Firsts

We mark our lives with milestones, tattoos of events on days that would otherwise slip into oblivion.

Today, I told my patient that he was going to die.

My resident told me that I did a great job. Professional and compassionate. I remembered my training, spoke in matter of fact terms, simplistic, realistic. No false hopes. Chemotherapy was an option, but only to provide comfort. The cancer that now riddled his insides could not be cured and he needed to discuss with his family what his end of life goals were. We would make him comfortable. I don't know how long it will be, how long he had. We have to wait for answers, for the biopsy results. The death word didn't pass between us; as much as I wanted to convey exactly what was going on, I couldn't bring myself to say it. He understood anyway. He took the news as his family had the day before when I first broached the subject. Stoic. Shocked. Asked the appropriate questions. Until I paused and said. "I'm sorry."

The sobs started then, and he clung to the hand of his relative beside him. In the stark hospital room, I could only stand there, touching his knee, without any kind of reassurance that it would be alright. He had fought cancer twice before and conquered... he had come to the hospital with the dreading thought that it had come back, but confident that it could be overcome, just like it had in the past. I dashed all of those hopes in a ten minute conversation. Ten minutes and I changed his life, put a stamp of expiration on his outlook on the future.

Ten minutes. I delivered the news and dashed off, another patient to see, another page to answer, another note to write.