See Ya Tomorrow

I finally finished my grueling oncology rotation and started my cardiology rotation. I was never so happy to move from one rotation to another. However, the thoughts of my oncology experience that I spoke of last week continue to linger.

We have so many patients in the hospital with chronic diseases that we fail to keep out of the hospital due to non-compliance issues. We all have the patients about whom we say, “Oh yeah, I had her/him on my service when I was on two months ago." We try our hardest to keep them out of the hospital and improve their quality of life, and they have to follow our recommendations, like watching the salt in their foods or taking medications on a regular basis.

Then there are the oncology patients. They do everything in their power to do what the physician prescribes. They will take drugs that will give them the worst side effects known. They will change their life habits and do everything we say ... but we still can't cure them. That's the hardest part.

I had this patient on service that I still visit to this day. He’s a young guy with bright red hair and an ebullient personality. He’s always so upbeat and often had a smile on his face. He has a horrible cancer that hasn’t responded to the treatments he’s tried.

I stopped by to visit him on the first day of my cardiology rotation. He was in bed, wearing a high-flow oxygen mask. I said hello and asked him how his day was. He said he was having a good day, but he was scared again. I could see it in his eyes that he was not doing well.

His new doctors had come to see him earlier in the day and explained to him his grim prognosis. He looked at me said, “I miss you as my doc,” and he let out a tear. I held his arm and his shoulder and told him that I missed having him as my patient. He said, “"How can I leave my beautiful baby boy or my wife?” He said, “I never thought that at this age I'd be thinking about life after death.”

That hit home because I'm at that age too. I haven't thought about that stuff, and it's a very deep thing. I almost lost my composure.

I saw him again this morning. The fire in his eyes is fading by the day. It’s so frustrating to know that no matter what I do I can't make him better. When I was caring for him, at the end of every day I’d say, “I'll see ya tomorrow,” and he’d say the same thing back. But today, for the first time, he hesitated before saying it. I could see in his eyes that he couldn't say it and mean it 100%.

He said, “I don't see how anyone could do their job, telling people they are going to die, or that they shouldn't keep fighting because they wouldn't make it. But I think I'm not doing worse. I think there's something that can be done.”

The human side of me wanted to say, “Your opinion is all that matters,” but the scientific side of me wanted to say “Your docs are very experienced, and they’re leaders in their field. They are trying to tell you what is best for you and your body.”

I didn't pick a side. I couldn't.