Yea we had a good time, packed out stuff up we were on our way...today started off a little shaky. My patient on the gyn/onc service who has had a giant mass in her tummy for 3 months was finally told she had cancer last night. I thought she had known all along...everyone knew, except for her. The doc didn't tell her. Her brother did. Anyhow, she slept not a wink and she just kind of let loose on me all the anger and frustration when I walked in this morning.
I gave her a chance to chill, then I went to go and check up on her later in the day. I made it a point to take off my white coat...it's really heavy and burdensome. If you've never worn one, it's hard to describe. Aside from being weighed down by 20 lbs in books, there a huge psychological burden associated with putting on that damn coat every day. The cool part is, when you graduate, the coats have little pocket holes so that you can stick your hands in your pockets again. But I digress...
For some reason, my patient and I clicked really well when we first met. My attending was horrified as I talked about wanting to go to a drag show and getting drunks with my friends on the weekends. I'm sure my professionalism score will take a hit, but I hit it off with my patient. It turns out she is an old school lesbian. Got married to cure her "disease," but it ended up not working. She struggled with substance abuse issues and she works as a counselor and takes care of her mentally ill sister. She is rich with stories and personality. Plus, we share little South Park inside jokes together.
Being a med student is kind of a weird privileged position. I was there for the surgery, the tumor exploded next to me and I felt her diaphragm and liver edge. I saw the cancers and kind of let out a little scream when the tumor popped out of the belly like the head of the lil creature in the movie, alien. She kept asking me questions about what I saw and what I knew about her condition. It was like fencing, dodging questions, strafing side to side, rephrasing half-truths. I think she knew as well as I that what we had found was badness. It wasn't my place to tell her, but I felt she deserved to know.
It's funny that I fell asleep in Doctoring not two days ago on the techniques of delivering bad news. It's a tough position and it's awesome how much potential there is in that moment to start the healing process, or to mess things up completely.
On a sidenote...my 4th year AI is a she-devil satan spawn. Ray, I love you bro. Thanks for your help.
Another sidenote. My new intern is amazing. She has the most warm and sincere bedside manner of anyone I've ever seen period. Yet, she comes out and doubts herself and if she helped the patient feel a little better about her condition. I am planning to bust my ass for this girl.
-bender
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