For myself I am an optimist — it does not seem to be much use being anything else.
-Winston Churchill
Even before I met him, I could tell that his cancer was extensive. His problems had started several months before with a cough, a voice change, and some trouble swallowing. His primary doctor had not spotted anything but had kept an eye on him. Antibiotics and cough medicine had not helped. After he coughed up a little blood and developed a mass in his neck, he had seen a throat specialist. Sure enough, he had a cancer.
Before walking into the examination room, I reviewed the reports and scans. The cancer involved much of the throat and had spread to lymph nodes in the neck. This cancer is very dangerous, I realized. I prepared myself to meet someone who I assumed would be pretty miserable.
Instead, when I walked into the room, my new patient greeted me enthusiastically. As he energetically shared his life’s story, his wife shook her head and smiled. The doctors near his home had recommended chemotherapy and radiation. He had decided to get an opinion at our center. "You’re a surgeon," he reminded me. "If you recommend chemotherapy and radiation instead of surgery, then I will know that they are on the right track!" He laughed.
I completed the examination and told him that he had, indeed, received sound advice. If surgery would ever be necessary in the future, I would be glad to see him. "That’s great, Doc!" He smiled. "Hope I never see you again!" Pretty soon, he was shaking everyone’s hand, waving to folks down the hall, sharing more stories, and heading to the parking lot.
Later that night, as I was typing his progress note on the computer, I spotted something that I had overlooked during his appointment. In reviewing his family’s health history, almost everyone had died of some type of cancer. His own parents had died at ages 69 and 70.
I rechecked my patient’s birth date. He had just recently turned 70. He was exactly the same age at which both of his parents had died. Now he, too, was facing cancer treatment.
I wondered: was it possible that my irrepressible patient had not noticed the coincidence? That seemed very unlikely. Was there anxiety bubbling under his surface that I had overlooked? If so, he had hidden his worry well. Or was it possible, I wondered, that he was just not worried?
It left me amazed with the wide range of skills that some people have that allows them to cope with difficult and frightening circumstances. It also reminded me that, over the years, I have met some truly amazing patients.
The following is feedback received for this blog:
Once again, friend, a thoughtful and insightful piece. Look forward to the White Coat Ceremony!
- RICHARD HOLLOWAY
