To cure sometimes, to relieve often, to comfort always. -attributed to Hippocrates
I saw Mr. C’s last name on the board. Was he still alive? No, the first initial didn’t belong to him…He was long gone…
The first time I met Mr. C, he was slumped in a chair, unable to move his right leg. Gray speckled his brown hair, the same shade of brown as his eyes, now tearing from pain. His wife grasped a folder full of notes from their physicians, carrying a diagnosis they could not pronounce for a cancer rarely diagnosed in adults.
I had never heard of the term, but it sounded dreadful. I was a third year medical student, eager to prove myself on the wards. Not wanting to admit my lack of knowledge to the patient, I scribbled down the diagnosis to look up on a nearby computer.
When I did a literature search, I found only a few cases that occurred in adults. There was no treatment. The cancer started in bone and muscle and would grow and spread, to lymph nodes, to the liver, to the brain. Prognosis: weeks, months if lucky. What hope was there for Mr. C?
Yet the eyes of Mrs. C gazed into mine with both worry and hope. Putting on a professional demeanor, I asked, “Can you tell me more about why you’re here today?”
She explained, “We were in the Caribbean, on our second honeymoon a month ago–we’ve been married thirty years. My husband had been complaining about some pain in his thigh, so I rubbed some ointment–I have the bottle here if you want to see it–onto his leg. That’s when I felt a lump. It just didn’t feel right. I had to argue with him for days until he would see a doctor. The hotel doctor said it was a ‘pulled muscle’ and that it would get better in a few days.”
But the “pulled muscle” did not go away. It grew rapidly, expanding to the size of an orange by the time they returned home. They went to their family doctor, who referred them to an oncologist, who in turn referred them to a famous cancer institute. The institute recommended that they return home to discuss options with a local oncologist.
Even though I woke Mr. C at 6 am each morning during rounds, he always greeted me with a smile. I examined his leg, measuring the size of the tumor to see if it was responding to radiation and steroids, touching different areas of his leg to test his sensation, checking for muscle tone and strength. When I was done, he said, “Thank you. You have the healing touch.”
I couldn’t look him in the eye. Did he grasp that there was no chance of a cure? Surely his oncologist had advised him on his prognosis during their meetings. Did he understand that the treatments had severe side effects, such as nausea and vomiting, weakness, and confusion?
Mr. C wore a wooden cross around his neck. I asked, “Did someone make that for you?”
He replied, “My nephew.”
I noticed the Bible beside his bed: “Are you spiritual?”
“Well, I try to be.”
“Do you feel you have enough social support? Do you have people you can talk to about what you’re going through?”
“Oh, yes, my priest comes everyday. My family comes everyday, but I try not to worry them too much. My daughter is pregnant with her first child–my first grandchild–and I want her to take care of herself.”
Attempting to change the conversation to a happier subject, I said, “When is the baby due?”
“Six months from now. Do you think…do you think I’ll be able to see the birth of my grandson?” He leaned forward, anxious to hear my response.
How could I answer? To be completely honest, I would have told him, “No.” Yet he had faith that with aggressive multi-drug combination chemotherapy and radiation, he would survive in time for his grandson’s birth. Not wanting to tear that hope away from him, I responded, “Well, I’m not the expert. I think your oncologist could give you a better answer. But I do know that these things are hard to predict.”
Composed, I walked out of the hospital room. I believed that physicians should not cry in front of their patients. It was only when I locked myself in the bathroom that I began to sob, feeling powerless to help Mr. C in any way.
Every afternoon, I met with his wife and daughter. They continued to call me “doctor” even though I explained I was just a medical student. In private, they confided that their husband and father rarely complained, that it was likely he was in more pain than he showed. I would explain what pain medications we were giving him, and that we would increase the dose to manage his pain as necessary. I would explain how the steroids helped to improve his appetite and energy. I would explain how the radiation would hopefully kill the tumor cells, and help to shrink it. I would explain how the oncologist was planning to use different chemotherapy drugs to kill the metastasized. They clung to my words, as if words had healing power.
Weeks later, on my last day on the service, Mr. C was still in the hospital, waiting for a port placement for chemotherapy. At the end of my morning physical examination, I told him, “Today is my last day. I wanted to say goodbye and wish you the best.”
He replied, “Thank you so much for all your help. I don’t suppose I’ll ever see you again. I wanted to let you know that your kindness meant a lot.” A single tear flowed down his cheek. I could not hold my tears back. He reached for my hand, pressing it firmly.
Janet Shu is a second year medical resident at the Harvard Longwood Psychiatry Training Program. She graduated with honors from Brown University, where she did a Senior Capstone Project in Creative Writing with C. D. Wright. Other honors include winning 2nd place in the national DeBakey poetry contest, membership in the Boston Poetry Union, and acceptance in various publications. She is interested in all forms of writing including narrative medicine, but poetry is her first love. To order a chapbook of her poetry, please email Janet at firstname.lastname@example.org.