I’ve been thinking of how I will say it, how I will turn someone’s life upside down as I move from patient room to patient room. Room one holds a gentleman that is having trouble getting his diabetes under control and has diabetic kidney and eye disease as a consequence of his over indulgence. My second patient, who has known coronary artery disease has been experiencing chest pain over the last week, awakening him every night with “an elephant on my chest” in a pool of sweat. “Luckily he is not currently having any chest discomfort,” my nurse tells me.
I scan the list of my morning patients; hypertension, follow up labs, complete physical exam, back pain, trouble swallowing, shortness of breath, abdominal pain and weight loss. Then it’s lunch with a stack of lab results, adjusting blood thinners, pathology reports and back to seeing my patients at 1 o’clock.
Then I see Allen on my schedule! There it is at 1:30 pm. FOLLOW UP RESULTS. The young man is in his late 20’s, is engaged and has the whole world in front of him. Except I’m going to tell him in the most tactful, gentle, and compassionate way, that he likely will not be around in a year. That all the planning he has made for himself and his bride to be, the house they want to buy, the names they like for their future kids, the “full and happy life” that every 20 something young man or woman feels is all in vain.
I see all my morning patients…which seems extra difficult today. I can’t seem to get Allen out of my mind. “How in the hell am I going to do this? How in the hell CAN I do this?” I never received any training whatsoever on this sort of thing…breaking the news, telling a young man his life is over. That the remaining time he has on planet Earth will mostly be spent suffering, in pain, scared…scared out of his mind at times. And the fiancée…the woman who loves this man more than anything in the world. The woman who not just two weeks ago brought him into me for a “nagging cough and some shortness of breath” that has been going on way too long as far as she’s concerned. The young woman who just told me about all the details of their upcoming wedding and honey moon and who absolutely adores her “soul mate”, her fiancée.
I feel sick. I resent my job as I poor over the biopsy results and PET Scan findings once more during lunch, looking for any sign of hope, anything at all I could use to avoid having “to be the one” who shatters Allen’s life. Nada…there’s nothing. It is stage four metastatic melanoma. Any treatment will be purely palliative, that is, comfort and support. To look inside Allen would be akin to ripping open a bag of Kingsford’s BBQ Charcoal and peering into its contents. Nothing but black everywhere. Black Death. Melanoma is as black as a starless sky at night.
“You ok?”, asks my nurse as she tells me the lab is on the phone with a critical result on some other soul I hope I can help. “Yeah I guess,” I reply as I glance up at my office clock. “Allen’s ready in room four, his fiancé is with him,” she states while looking me straight in the eye. I can tell she could literally breakdown right here, right now. That goes for the rest of the employees I work with on a daily basis. Sure I’ve had to tell others very bad news. I’ve had to explain that treatment is futile. I’ve had to work against a minds instinct to survive…no matter how bad or bleak a picture I paint for them. Every instinct cries out! Survive! Survive! Survive! As my mouth gets dry, my gut wrenches.
“Can you call over to the hospital and get one of our social workers over here to standby in the clinic? Get ahold of our hospital chaplain as well could you?” “Yeah, of course,” she states.
What was scheduled as a forty minute appointment with me ended up taking close to two hours that day. Since then I’ve had to break a lot of bad news. Seems all the “good news”, the tears of joy (if you will) are long forgotten when a difficult task, such as the one described above is carried out.
Feeling sorry for myself seems so selfish, so self-centered. But that’s how I felt believe or not. “How can I ever be the same?”, I thought daily while driving to the office I’ve devastated someone’s life. I couldn’t help…I went through all this training and school so I could help people, not hurt others”. And then, as I sat down at my desk, ready to plow through the morning’s labs, etc., an envelope lay against my laptop. On the outside was one name; Brett Davis -Physician Assistant.
I opened it. It contained a brief note:
“I’m so sorry you had to give me the news that you did a few weeks back. It must have been very difficult for you to do. I imagine it created a great deal of discord with your soul, your heart. But I must say you did it with grace and compassion and I am grateful it was you and not someone who would have fumbled through it, acting as though they just wanted to get out of this room and move on to the next patient. Thanks. I do not look at things the same any longer. I look into her beautiful eyes and can’t help but feel both love and gratitude; I look into her eyes and can’t help but feel tears well up inside me. I am so dam fortunate. So fortunate to look out a window and see majestic mountains, to see deer along the road as I drive home. I am so fortunate to experience hearing the creek tumble through its twisted and graceful course behind my house. I am so lucky to awaken each morning knowing that the day holds hope and to greet each day with the same vigor that the sun has when it first touches the mountain tops each sunrise. For today, this day, is the only day that matters; not tomorrow, not next week or even next month. Today well lived makes yesterday a dream of happiness and tomorrow a vision of hope. Look therefore to this one day, for it and it alone is life. Thank you Brett, for you have given me a reason to live this day to the fullest. The wind is sweeter, the flowers more colorful, the birds in flight more amazing…and the love in my heart is immeasurable.”
I truly learned a great deal about humility from this patient of mine. I also learned how I helped this young man, ironic as it may seem, and how he helped me. He allowed me to realize just truly how amazing today is. Today, this day, right now is what matters most. What truly is important in life? Not that new car I want, not the upcoming cruise that Kelly and I anticipate so much and not even thinking about my precious little girl who will be waiting with arms wide open in her crib tomorrow morning at 6am waiting for “dada” to help start her day. No. Right here, right now is what’s important. It’s what makes all the tomorrows so worth it. It’s how we live…right here…right now.
Brett Davis- Physician Assistant- Sophia’s Dad