MS-4 · neuro

Odd couple

The pathology on my brain tumor patient was read today as “ugly.” I saw it myself — it’s gross. Lots of mitotic figures, cells piled up on top of each other like a bad accident on the George Washington Bridge.  When I visit him, he asks about the treatment in a sort of perfunctory way, but his main concern is his rent.  August is coming up, and he’s so worried about having bills to pay, and his first Social Security check arriving in the mail.  He cried today, the first time in front of me — this is an older, very stoic, very Irish-American gentleman.

Across from him is another of my patients, a woman with a similar presentation but a different disease process.  Her disease doesn’t shorten her life, though you wouldn’t know it to look at her.  She sobs and rails at the world and generally is a pain.  I suppose it’s sacrilegious to be annoyed at patients like that, especially for a person like me, student-teaching the Doctor-Patient Relationship class for the third year med students.  Her husband and daughter are reasonable; she herself is like a character out of a Woody Allen movie, a parody of the neuroticism of the Upper West Side though she lives elsewhere.  I didn’t mind her much at first, but her refusal to understand that she can be treated, and her persistence in Being Sick, is starting to annoy me.  And also that she calls me “Pretty little girl.”

My countertransference for these two could fill a chapter, but for now, let’s leave it at this: to enter that room every morning is to observe the human spectrum.  As a writer, I couldn’t ask for anything more.


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