Oncology is a kind of specialty in medicine that involves seeing the same patients for many years. This can be beneficial when your patient is cured in cases of limited-stage disease or if the disease is stable on treatment for a long period of time in cases of advanced disease. In both scenarios, you follow the patient closely regularly and form a strong bond with them, even if you don’t try. You get to know their personal stories, and they get to know you.

Some patients, who always remain in good spirits, undergo their treatment with a lot of patience and ultimately become disease-free; they are prized by the doctor and form the closest and most friendly bonds. These patients are the favorites, whether the physician expresses it or not. One such patient is a 60-year-old lady with breast cancer. On her first visit, she was accompanied by her son, who is around 25-30 years old. I always remember those patients whom I examine or take their history on their first visit, maybe because it is the longest and most detailed interaction with the doctor. She had multiple comorbidities and came with a huge breast lump. Despite this, she was always in good spirits whenever she came. Thankfully, her metastatic workup was negative, and she was started on neoadjuvant chemotherapy. At each cycle of chemotherapy, she came with her younger son, who was very lively. During her first meeting, she told me about her two sons: the elder one, a rheumatologist in America, and the younger one, an unmarried businessman. The younger son was super supportive and caring throughout her treatment.

She became one of my favorite patients because whenever she came, she would find me wherever I was in the clinic. She would meet me and tell me all the details about her treatment, her sons, and her daily life. She continued her chemotherapy with good tolerance and then underwent surgery. I went to meet her when she was admitted for surgery. She was in a good mood and really happy to see me. Her younger son was sitting beside her bedside, and we had a good conversation about her post-op care and further treatment plans.

After surgery, she had radiation therapy and a few more cycles of oral chemotherapy. Today was her last day of the final chemotherapy cycle, and this time, she came with her elder son instead of the younger one. After thoroughly examining and reviewing her labs, I met her elder son and asked about the younger one. He told me that his younger brother had recently gotten married and had come to Pakistan to attend his wedding. He was extremely surprised when I told him I had known him for the past two years because her mom had mentioned him on each visit. I was happy for her because she had completed her treatment today, and her favorite son, whom she missed a lot, was also there for this visit. I pray that she remains disease-free and happy as she is today.

Another favorite patient of mine is a little boy who is only four years old. He had a Wilms tumor, and we treated him with chemotherapy and radiotherapy. Currently, he is on follow-up and disease-free. On his first visit, he was a bit scared but became comfortable after some time. Whenever he comes, he first hugs me, then sits on my lap during the consultation and tells me about his school. He speaks Urdu with a slight lisp, and he is really adorable. When he leaves after the consultation, he hugs me again for a long time. Sometimes, I am the last one to let go. Then he always says, “Now please let me go home, doctor.” I feel as if he is my own kid, and I wait for him every three months. I always keep chocolates for him, and he finds me in the OPD even when I am not on rotation with his treating physician because he knows he is very dear to me. He makes my day brighter with his presence. I always pray for his health and happiness and enjoy seeing him grow a little at every follow-up.

Oncology is about living for such interactions, and even one of these patients can lighten your mood and make you forget the extreme weariness of the day. If I can make a difference in a single patient’s day with kind words or a little affection, it makes me happy and proud of my work.

Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work. One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out, ‘Good morning! May I ask what it is that you are doing?’

The young man paused, looked up, and replied, ‘Throwing starfish into the ocean.’

‘I must ask, then, why are you throwing starfish into the ocean?’ asked the somewhat startled wise man.

To this, the young man replied, ‘The sun is up and the tide is going out. If I don’t throw them in, they’ll die.’

Upon hearing this, the wise man commented, ‘But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can’t possibly make a difference!’

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At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, “It made a difference for that one.”
— Loren Eiseley

Damane Zehra is a radiation oncology resident in Pakistan.