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Sunday, July 17, 2005

Terminal

"So how much time are we talking about?"

The family was quite blunt and to the point. They all stared at me, waiting for the answer.

Waiting for something nobody wanted to hear.

I hate giving time estimates. How do you go about telling someone that their life is limited? That within weeks, months, that they will become severely debilitated. That the cancer will continue to spread until it kills them. That their loved one is beyond hope.

I thought back to the patient's abdomen I was palpating just a few hours ago in the operating room. I thought back to the hundreds of satellite cancer growths scattered throughout her intestines, organs, and abdominal wall. I thought back to the large firm mass sitting on the stomach, growing into the pancreas and the surrounding vessels. I thought back to the sense of defeat, knowing that there was nothing I could do surgically to help my patient.

She had maybe a few months. If that.

Moments like this, I think back to the emotions that ran through me as I took care of my dying mother. And I remember how much I appreciated the honesty and frankness of her physicians, and how the truth, painful as it was, helped me to come to terms with her death and her illness.

I looked into my patient's eyes.
They were trembling.
I could see the fear in her eyes. Her hazel eyes.

I took a deep breath and gathered my thoughts.

"Ma'am, we're talking a few months at best."

She closed her eyes as the tears began to fall, and sought comfort in her daughter's arms. "Are you sure?" she asked quietly, inbetween sobs.

I hung my head, hopeless, unable to offer my patient any refuge.
"I'm sorry..."