Monday, April 03, 2006
Monday, April 3rd, 2006
"Picture: University of Pittsburgh Hillman Cancer Institute"
8:30 am, Presbyterian hospital:
A 52 y.o. lady, previously healthy, was just diagnosed with an esophageal adencarcinoma. The primary team just gave her the brief news, and promised her the oncologist will come and address all issues.
My first patient as a fellow.
The patient looking at me after I was talking for at least 10 minutes, explaining about the cancer, the options of treatemnt, the side effects of treatments...etc.
"well, doc, I really appreciate the detailed information, but what I need is an answer to one question". Still looking at me, "why me? I never smoked, I always tried to eat healthy, live healthy, so how come I got cancer?".
10:30, Hillman Cancer center:
A 53 y.o. lady, with a diagnosis of active chronic lymphocytic leukemia (CLL), is being given the pre-transplant education.
"So, the immediate mortality from the mini-ablative procedure is, as you see on the graph, 10-20%, with a response rate of 30-35%, and the rate of GVHD side effects is this, while the failure is that...ect etc", Said the transplant attending.
The lady calmly says "with all my respect to the statistics you're giving, Doc, I really don't care. What I care about is where I fit in this graph...with 10-20% unlucky poor who will die, or those who'll make it? Where do I stand? Can you tell me?".
3:15 pm, Still in Hillman cancer center:
An 81 y.o. gentelman, with a history of myelodysplastic syndrome, just got the bad news that his disease transformed to acute myeloid leukemia (AML). After I examined him, and talked with him, he grabs my arm, and says in a weak voice " I'm not dying, doc...am I? I know you won't let me die...right?"
"this is just my first day..." I was thinking. Never dared to say it, however.
What a day!
I felt so limited in what I can do.
How much I need to read.
And still, how much I need to learn, from the patients!
How much we miss the whole point, and concentrate about their least concern.
Do we treat cancer, or people with cancer?
I definitely learned today I'm ought to talk more to patients.
Meanwhile, Ghassan, Mirvat, and all the people in cancer research, we need your help guys...
God knows how much we need you!
Ok, tommorrow is a new day.
(I apologize from my friends with nonmedical background for using medical terms here, but those were just presented to the poor patients as such)