I was working in my oncology ward as usual when I received a call from the medical ICU to evaluate a patient. The patient was a young male who had been admitted a few days earlier with severe respiratory distress. His workup raised suspicion of a possible malignancy (cancer). This was the information provided to me by the doctor in the ICU.

When I entered the ICU, I met a young male doctor who accompanied me to see a particular patient. He provided a brief history on our way and guided me to the patient’s bedside. Upon arrival, I saw that the patient was a simple young man in his 30s, on high-flow oxygen and visibly breathless. The young doctor introduced me to the patient, explaining that I was his senior from oncology. The breathless young man nodded in acknowledgment and looked at me. For some reason, he extended his hand toward me. The young doctor watched my reaction with curiosity, as this was an unusual situation for him. I couldn’t help but smile at the curious expression on the doctor’s face. Regardless, I took the patient’s hand. How could I refuse to shake hands with a sick patient? His hand was cold and damp.

I signaled to the young doctor to continue with his work and to leave the two of us alone, as I wanted to speak to the patient in detail. I sat by his side and asked about him, and he informed me that he was 31 years old, a truck driver by profession, married, and had a 3-month-old baby girl. He was very breathless, which made it difficult for him to answer my questions, but he did his best.

He told me that he had been completely well a month ago when he started experiencing a cough, occasional blood in sputum, and shortness of breath. Over time, these symptoms worsened, and he collapsed a few days prior after a sudden and severe coughing spell. He was then taken to the hospital, where a chest X-ray was performed that showed pleural effusion (fluid in the pleural cavity, which is around the lungs). The pleural fluid was sent for cytology, which indicated the presence of malignant (cancer) cells, but further characterization was needed.

After the patient’s history and conducting an examination, I saw the CT scan, which was quite horrifying. It revealed a large solid tumor in the abdomen and pelvis, along with multiple lung masses and pleural effusions. There was very little healthy lung tissue remaining, which was contributing to his severe breathlessness. I recommended a biopsy of the mass that was most accessible, located closest to the chest wall. The biopsy was performed immediately, and the patient was given analgesics, allowing him to fall asleep. That was the last time I saw him.

A few days later, I thought about that patient and checked his medical records. I entered his medical record number and checked the biopsy results. It confirmed that he had leiomyosarcoma. Leiomyosarcoma is a rare but aggressive type of soft tissue sarcoma that originates from smooth muscle cells. This cancer can develop in various parts of the body, but it is most commonly found in the uterus, abdomen, or limbs.

I called the ICU doctor to check on the current status of the patient and found out that his respiratory distress had worsened after I had seen him. He could not be stabilized on high-flow oxygen after he fell asleep following the biopsy that day. He was intubated and kept on a ventilator for a few days, but then he did not wake up and sadly passed away. All investigations were inconclusive for any other causes, except for respiratory failure. There was no iatrogenic trauma related to the biopsy; it simply happened. He just left us, without even a diagnosis.

It’s truly sad and unexpected. The life he lived was short and difficult. He was born into poverty, never had the opportunity to study or travel, and spent nearly ten years driving a truck. He missed out on playing with his daughter and watching her grow up. He experienced so little, and then, in just a matter of days, he was taken away.

How short-lived life can be. It can vanish so simply and so quickly. I am unable to explain my emotions right now. I cannot name them. Sometimes, I don’t understand why we cross paths with certain people, getting to know them for just a brief moment. We learn their stories, share smiles, shake hands, and then never see them again. He drifted away just like that. He died. He passed away shortly after that handshake.

Life is so transient and ephemeral; we will not be here after just a breath. Sometimes, I feel that all our lives are like stories — interconnected stories. His story was like a one-page story. So simple and brief. That’s why we should make an effort to improve these narratives, whether they are our own or those of others. If our love and thoughtfulness can beautify someone else’s story, it will be worth it. So we should be a little more accommodating, a little more kind, approach situations with compassion, and write our stories with love. This way, our stories may live a little longer.

“With life as short as a half-taken breath, don’t plant anything but love.”
– Rumi

Damane Zehra is a radiation oncology resident in Pakistan.