She has an extremely rare form of cancer. It is called adrenocorticalcarcinoma and is a cancer of the adrenal gland. Within a span of two weeks her cancer had grown from 9cm in size to 20cm. She underwent surgical resection which was essentially a complete resection. However, within two months cancer had spread to her liver, spleen and lungs. I had initially seen her right after the diagnosis, in preparation for surgery. Post-surgically I was involved in her care for treatment with a drug called Mitotane that is generally managed by endocrinologists. She has failed this treatment. Experimental study that she participated in another center also did nothing to halt her disease process. Now she is participating in a combination chemotherapy with quite toxic medications that will be managed by oncologists.
I saw her two days back in my clinic. She was not crying, she was not disheveled, she did not appear desperate, she did not appear depressed, she did not appear hopeless.. She smiled as always and was extremely polite and pleasant. I learned, her father passed away the day before yesterday. She was planning to go to funeral the next day. I wanted some blood tests which had to be done in the morning. She told me she will do this in the morning before going to her father's funeral. Depending on this blood test I was planning to make a decision about one hormonal medication, which could be stopped if her cancer was producing it in excess. After that, there was no point for her to see me, and undergo all the trouble one has to take to see a doctor, since there was nothing more to offer her from my specialty.
Today, I got the results. She does not need the hormonal medication; cancer is producing it in excess already. I called to let her know about this.
She is dying, in a few weeks to months. This is an unusually aggressive cancer for which there is no effective treatment available. The measures used are desperate ones but without any consistent benefits. Death is fairly rapid. At the end of the conversation I found myself scrambling. This is a goodbye, at it's true meaning. This is most likely my last conversation with her. What do I say? Goodbye? It sounds like a mockery to her plight. A mere word authenticating her doom. Consolidating inevitability, as if one has that authority. Does one say, good luck? As if the fate had not been clear enough to remind her of the injustice. Does one say, I hope you feel better? When, in fact, she has arrived at your clinic the day after her father's death, aware of her own diagnosis of terminal cancer, smiling and cheerful, conscious not to be pitied upon. What word will actually say bye, and a good bye?
I saw her two days back in my clinic. She was not crying, she was not disheveled, she did not appear desperate, she did not appear depressed, she did not appear hopeless.. She smiled as always and was extremely polite and pleasant. I learned, her father passed away the day before yesterday. She was planning to go to funeral the next day. I wanted some blood tests which had to be done in the morning. She told me she will do this in the morning before going to her father's funeral. Depending on this blood test I was planning to make a decision about one hormonal medication, which could be stopped if her cancer was producing it in excess. After that, there was no point for her to see me, and undergo all the trouble one has to take to see a doctor, since there was nothing more to offer her from my specialty.
Today, I got the results. She does not need the hormonal medication; cancer is producing it in excess already. I called to let her know about this.
She is dying, in a few weeks to months. This is an unusually aggressive cancer for which there is no effective treatment available. The measures used are desperate ones but without any consistent benefits. Death is fairly rapid. At the end of the conversation I found myself scrambling. This is a goodbye, at it's true meaning. This is most likely my last conversation with her. What do I say? Goodbye? It sounds like a mockery to her plight. A mere word authenticating her doom. Consolidating inevitability, as if one has that authority. Does one say, good luck? As if the fate had not been clear enough to remind her of the injustice. Does one say, I hope you feel better? When, in fact, she has arrived at your clinic the day after her father's death, aware of her own diagnosis of terminal cancer, smiling and cheerful, conscious not to be pitied upon. What word will actually say bye, and a good bye?
A powerful tale of true story, sir i truly had a sensational read. all of ur posts are equally smooth and sensitive.
ReplyDeleteThanks Neeti. I am glad you enjoyed reading them.
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