To patient or not to patient
Written on August 5, 2023
Of our patients.
…
Once upon a time, there was … a patient.
In her youth she’d been a dentist. Knew all about painkillers and antibiotics. Let us know there was no defense musculaire during the physical examination.
The first day she only looked at the doctors. When I was the only one in the room, she kindly asked me if I would also make the specialist aware of her concerns.
The second day she answered my questions, looking at the two internists beside me.
The third day, I went alone to the room again. I shared our concerns about one of her symptoms. She was more than willing to brainstorm with me. Shared things she’d observed while still working as a dentist. She had her own hypotheses which she lively shared.
On the fourth day, I was still amongst the doctors, but she looked at me. And when I announced our treatment plan, her questions were also directed to me.
”thank you for the good care, doctors” and this “doctors” landed on me. I had earned my place.
She wished us a good weekend. She would see us again on Monday. I told her I hoped the next week would be better for her.
I wasn’t going to see my patient again. I knew but hadn’t mentioned it. I don’t particularly like goodbyes. Not to mention that for her, I would be just another medical student. To me, it felt like she was my first actual patient.
My patient who I really hoped would still be alive in a year.
…
Our patients, I feel, we take under our wings. Care for them in our way and try to protect them.
Still, we cannot prevent the inevitable. Some diseases, we cannot treat. We can join their fight with them, sometimes offer them weapons, while knowing they’re not the most suitable ones for this battle. If there’s hope, we hope with them. ”This one’s young or fit, maybe he’ll make it”.
When I first heard this expression, it was from an oncologic surgeon. A strange statement to make. Life – and cancer, do not work that way.
…
While in the hospital, my patient was still reasonably healthy. She’d gotten her diagnosis less than a month ago.
Still a curative treatment was out of the question. The disease was already progressed on presentation.
And as I looked at her, from across the room, it was difficult to put two and two together.
She looked tired, but not terminally sick.
And with all my heart I wished that we could stop the time. Then and there. While she was still healthy and hopeful.
Sometimes all you can do is standby and observe as things take the downturn. Striving not to make it better, but more comfortable. It is not enough or fair, but it is all that is left to do.
…
A big part of my time in medical school I’ve spent wondering whether I’d be better off with or without patients. Whether I needed them in my life.
It’s not a question of needing anymore. It’s more a question of whether I can bear to see more patients like my patient come by.
The tragic irony of oncology. Different protagonists -the same ending.
How do you allow yourself to bond with someone while knowing their time might be limited? While accepting that you cannot change their fate?
