Tuesday, February 05, 2008

"The chemotherapy hasn't helped yet, but I can beat this."

In yet another assignment to hone my interviewing skills, I found myself on a hospital ward this week asking a charming patient about her medical conditions. Though it wasn't what had brought her to the hospital this time around, I soon found out this fairly young lady was battling pancreatic cancer, and could no longer work due to the severity of her condition.

"I come in twice a week for my chemotherapy. It hasn't really helped yet, but I don't think I've been on it long enough for it to start curing the tumor," she said, fidgeting with the Natural Cures for Cancer book on her lap. "I'm pretty optimistic that I can beat this."

I was inspired by the patient's courage. Given her dismal condition, it was nice to see there was a ray of hope promised by the treatment.

Before I presented the patient's story to my preceptor, I obtained some collateral information from the chart as I had been asked. From what I read there, however, any ray of my hope in my mind quickly dimmed.

I'd had a feeling during the interview that something wasn't quite right. While I'm not a doctor yet, let alone an oncologist, I do know that pancreatic cancer is pretty serious. But, I had taken her on her word that there was an encouraging outlook. Perhaps her type of pancreatic cancer responds well to chemo, I thought.

What I found in her chart confirmed my initial suspicions:

"Patient has Stage IV advanced pancreatic adenocarcinoma, receiving palliative chemotherapy."

Though palliative chemotherapy can help with the pain and other symptoms of cancer, it's not provided with the intention of "curing the tumor."

Maybe nobody ever fully explained to her the role of palliative chemotherapy. Worse yet - heaven forbid - maybe she hadn't even been told that her therapy was palliative.

But the situation probably wasn't either of those. Because right after that, the physician had written,

"Patient is in denial with regards to her condition, despite numerous discussions regarding prognosis."

When I discussed the case with the doctor, he explained it to me another way. "Barring a miracle, the flowers in her room will last longer than she will."

I still wonder if I should've gone back to her room to say goodbye.


anna bee said...

My mom has been battling cancer for 5 years now and it has finally reached the palliative stage. We've seen scores of doctors, nurses, students, residents, techs, etc. She always remember the ones that notice her as a person and loves it when they come to say goodbye or even wave from the hallway. Granted, she's not in denial and maybe the situations don't correlate, but I know it always makes an impact on her.

Anonymous said...

Thats so sad.
seems denial was a coping mechanism for her.. kubler-ross's old five stage model.. seems very artificial to stick a patient into a ready made catgory though..

jysika said...

That's really sad! And she's young too!

It must be hard for her family too. Her having hope when there is none.