Earlier this week I was asked to see a patient in the preop holding area. His orthopedic surgeon was planning on taking him to the OR for a very extensive resection of his left femur. The anesthesiologist was nervous because he hadn't been cleared for surgery by anyone and he had some new EKG findings - won't bore you with the details. Long preamble short, they needed me to clear him.
The background story on this patient is that within the last month he was diagnosed with a chondrosarcoma (cartilage/bone tumor) in his left leg - hence the need for this resection. Just last week he was found to have ridiculous numbers of mets to his lungs. At the same time, they found out that he had multiple pulmonary emboli (blood clots in the lung) requiring high dose/long term blood thinners. Did I mention that he's a previous cancer survivor? Or that he happens to be one of the nicest men I've ever met in my life?
I went through the necessary steps to clear him for surgery and with each interaction grew more and more attached to him. Right before he went into surgery he thanked me for my "conscientious and compassionate care." He asked me if I was married and had a family of my own. When I told him that I wasn't married but did have someone special in my life, he told me to "tell him that he's a lucky man." And, of course, I did:)
He made it through surgery like a champ. His surgeon and I butted heads about what to do with his blood thinners - he wanted to decrease the dose significantly in an effort to minimize the postop bleeding risk and I was super hesitant to do so as it wouldn't be adequate treatment for his PEs. We finally agreed on full dose anti coagulation with a very short acting medication. We reasoned that if the undesirable happened, we'd turn it off and go from there.
Why is that those undesirable events always happen to the least deserving people?
Today we had a long, and very emotional, talk about our options. We came up with a less than ideal plan in an effort to save his leg. And we talked about his life and what he had left of it. As I was leaving the room he stopped me and asked, "How did your young man respond to me saying that he had himself a really good deal?" I assured him that it was well-received and he had adamantly agreed. With a simple, "Good" he closed his eyes and I left the room.
I won't ever forget this true gentleman and the dignity with which it is evident he has lived his life. Or the dignity with which he has started the process of leaving it.
3 comments:
My brother was diagnosed with stage 4 breast cancer in 1999, he was not expected to make 3 months.
He passed on to new life in 2008 still looking like the "biker bar bouncer" he once was, (non of that skinny "cancer look" for him).
In 2004, we had a season of what we like to call: a series of unfortunate events or the year of living dangerously. Every member of our small extended family ended up with some life threatening illness, each month someone new.
By Thanksgiving my church asked me to represent them at the ecumenical service, I accepted, and gave a Sermon on why I was thankful for my brother's breast cancer! Basically we developed strong support for everyone in the family, even though we all live thousands of miles apart.
Sorry for such a long blurb from someone you don't know . . . but thought you might like to hear "the rest of the story" in one case.
Thanks for sharing, Alice:)
Wow! Found your post on the "Next blog" link. I read it because I had biscuits for dinner, one of my favorite foods. After doing so, I see death arose as a subject. It was a big subject for me today. I work in a nursing home and we lost two today. One was expected, but one was not.
I don't have anything brilliant to say, but I found some balance in your post when I did not know I needed to. Thanks.
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