Cancer Sucks

Some days I really can't believe that I survived the last two months. It is the end of a long, long journey. I've grown and learned a lot, but there is one realization I knew going into this that has only been solidified: Cancer Sucks! And, at times, it does Big Time.

Sure there are plenty of other diseases that can give a person a shorter life expectancy, and sure there are more and more treatments and possibilities for cure than every before, but still there are no other more earth-shaking, life-altering, gut-wrenching three words that I, as your doctor, could say than: "You have cancer." And if it's earth-shaking, life-altering, and gut-wrenching for me, there is no possible way to begin to understand what it is like for you, my patient. The faces of the people with whom I've had that conversation are burned in my brain. Over my short career, it hasn't gotten any easier - actually, maybe it's getting more difficult. The other day, I was surprised, and a little relieved, to hear one of our staff oncologists, who does this everyday, say that it hasn't gotten any easier for her either.

To those parents who are, or have, watched their children (grown or not) battle this disease, I'm sorry. So sorry. There are few things that could be more painful or more unfair. I understand that you're angry. When I was frustrated with you for being frustrated with us for not doing things fast enough or good enough even though we were doing things as fast and as good as possible, I imagined Owen laying in that bed. Wow, does that sting. I snap out of it in less than a second because it hurts too much and come back to the reality that I have a healthy boy running around at home. I can't bring myself to even imagine him crying out in pain, full of fear, and leaving me helpless to change it. Me, running back down the hall after I stepped out of his room just to get a drink when I hear a beep echo and think that it is something terrible coming from his room. Thank God, He has a plan.

It has been one thing to take care of patients with cancer this month, but even when it has been my turn to go home and set the pager aside I haven't been able to escape. A few months ago, our sweet Uncle Loyd was diagnosed with cancer. Metastatic. Painful. Incurable. The stubborn man with the great stories and a huge soft spot for Owen is slipping away. And fast. In November he was working two jobs. December, he made his famous Christmas breakfast. January, on a train to California to see his family. February, fighting. March, losing. April, realizing it. Now in May, he's laying in a hospice bed with no chance of balancing relief from the pain with sedation from the medication. Do you mind if I say it one more time? Cancer sucks.

I think I've cried more these past two months than the ten before. I've said prayers, but not enough. To our family facing the reality of cancer, to my patients' families, and to yours if you find yourself stuck in this too, God does have a plan. A wonderful plan. But if it helps, it's okay to admit, to say, to yell: Cancer Sucks!

Other Side of the Coin

After my rant about being tired and overworked yesterday, I did feel better. However, it also made me reflect on the past few weeks. In the midst of that reflection came a realization that there have been some pretty awesome moments, too. I'd feel like a used car salesman if I only told half of the story and didn't "rant" about the good stuff, too.

On my only night that I didn't get called in for a new admission, I came in for a different reason. One of our patients had a sudden change status. It was so unexpected that I didn't even check my bed hair in the mirror before heading out the door at 2am. His blood pressure and heart rate were off the charts. He had a fever literally radiating off his skin. And when we were able to wake him up we almost wished we hadn't with his swinging arms and kicking legs. Immediately, we started testing and treating for all of the bad things this could be. (After all, there aren't too many good things this could have been.) Within a few long hours and a few wrong hypotheses, we had our answer. Thankfully, we hadn't waited those few long hours to begin treatments, because otherwise, as my boss put it later that week, "we would have diagnosed it on autopsy." He also told me, "The decisions you made that night saved his life." Catch that - Saved His Life. Awesome.

Recently, I've been seeing a patient who is in complete denial about the terminal part of his diagnosis. (And maybe that's not an all bad way to live the short life you have left. After all, no one really can say I have any more days than he does and sometimes I live in denial of that.) I've decided to just let it be. I'm learning that it's not my job to beat it into his head until he cries. He knows. Now I'm just trying to make him feel a little better each day. Today was a good day. "You're the best, Doc" he called out as I left the room this morning. Rewarding.

