Helpless/Hopeless

The Set-up

So, my story comes from when I was on ACS. I'd say it was the toughest day that I had on ACS. They asked me to go see a consult for a middle-aged lady for what we thought was rectal cancer.

She has like a mass in her rectum on the CT. I remember getting there, and then looking at the chart. She spoke the same language as my partner and his family speak. I remember going to see her and she understood very few English words. She was there with her young daughter who couldn’t have been older than maybe 19, or 20. I was trying to get a history from her, and it was all going through the daughter. I was trying to prepare them a bit that it could be something not so good. I was sitting there with her and we're just about to get the report of her CT scan. I just remember feeling nervous, like, oh, we have to break the news to this lady today that she has cancer. I interviewed them as best as I could and headed back. We got the CT report and went back as a team to go see her. There was senior and the junior with me. We just pulled them into this one room in the emerg. It was the three of us, and then the mum and the daughter. All five of us were in there for some reason. I don't know why there were so many people in there.

It came time to tell her that she rectal cancer and so we told the daughter, and then the daughter had to tell her. I remember the daughter telling her. I thought to myself, as a mom, she didn't really react like we had said something very serious. We see a mass on your CT scan. You have rectal cancer. And yeah, the mom didn't really react. I was surprised and I was thinking, what does she think of this? Like this is pretty crazy, right? And then me and the one resident left the room, and I was walking down the hall and I remember hearing her scream. Yeah, and it was just so tough to hear because she was trying to hold it all together. And there were so many of us in there and it was probably so overwhelming for her and I'm sure she just didn't even register for a second what we are telling her.  And then on top of that, the fact that her daughter, her young daughter, was the one that had to actually tell her right, because we couldn't tell her. It just really broke my heart to hear her scream. 

How do you think this is going to impact you and the care that you provide to patients in the future? 

On I remember going home that day, and thinking, “Why were there so many of us in there? Why wasn't it just one resident, and then even like a translator so that the daughter didn't have to tell her own mom that she has cancer?” That could have been set up so much better. Like, what kind of setup was that? It just really, really upset me. I mean, of course, setting it up doesn't necessarily change the fact that she has cancer. But I'm sure it would have made all the difference for her and her daughter if we took the time have a quiet place, having maybe a translator, and not more than one health care provider in the room. It was also hard because she was the same age as my partner’s mom and spoke the same language. What if that was my mother-in-law? How would I feel if she got sensitive news in that way?  

I think physicians in general, as they get more into their practice become almost become desensitized to it. I remember shadowing emerg in first year, and there was a man that was having an MI. The doctor just was like, “Yes, your husband's having an MI. We’ll call cardiology.” And the wife was crying because she's like, “Oh, my God, is he going to die?” I was standing there thinking this is not how medicine is practiced. How you set it up and leaving time for questions and acknowledging their emotions, I think is huge. My overall take away from this is that I never want to lose the human aspect of medicine. I want to look at people as people, not patients. A “55-year-old woman with rectal cancer”. No, she has a daughter, she has a career, she has a life. It’s the whole world to her that she has cancer. To us, it's just another day.