When I think about cancer, I think about the fight, my patients, a scary diagnosis, and a peaceful death. I also think about the education of staff, patients, and families. In the beginning, and at the end, there are so many questions. Right now Iím thinking about the end.
We currently have a patient who is at the end of her life. She has been in and out so many times over the past couple of months it's honestly just sad. I discharged her after her longest, most recent stay, but re-admitted her again yesterday.
I know a lot about this womanís journey. I also know a lot about her life -- she has ovarian cancer and can no longer receive any more treatment in the form of chemotherapy and radiation. But fortunately for her, she has an extremely supportive husband, two children, and grandchildren on the way.
While I was admitting her, we spoke about why she keeps getting re-admitted within a day of discharge. During the conversation, she started crying while bringing up a recent conversation that one of the Gyn/Onc doctors had with her. He (in her words), told her that she was dying, and that thereís really no hope. She didn't want to believe it.
When I spoke to the on-call resident, we discussed this, as well as how she was doing right now -- sheís depressed, gray, and she doesnít want to give up hope. The key is, she doesnít want to give up.
Instead of enjoying the last few months (probably just weeks) of her life at home with her husband where she can enjoy the pregnancies her children are experiencing, she is spending it in the hospital getting worse by the day. It breaks my heart. It breaks my heart because I donít see it as giving up -- I see it as living it out.
How do we discuss this with someone whoís just not ready to hear it? My approach with this patient was to try to bring it up, but she just wasnít hearing it. So instead, I comforted her. I told her we are here to support her and help her find something that will work for her when she goes home so she can stay there. I told her she needs to be honest with herself and with us. We canít help her if we donít know what isnít working.
She shared with me her main concern, and I passed that on to the resident in our conversation. I know she doesnít have much time left here on this Earth. For her sake, I cannot wait until she comes to grips with this. I hope she does make it out of the hospital one last time in order to have some quality of life at home with her family around her.
Until then, for her and all my patients, I will continue to fight the good fight and help them all to find peace through their journey, regardless if that journey ends in cure, remission, or death.