch another cancer, this one new. Too many cancers. Too many nice people, young people. Non smokers, good helpful people. It challenges me to keep any optimism that there is something or someone watching out for us when these people are in pain who certainly did nothing to deserve it.

I walk out of the room and one of our new nurses sees my face. She didn't know which patient I had just seen or that I had ruined a prom and a graduation and put a family into a depressed state. "Not now" I said and walked to the bathroom to gather myself. The cold in the next room just seems really pointless and unimportant all of a sudden, but I have to take care of them too. They are hurting in their own way.

Tomorrow maybe I can escape without too much hurt to others.

Some people wonder how you can become a hardened doc, able to look at people and not feel. I don't know that it really ever happens but I do know that if I got too caught up in this empathy/sympathy, I wouldn't be able to do my job. I have learned not to put aside my empathy but to let it only live in the moment and my end of the day stories with my husband (and apparently this blog), to give my hand of support and then package it away to think about later (never maybe).

And I have my own medical tragedies to deal with. Sometimes that interferes more than it should as well. I will be blogging on a different site for a while detailing my own adventure in the medical realm. Nothing life threatening but hopefully life producing. My own struggle. Hopefully, I will be more diligent with this blog than I have been here!

You can check it out over here http://carrfamilygrows.blogspot.com.......