Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Being an oncologist is a privilege, even if it’s sad

Don S. Dizon, MD
Physician
January 27, 2017
Share
Tweet
Share

asco-logo

One of the privileges of medicine is the chance to meet people from every walk of life — many of whom you might never get a chance to know otherwise. Of course, such meetings are never spontaneous. In medicine, we are brought together by illness, and the people coming to see me are seeking advice on treatment for cancer. With new therapies, fortunately, oncologists are now seeing patients over the span of years, and we get to know the person who is the patient beyond their illness. Many also bring along others on visit after visit, and we get to know each of them too.

Such was the case with Alice*. I had met her two years earlier after a diagnosis of advanced ovarian cancer. She came with John*, her husband, and Lauren*, her younger sister. All three listened intently as we spoke of her diagnosis and my recommendation for treatment. John took notes while Lauren listened and asked questions. Alice was silent and, in retrospect, the most frightened. Over the next year, she underwent adjuvant treatment and entered follow-up. John and Lauren always came with her.

I learned that Alice taught music in middle school — a job she loved. I learned that John had proposed marriage to Alice right out of college, and they had been inseparable over the next two decades. I learned about their two children who lived far from them but called every night to see how mom was doing. I learned that Lauren was a successful entrepreneur and that she and Alice were the only family they had left. There was a time when Lauren stopped coming to the visits; it must’ve been as Alice entered her second year of remission. I had gotten so used to seeing all three that I asked why she hadn’t been coming.

“Lauren was in a car accident,” Alice told me. “She almost died, but thank God — she made it. She’s in a rehabilitation center getting stronger.”

“Oh no,” I responded, “How awful. I am so sorry!”

“It could’ve been worse,” Alice replied. “I don’t know what I’d do if we had lost her.”

As we entered the third year of follow-up, Lauren started to join them again. She looked great, and I made it a point to tell her.

“Thank you for saying that, Dr. Dizon,” Lauren responded. “I am fine, out of rehabilitation and will get back to work next week. I can’t wait, actually!”

Six months later, Alice became bloated and experienced worsening abdominal pain. An exam suggested ascites, a sign of relapse, supported by a marked rise in her tumor markers. I ordered a scan then, and the results confirmed relapse. They had waited in my office for the scan results, too anxious to return home.

“It’s back,” I said to all three of them. John was the first to cry. Lauren asked questions. I made arrangements for a paracentesis to improve her comfort and allow her to eat and then recommended chemotherapy.

Over the following months, she cycled through many different treatments, each less effective than the previous line. She also began to show signs of the advanced cancer within her: she lost her appetite, grew more tired and experienced worsening of nausea first, later accompanied by pain. Each time I saw her, her sister and husband were with her. They had tried to remain optimistic, but with each passing month, the look of worry on their faces became more evident.

One late evening in December, I received a page that she had been taken to the emergency room. She had had an acute onset of severe abdominal pain and nausea and had started to vomit. A workup revealed a bowel obstruction and evidence of free air within her abdomen — a sure sign of a bowel perforation. She was immediately started on pain medication which helped her get more comfortable. She was offered surgery, but she opted against it. She felt her time had come.

The next day, I made my way to the floor to see them. It was early, so I quietly entered the room. Alice had her eyes closed, a grimace still visible on her face. John was seated by her side, looking at her intently, eyes wet. He was caressing her arm. I know it was meant to comfort, but I could not figure out if it was to comfort her or him.

ADVERTISEMENT

“Hi,” I said. At the time, it was all I could think of.

Alice opened her eyes and smiled. “Hi, Dr. Dizon. It is nice to see you.” John also greeted me warmly.

“You too. Both of you. I am so sorry this happened. I had hoped you would have more time.” We talked some more, making sure her pain was better controlled, and that any questions John had were answered. As we spoke, Lauren also came in. She looked exhausted, eyes puffed from crying. We spoke as well, and she seemed resigned to the fact her only sister was at the end of her life. The sadness was made even harder by the fact it had happened around the holidays. I tried to find a silver lining in this very dark cloud, but I could not.