A hug from a patient or a family member is always lovely. The hug I got a little while ago was even more so. She hugged me out of genuine thanks and gratitude for making the long phone calls that made it able for her to get on a plane from Afghanistan to Omaha in order to be with her dad in his last few days. The pride, peace, and joy in his eyes brought tears to mine. Unforgettable.

Lastly, a patient was sitting in her chair as we came in for morning rounds. A tube was coming out of her nose, IV's connected her arms to poles, and the few hairs left on her head were laying every which way. She scanned the crowd of seven-or-so of us as if trying to figure out who we were. Then her eyes landed on me. They brightened. "Dr. Newman. You're the faithful one." Turning to my boss she said, "She's here everyday." Ahhh... appreciated.

14 Days and a Few Hours

If this month is any longer than 14 more days and a few hours, it may be the end of me. I'm dying. I knew Oncology would be a difficult month, but it has far exceeded expectations. My patients are awesome... for the most part, and the actual work itself isn't bad. However, there are only two residents on the service (for some ungodly, political reason) to split the call. I'm not that great at mental math, but there aren't too many creative ways to split a month of being on call between two people and end up ahead. What it has boiled down to is what we call "q2" (in layman's terms - I'm on call every other freakin' night). And the way my luck would have it, even though it's calls we can take at home, I'm at 100% for having to go back into the hospital during the night for a new patient or something going on with a current patient. My body is exhausted, sick and dehydrated, and my emotions are fried. When I'm finally able to break away and come home I'm torn between my need to sleep, eat, cry, go to the bathroom, or spend desperately valuable time with Owen and Jason. That doesn't even touch the things I "want" to do: cook, buy groceries, watch the news, buy something for this neglected baby I'm carrying, clean the house we're trying to sell, do laundry, buy my husband a birthday present (especially because his birthday was May 14th), call my parents, hang out with friends who are moving away, go on a date with my husband, take Owen to the zoo, go to church, get a haircut, buy a few more maternity clothes that actually fit this ever-expanding belly, etc... Not that I'm frustrated or bitter or anything. Ahh, the life of an intern. Honestly though, I couldn't make it a second more than 14 days and a few hours. The count down has begun.

whew... that felt good to get off my chest. sorry for being such a debbie-downer. i hate being so negative, so here's a little something that will make anyone smile...

Oncology

Once again it is a new month. It's a little bit warmer outside, the sun is still up when Owen goes to bed, the grass is greener, the heater is off, and I find myself yet again on another new rotation. This month: Oncology.

The general chatter in the resident lounge on the first day of the month is figuring out what everyone else is doing. Most of the comments thrown my way were: "Susan, glad to be done with ICU?", "Susan, haven't see you in a while, when are you due?", "Oncology this month, huh? Sorry about that", but my favorite - and what says it all: "Oncology right after ICU. Who hates you? [pause] and your baby?!" If you can't tell, Oncology is not going to be a restful month. Today we got the talk by our supervisor (also known as our "fellow" in case I use that term later) that this rotation can be draining, not only physically and on our time, but also on our emotions. If ICU wasn't enough, here comes more bad-news-talks and more dying patients. Oddly enough, that isn't what I dread. (And actually, in some strange way I find that part satisfying. That is, helping people die gracefully - how and where they want. Honestly, my entire job, from PAP smears to doing CPR, is just delaying the inevitable and asking people to choose between quantity and quality of life. Anyway...) What I am dreading more than anything is another month filled with sleepless nights away from my family.

Thankfully, this should be the last worst month of residency. Next month, in June, I'll be doing Geriatrics and basically just taking care of nursing home patients. Honestly, it will probably be more dying patients, but it should be a lot less busy and lot less stressful. I hope. Then, after June, I'll be finished with internship. Can you believe it?! Woohoo! I think I can get through this month because I can see the light at the end of the tunnel.