Friday, September 23, 2011

Our Relationship Was Difficult

Our relationship was difficult. I dare say strained at times.

I internally gasped as I listened to my own words as if they had come out of someone else's mouth. The walls closed in on the little office as the three men lingered by the door. They each appraised me differently. The oldest nodded his head in agreement while the middle stared at me blankly. The youngest twisted his mouth in a scornful grin.

There was no doubt about the elephant in the room. They wanted to know why their mother suffered six months before dying. Why the pain and weight loss could only be attributed to cancer in the last moments of life.

I had no clear explanations for why I, the oncologist, and the pulmonologist couldn't make a proper diagnosis. It mattered little that her emphysema was severe or that her heart was already failing. It calmed few nerves to assure that even if the cancer had been diagnosed she wouldn't have tolerated surgery or chemotherapy.

I can see the youngest squirm

But she said you were always rushing out of the room. That you never had time for her.

And she was right. She was the kind of patient who needed everything done in triplicate. She would pick apart each sentence. Forty five minutes later she would look up and accuse you of not explaining and want to start over again.

Most of her doctors had thrown their arms up in the air and given up. They abandoned her when the appointments began to prolapse into their other commitments.

Yes. At times your mother's needs were overwhelming and I'm sure she felt like I was rushing.

I wasn't going to hide the truth. I wasn't going sugar coat.

I handed over a copy of the medical records without being prompted. I urged them to take a close look. Talk it over with family and call me back with questions.

They slowly filed out of my office, the youngest clinging to the stack of papers.

I never saw or heard from them again.

I would love to end this blog post with something pithy or profound like my others. I would love to say that some greater truth evolved that brought peace to the family or made me a better physician.

But I would be telling a lie. The doctor patient relationship can be difficult and complicated. Each side comes to the table with inherent biases and personality disorders.

Sometimes it works and sometimes it doesn't.

It ain't always a bed of roses.

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