During my life I've had many challenging experiences that have tested my ability to stay calm and focused. Usually I've been able to meet these challenges without letting them affect my mind.
Until this month.
I'm getting done with my Solid Tumor Oncology rotation, and emotionally this month has been the hardest thing I've ever gone through. There were multiple times throughout the month when I would come home on a non-call day and find myself unable to fall asleep. I couldn't sleep because I would have to log into our medical records system from home and check in on a patient I was taking care of. I would look at their vitals and make sure the orders were correct for the next day. It was eating away at my soul, because I was investing myself in my patients, and when they had a setback I would feel that pain. The patients the people I took care of on this service were some of the most grateful and friendly people I've seen all year.
There was one specific moment that embodies my experience this month.
I was treating a middle aged gentleman with one of the most colorful personalities I've ever seen in a patient. He presented for a second opinion on an advanced pancreatic cancer. He stayed with me for quite some time, and throughout the time he stayed I would go in to pre-round on him. We would speak about things like his favorite college football team, for which he's had season tickets for years, and watching his daughters grow up.
He was one of those patients who had multiple setbacks. Each time I would be disappointed in myself, wishing there was something I could have done differently. He was a difficult patient medically but one of the most jovial I've ever met.
As we got to the point where we couldn't improve his status significantly, he and his family decided that it was really important for him to get back home. The day of his discharge I prepared all the paperwork so he could show the recommended chemotherapy regimen to his local oncologist.
As I was talking to him about all of this, he stopped me in the middle of a sentence and asked, "What do you want to go into after you finish residency?" I looked at him and said, frankly, "Not oncology." He smiled and said "Yeah, I don't think you have what it takes."
At first, I was kind of taken aback. I wasn't sure what he meant. Was he unhappy with the care I provided? He noticed the puzzled look on my face, put his hand on my arm and said, "You have to have a rock-solid heart to send someone home knowing that they're going to die. You put too much of yourself into work, but that's what makes me like you."
Ever since then, those words have reverberated in my mind as I leave the hospital. Hearing them made me realize that I could never do oncology and that — even if I tried to — I could never bridge a fundamental difference between myself and my colleagues in the specialty.
Four days later, I received an email from his daughter. She told me the unfortunate news. It happened so quickly, but he got to go home and was surrounded by the people he loved. He won't get to walk his daughters down the aisle on their wedding day. He won't watch his favorite football team play one more game. He didn't make it. But his personality will forever live in my memory.