It's been a long time since I've written on this blog but I'm going to be "hopeful" about starting it back up again. It was very helpful for me previously to process some of the experiences I have in medicine and to help with the "meaning making". Now that I'm working in my chosen field - palliative care - doing all the self care work is pretty key to staying healthy and making this a sustainable career.
Today I spoke with an Oncologist whose patient I was involved with last week. The physician had had quite a long relationship with the patient, and had in fact cured her cancer (which normally has only a 30% chance of cure) last year. Ever so sadly, she developed a second cancer because of the treatments and this one struck with a vengeance. So hard & severe, that the patient died within just a couple of days of being diagnosed.
I had been asked to see her to help with pain. But what I found to be different with this patient, was just how much she had captured the hearts of the nursing team on the Oncology ward as well as that of her Oncologist. The nurse leader hovered at her bedside with tears in her eyes and whispered loving words while I administered pain medication. Her Oncologist was hear the door, making sure that her needs were being met as much as possible. She needed urgent transport to Vancouver and unfortunately, by the time the Air Ambulance arrived a few hours later, she was too unstable to go. She was transferred to ICU. The next day, I read a consult note from the Critical Care physician who tried to make sense of why she was declining so fast, again I saw mention of the Oncologist who had obviously been at the ICU that night as well. The patient didn't make it. She died that night in the ICU surrounded by her family.
I meant to call the Oncologist to debrief things with her, but last week I didn't get around to it. Today, I ran into the nurse leader who told me about how special this patient was to the nursing team, and to the Oncologist. And all of the events of last week, they happened on the Oncologist's birthday. So finally today, I called the Oncologist to debrief. I actually didn't have much to debrief myself, since I'd only been involved with the patient for a few minutes while I worked to assess her pain and get it under control. But I thought she might need to. And even more, I thought she might need to hear what a wonderful job she did with this patient and to share my condolences.
Most of us go into medicine because we care about people and we want to help. Yet it seems to be rare to support each other through difficult experiences - especially in teams outside of palliative care, where fortunately I feel well supported. As I asked about the patient's death, the Oncologist recounted the events of the day in great detail and humility. She did an outstanding job, going above and beyond to advocate for this patient whom she cared about deeply and yet, despite her best efforts, the patient died. As I told her today, that I thought the patient was fortunate to be in such good hands and that she provided excellent care, she replied to me with a very soft "Thank you", with her voice cracking a bit with emotion. It's true, and I don't think that we express our appreciation of each other enough in medicine.
Today I am thankful for doctors and nurses who care so deeply that they go far and above what's required. Thank you from all of us - current and future patients, from those who live and those who die. Because while the curing comes from the medicine, the healing comes from the caring.
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