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.