He came to me for back pain, which sounded like fairly benign stuff. But when he worsened dramatically after 2 sessions of physical therapy, it was time to look further.
Unfortunately, the MRI showed a malignant tumor, leading to a bigger work-up. It was quickly obvious that he had widespread metastatic disease.
We put him in the hospital, and he went through chemotherapy, radiation, and back surgery. Fortunately his disease responded to treatment and he got better. His back pain improved and his leg strength returned. My job was done, now it was up to the oncologist. I signed off his case, wished him good luck, and told him to call me if any new neurological issues came up.
Time went by. His oncologist kept sending me copies of her notes, so I peripherally kept up to date. I'd scan them to see how he was doing, make sure there weren't any neurological issues I needed to deal with, and put them in his chart.
This went on for 2 years, when his notes showed he'd taken a turn for the worse. He had more difficulty breathing, and they found the cancer was back. Further chemotherapy and radiation weren't as effective, and he kept going downhill. I watched, sadly, as his weight and health declined in the increasingly frequent notes from the oncologist.
Then, yesterday, toward the end of the day, Mary handed me a piece of paper. He'd called, looking to speak to me, and asked that I call him at home. He said it wasn't urgent, so I stuffed it in my pocket and wrapped up the day. There were kids to pick up, homework to supervise, tomatoes to buy.
After dinner, when the evening had settled down into the usual quiet chaos, I went to my desk, brought his chart up on my laptop, and called.
Dr. Grumpy: "Hi, it's Ibee Grumpy. You were looking for me?"
Dr. Good: "Hey, thank you for calling me back. Haven't talked to you for a while. Have you been following my notes from Dr. Onco?"
Dr. Grumpy: "Yes."
Dr. Good: "Good, so you know what's going on. She's a damn good doctor, glad you sent me to her."
Dr. Grumpy: "Yes, how are you..."
Dr. Good: "Look, Ibee, I'll get to the point here. I've had enough of this shit, and it's time. I've decided to stop treatment, and signed up with hospice today."
Dr. Grumpy: "I'm sorry..."
Dr. Good: "Let me finish. Anyway, I know I haven't needed you since this all started, but I just wanted to call and say thank you for everything. I know you and everyone else did your best, and by catching it when you did you guys bought me an extra 2 years I wouldn't have had. You're a good doc, and I know you care. I think of all the patients that I saw, and I hope they feel the same way about me."
Dr. Grumpy: "Thank you, I..."
Dr. Good: "That's all. Thank you for everything, and good luck. Maybe we'll meet again out there."
He hung up.
He called to say "thank you."
I stared at the phone for a long time.
26 comments:
Situations like this reminds us why we do what we do, I think. I'm a horse veterinarian and this reminds me of a case a few months ago...I had to euthanize a little girl's horse after diagnosing a very bad colic that was to far gone for surgery-- the little girl hugged me and thanked me for trying to help anyway. Tore me to pieces, and still does, but when I have a bad day with crappy clients, I think about her.
What a wonderful story. I often think that when my time comes (and if I know about it in advance, of course) I want to do the same thing and include favorite authors and musicians who added so much to my life experience. I might as well thank you now for all the enjoyment your blog has given me. Yikes...now I got superstitious. Hope this early goodbye doesn't mean anything.
This is why we do what we do.
No, not to get the phone call.
But, to do right by people and give them the best care possible.
Not every patient will realize it, but know that when one person thanks you there are likely many others out there who feel similarly.
And that's what keeps us going.
Wow.
When my partner nearly died a couple of years ago, we made a point of thanking everyone, and when we moved out of the area, we came back and visited her oncologist (near the end of the day, when he's wrapping up, so we didn't disturb him too much). He nearly cried when she walked in, since the last time he'd sen her she was still bed bound and weak, bald, and barely functioning. We were so glad to be able to do it.
Wow Ibee,
I teared up reading your story. You need to have a warning posted on that one.
Dr. Good, what a great name for him.
I just called to say I love you.
What a wonderful man. I'm sure he was a wonderful doctor too.
There's that compassion you talked about last week. Even when you feel like you're losing it, it still shows and people feel it.
Tears here ~
That is what it's all about ~
This is what ought to be engraved on medical school diplomas.
What a wonderful vignette. It speaks volumes about two people.
Damn it's dusty in here...
And just like that you suddenly are energized to slog your way through 10 more insurance prior auth requests, 3 seriously tardy (and noncompliant) patients, and an unreasonably rude family member...all because somewhere down the road is the next patient who really needs you (and who is grateful that you go to work each day.)
In a sad but bittersweet way, your conversation with Dr. Good, reminds me of the beginning of the Hitch Hiker's Guide to the Galaxy...Impending morality and all that goes with it...
"So long, And thanks for all the fish"
https://www.youtube.com/watch?v=ojydNb3Lrrs
Thanks for sharing Dr. Grumpy. This story is the perfect counterpoint to your August 27th piece and the very reason you still hang out your shingle every morning.
And he probably kept it short so you both didn't start bawling your eyes out.
Even in the most depressing times there's often a ray of sunshine peeking through.
We have no idea sometimes what an appreciative word can do. In 2006 my appendix ruptured. The Radiologist that read the CT mentioned that something did not look right with my ovaries. I told the ED surgeon that I had an appointment with my OB/Gyn in 6 or 8 months, I'd bring it up at my next appointment. The Rad rang my room. She told me not to wait 6 months, or 6 weeks or even 6 days, to call my Gyn doc now and get it looked at. I did --had ovarian cancer. Was found early enough to make a difference and after total hysterectomy and chemo I'm one of the rare ovarian cancer survivers. I got a job working for the rad that made that call. When I told her our history she teared up and gave me a hug. She said as a radiologist they don't get to follow patients out side of the hospital and rarely find out how their diagnoses turned out and she was so happy I told her what a difference she made. I am so grateful that she bothered to make that call because frankly, I felt no urgency to call and often skipped an anual Gyn appt. If I had waited. . . . Thank you is not enough Dr. H.
and now I'm crying over breakfast.
Beautiful.
balm to soothe the wound from the serpent's tooth.....
this is one of the two blogs i read every morning. curiously, the other blog has a very similar post today. both posted on 9/11, but referencing it.
thank you for writing and sharing this piece, Dr. Grumpy.
There's the bad, and ugly, and then there's the good ... . Thanks, for sharing, Dr. G.
Enjoy the thank you. I just started my 26th year of teaching and in 26 years I've had exactly three parents that have bothered to write a note or call and thank me for what I did for their children. Good thing I'm a teacher for the big money.
You gave him 2 years! Thank you for the love you give!
I'm a family doc going on 26 years now. One Sunday morning I got a call from a mom who's diabetic 6 year old son I'd picked up on a volvulus early, leading to life-saving bowel resection and later, liver transplant. He had just died at age 10, and she was calling to thank me for 4 extra years with Ryan.. I don't remember how long I sat on my laundry room floor after that call, but I didn't make it to church that day. This job can be awful and awe-inspiring at the same time. Thanks for sharing!
I am a pharmacist
Years ago I did not fill a rx for a patient as I thought the dose was far too much for her( morphine)
The md called me to thank me for not filling as did the patient
Years later we accidentally gave her mother ( who had a common name) the rx bag for another women with the same name
The daughter who I probably saved fro dying reported this to every dept , paper , linkined in Facebook etc
Cheers
Canada
What an honour! And you bear it with humility and grace.
You're a good egg Dr. Grumpy! :-)
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