Thursday, January 7, 2016

Goodbyes

Mike is a great guy. Doing remarkably well even into his late 80's. He's had epilepsy since childhood, which is controlled very well with medications. I've been seeing him since he moved here 15 years ago. He comes in once a year for me to refill his medication. Because he's so stable it's really more of a social visit. We talk about families, baseball, and (his favorite topic) horse racing.

He came in for his annual visit yesterday, and looked awful. He's been diagnosed with metastatic esophageal cancer, way too extensive to operate, so he's just getting palliative treatment.

There was really nothing, from a neurological view, for me to do. We talked about the usual things, especially his excitement at 2015 having brought the first Triple-Crown winner since 1978. I refilled his medication and sent him out with a handshake, like I always do.
I know I won't see him again. He probably does, too. On the "next appointment" line I just scribbled "will call" because it seemed cruel to write the usual "1 year."

Even the easy patients aren't always easy. It's part of the job, but that doesn't mean I like it.

16 comments:

Moose said...

I'm sorry, Doctor G.

Esophageal cancer is one of the two cancers that runs in my family - that from one side, and ovarian cancer on the other. My sister suggested that with our genes we might as well take up smoking, too, and go for the trifecta. (No, we haven't.)

Anonymous said...

I'm at the point in my career-13 yeares at the same practice-where all the puppies I saw fresh out of school are dying of old age. It's not the same as people, but man is it depressing.

Kelley said...

So sorry to hear this, Dr. G. It's nice to know Mike had a doctor such as yourself caring for him for the past 15 years. I'm only 29, but have yet to find a freakin' GP/PA that's kind, caring, and non-judgmental -- traits I know you possess simply by being a longtime reader/first-time commenter on your blog.

Anonymous said...

I'm sorry. I'm glad you have been his doctor all these years.

I have to tell you, though. Your kindness means a lot to him.

A few years ago, when my father was dying of long-term use of methotrexate to make his rheumatoid arthritis endurable. Or, maybe it was the long-term effects of rheumatoid arthritis that caused the pulmonary fibrosis, and the methotrexate had allowed him to lead a full life-- spelunking, hiking, enjoying life visiting with his many relatives--grandchildren dear wife, the precipitous deterioration in the disease provided a measurable estimate of the rest of his lifespan, and so we all took our turn to see him for a time in his last few months.

He still had high hopes of the airline allowing his oxygen on board for a trip to Arizona to visit his newly married nephew, for whom he'd stepped into caring as a son, after the long-term battle with lymphoma by his younger brother.

Over the years, he'd had a callouses/plantar wart built up on the bottom of his right foot and periodically went to the podiatrist to care for it. I was able to witness the kindness of this gentle person who examined and treated his feet for years, who'd heard where the feet of a South Dakota farm boy had taken him, and knew quite well what was going on in this final visit he'd made the year before.

macHerb said...

I appreciate your sensitivity in this situation. You aren't really a grouch, are you? Just on your BLOG sometimes. Keep it real.

Anonymous said...

I'm so sorry to hear your sad news, Dr. Grumpy.
--Queen Anne's Lace

Packer said...

Yup , sometimes these people become your friends. My friend used to come in just to talk, I miss him greatly.

Anonymous said...

I lost my Dad at age 87 to cancer. What got me through it was the understanding that it was the natural conclusion to a long life well lived. ((hugs))

bobbie said...

Bless your heart for taking the time to talk with the gentleman; you gave him the precious gift of "normal" ~

If I may be so bold ~ here is a hug for you {{{{Dr.G}}}}

Ms. Donna said...

Sorry. As somebody mentioned, you are not such a grouch. The grouch is there to keep from getting hurt.

Don said...

Bless you Grumpy for your compassion. He knew it was probably his last visit with you too. He might have appreciated the kindness of the "will call" statement. It expresses an optimism that there will be a next time.

jen said...

I'm sorry about Mike but I'm happy to hear you treating him like a person instead of a medical record number as I have experienced before.

Anonymous said...

Any patient be it man or mans best friend is hard to see pass. The heart hurts either way.

Thank you both for your compassion.

Mage said...

Thanks for being you.

Shash said...

I know my mother, though she kept up a front of false optimism herself, hated it when doctors did that to her. In fact, she switched oncologists because of it. I'm sure Mike did appreciate your not writing "1 yr."

Hugs to you Doc. Don't forget Mike ever because there are other patients out there like him that you are and will be friends with.

Zed said...

That really is so sad

 
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