Ultimately, I sat with them in silence for a few minutes, and it dawned on me once more what an incredible privilege it is to be a doctor. Because of Alice’s cancer, I had gotten to know her, John, and Lauren and her entire family. I had seen her enter remission, diagnosed her relapse, and had treated her with the best therapies I could think of. And now, I was here, with her, at the end.

I got up then to give them privacy. I walked up to her bed for what I expected would be the last time. “Alice, thank you for letting me into your life. It’s been an honor to get to know you and John, and Lauren, as well as your kids. I promised you that I wouldn’t let you suffer, and I promise you won’t.”

She looked at me and smiled. “Thank you for everything, Dr. Dizon. And Merry Christmas to you and your family.”

“You too,” I said. It was all I could think of.

* Names and identifying details have been changed.

Don S. Dizon is an oncologist who blogs at ASCO Connection.  This article was originally published in the Oncologist.

Image credit: Shutterstock.com

Prev

Can independent practices stay viable using price transparency?

January 27, 2017 Kevin 11
…
Next

Why this physician can't be her family's doctor

January 27, 2017 Kevin 3
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
Can independent practices stay viable using price transparency?
Next Post >
Why this physician can't be her family's doctor

ADVERTISEMENT

More by Don S. Dizon, MD

  • As an oncologist, this is the hardest role I play

    Don S. Dizon, MD
  • Why physicians should acknowledge the validity of second opinions

    Don S. Dizon, MD
  • A patient who taught an important lesson in doctoring

    Don S. Dizon, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • Deploring racism isn’t enough: Addressing white privilege in medical school

    Jessica Cranston
  • Immigrant physicians: Acknowledge our privilege and move to action

    Toyin M. Falusi, MD
  • My white privilege perpetuates this country’s inherent racism. It’s time to change that.

    Rachel Fogel
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD

More in Physician

  • How market forces fracture millennial physicians’ careers

    Shannon Meron, MD
  • Unity in primary care: Why I believe physicians and NPs/PAs must work together toward the same goal

    Jerina Gani, MD, MPH
  • Guilty until proven innocent? My experience with a state medical board.

    Jeffrey Hatef, Jr., MD
  • How to balance clinical duties with building a startup

    Arlen Meyers, MD, MBA
  • When life makes you depend on Depends

    Francisco M. Torres, MD
  • Implementing value-based telehealth pain management and substance misuse therapy service

    Olumuyiwa Bamgbade, MD
  • Most Popular

  • Past Week

    • How hospitals can prepare for CMS’s new patient safety rule

      Kim Adelman, PhD | Conditions
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • Physician practice ownership: risks, rewards, and reality

      Paul Morton, CFP | Finance
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How market forces fracture millennial physicians’ careers

      Shannon Meron, MD | Physician
    • What I learned about health care by watching who gets left behind

      Maanyata Mantri | Policy
    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • Few people realize this common infection can cause serious complications [PODCAST]

      The Podcast by KevinMD | Podcast
    • Unity in primary care: Why I believe physicians and NPs/PAs must work together toward the same goal

      Jerina Gani, MD, MPH | Physician
    • My improbable survival of stage 4 cancer

      Kelly Curtin-Hallinan, DO | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How hospitals can prepare for CMS’s new patient safety rule

      Kim Adelman, PhD | Conditions
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • Physician practice ownership: risks, rewards, and reality

      Paul Morton, CFP | Finance
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How market forces fracture millennial physicians’ careers

      Shannon Meron, MD | Physician
    • What I learned about health care by watching who gets left behind

      Maanyata Mantri | Policy
    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • Few people realize this common infection can cause serious complications [PODCAST]

      The Podcast by KevinMD | Podcast
    • Unity in primary care: Why I believe physicians and NPs/PAs must work together toward the same goal

      Jerina Gani, MD, MPH | Physician
    • My improbable survival of stage 4 cancer

      Kelly Curtin-Hallinan, DO | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...