I have this patient. Nice guy. Sick guy. On admission, he said, “I don’t want no bad news, doctor.” I promised we would take good care of him.
Last night his cancer markers came back several thousand-fold higher than the upper limit of normal. It’s a bad cancer, what he’s got, very poor prognosis. So today we had to tell him.
We kept putting it off, but finally, after everyone else was tucked in and signed out, my resident, intern, and I went into the room.
Patient was sitting there with his sister. Feeling great, no longer short of breath, no more pain.
It’s so strange, talking to someone who feels nearly 100%, and knowing from a blood test that they are dying.
My resident handled it well. So well, in fact, that the guy thanked him. The sister was sobbing, and the patient was teary, and still he says thank you. That was impressive.
Afterwards, we three went back to the work room and just sat and stared at the floor. Then my intern was paged about another patient’s drop in BP, and we rushed off there.
That’s internal medicine. One crisis after another, and in between, staring at the floor in silence.