The Painful Goodbyes of Oncology

Written 22 July 2023

Of saying goodbye to a terminal patient.

…

One morning during my clinical rotation in oncology, we went to say goodbye to a patient being discharged later that afternoon. A woman in her sixties with metastasized cancer and no more treatment options available. She was currently in the process of writing goodbye letters and calling her closest friends and loved ones. Calls during which she ended up having to console others for her dying.

The plan had been to call three a day. A number that had now been reduced to one.

The oncologist advised her to let her wife make the calls and arrange the visits. If people wanted to say goodbye, it should be done on the patient’s terms.

“This way you can spend more time on the nice things”

the nice things …

She had been reading a book when we entered the room. Said it had been about World War II and had a brief discussion with the oncologist about it.

She would see the oncologist again in a few days. To me and another doctor present, she said goodbye.

She thanked us for the good care and said she hoped we would make something good of our lives.

I left the room with a knot on my throat.

The day before I had read a paper hanging on the wall about how to handle a “slecht nieuws gesprek” dutch for breaking bad news to the patient.

Prepare sufficiently, so you avoid being overtaken by your emotions.

In my head I kept repeating that during the whole conversation.

We are all going to die. Even just subconsciously -we know it to be true.

Still there’s something exceptionally cruel in hearing that your time is soon. In doctors wishing you a beautiful last few days, spent doing something nice.

It feels surreal and unfair and I cannot imagine how it feels to walk a single day in the shoes of these people or their loved ones.