Comments on: How Long Do I Have?

By: Boston Builds Better Mouse Model for Metastatic Cancer | Cancer Research Journal

Tue, 15 Apr 2008 23:48:52 +0000

[...] Related Links: WhiteCoat Rants [...]

By: virginia597

virginia597 — Fri, 21 Mar 2008 10:36:39 +0000

Ah, that sucks ass. I have to agree with Anonymous Surgeon and MM here–you did the best you could, and, although it may not feel like it, it could’ve gone much worse. It sounds like the patient had a pretty firm grasp of the severity of the situation, or she wouldn’t have even asked. My dad died of metastatic lung cancer just a few years back, same situation (in that he’d thought he had it beat). I was actually in school when he received his prognosis, so I can’t really tell a long story about it one way or another, but I know that we never would’ve gotten through the whole ordeal without honesty and caring from all his doctors.

From your description of her, I would guess that the patient was grateful to have gotten an honest answer, at the very least.

On a side note, I can’t help but recommend (although you surely already know, and I apologize if it’s troll-feeding) that you thoroughly ignore Truth-chaser and everyone like her. I would guess it’s either poor imagination, poor reading comprehension, or weak empathy skills that produce that sort of response.

Well, at least the rest of your month is almost guaranteed to go better than that. And may you never have to do that again.

By: The Next Twenty Years » Blog Archive » Sometimes being a doctor really sucks.-How Long Do I Have?

Thu, 20 Mar 2008 22:40:56 +0000

[...] wants to pass the buck to the family doc who knows the patient a hell of a lot better than I do. [ read more ] Categories: Cultural, Medicine/ HealthTags: Medicine/ Health var staf_confirmtext = ‘Mail sent’ [...]

By: The Wife

The Wife — Tue, 18 Mar 2008 11:32:19 +0000

My husband had his bladder removed from bladder cancer in July 2005. THe cancern was not through the bladder wall and was not found in the lymph nodes. A few months later, it was found in his urethat and that was removed. He has been cancer free since then. This past fall he had back pain that was attributed to a dislocated tail bone and ultimately arthritis. Two weeks ago, we found the real problem was metastatic bone cancer in the pelvic area and spine. We also found nodules in both lungs “too numerous to count”, a suspcisou area in his liver, and a small 4 cm mass in his abdominal area. We are going with radiation to treat the pain and them looking at chemo. When we asked the oncologist how long he would live, he just danced around the answer and never gave us one. I know the prognosis is not good, but it would really help if he had been more honest and open with us so that we could somewhat plan.

By: Anonymous Surgeon

Anonymous Surgeon — Mon, 17 Mar 2008 05:35:53 +0000

Considering the fact that it really was entirely inappropriate for a patient to be coming to the ED for a chronic, albeit terminal condition that really could be MUCH better addressed by her oncologist and PMD, I think you did great. Spitting out the necessary truth about a terminal condition is always hard, especially without knowing the patient or their family dynamics. I think it is best to talk about averages without removing all hope, but yet be realistic enough to let the patient and their family know that it is time to “get their affairs in order.” Some of the worst arguments I have had were with families that didn’t want “Dad” or “gramma” to know their diagnosis. Giving time estimates are near-impossible; the distribution around the mean varies so much person to person that I usually have to give a little speech about “average” and how there are so many trials and new treatments being discovered every week.

Really, these kinds of discussions are what oncologists deal with every day. Just like you can take care of asthma, chest pain, and a dislocated shoulder without batting an eye, that’s what these brave (and usually compassionate) men and women do all the time.

By: alex

alex — Sun, 16 Mar 2008 12:49:09 +0000

during my first few weeks as a nurse, I found myself caring for a Spanish speaking patient who was dying of cancer. her family withheld this information from her even though she was in home hospice care. she was admitted to the hospital for an unrelated matter and her family failed to tell us that they were keeping the severity of the patient’s illness from her. well, I was the only Spanish speaker on the unit that day, and the patient asked me point blank what was going on. I had no choice but to level with her. it was truly horrible. I’m not too proud to admit that we both cried more than a little.

as a nurse, I never expected to be in that position. when all was said and done, though, I was glad that I had not lied or deflected. I understand that there are cultural differences in how such news is handled, but I felt that being truthful was the only way I could give this woman the respect she deserved.

By: SeaSpray

SeaSpray — Sun, 16 Mar 2008 07:23:54 +0000

The oncologists do tell her that there is more they can do whenever she gets bad news.

By: SeaSpray

SeaSpray — Sun, 16 Mar 2008 07:22:33 +0000

Awww…I know that must be so difficult for doctors. I think you handled it well.

This was a beautifully written post on such a sad and frustrating subject.

This post also hits home because our aunt who was diagnosed with breast CA in September 06 had it spread to her groin and neck and liver. She was recently informed that it is no longer in her neck or groin but still in her liver. They said it is no worse but it is no better. They were going to give her a rest from the treatments (she’s so thin) but within a few days she wasn’t walking right or pronouncing her words right. At first they said it must be a virus go see your PCP but he was out of town. Good thing because the cancer doc said to come in and after another test discovered that she has lesions on her brain. So now she is getting treatments again and getting stronger…a little stronger.

I thought she looked a little on the yellow side when I saw her a couple of weeks ago. She has been enduring all this for almost 18 months.

By: Jamie

Jamie — Sat, 15 Mar 2008 00:38:44 +0000

How hard! I, too, wish that you were my doctor. Actually, I wish that you were my husbands doctor. Our current doctor will tell us there’s no hope, but he won’t give me a timeline or an idea of what to expect. It’d be easier to deal with if I knew.

If you’re having difficulty getting answers from your doctor, I have listed several medical reference sites on my “Links” page that you may be able to use to find more information. Good luck to both of you.

By: Louis

Louis — Fri, 14 Mar 2008 21:33:28 +0000

You can be my doctor anytime.
A tough article to read.
Had to be tough to write.