When I came home from a day of work at the general practitioner's office I was talking to my boyfriend on the phone when a thought dawned on me...I was recounting the trials and tribulations of my long day on the job and I jokingly said, "If Hollywood runs out of movie ideas, they should just hang out at a doctor's office for a few days!"
It has now been 6 weeks that I have spent on my Family Medicine rotation - which has really been a mix of Family Med, Internal Medicine and Vascular medicine...
But in the time I have spent doing this, I have experienced many interesting, sad, and thought-provoking cases!
Today was no exception...the theme in the office today was Tears and Sad Stories. Perhaps it was the blistery cold weather today, we could hear the wind rumbling outside and we watched as intermittent snow flakes sprinkled down, or perhaps its the fact that the sun now sets around 4:30pm. In any case, I encountered much sadness today.
We have a middle-aged patient who is in remission from breast cancer. She sadly told us of how her sister had died of pancreatic cancer over the weekend. Unfortunately, our patient had not even seen her sister for almost an entire year and the sister's daughter had kept her away while the sister began actively dying. This woman never had the chance to see her sister and say goodbye before she died. The emotional anguish she felt was palpable. She told us how she felt like she had not done the right thing! She wished she had seen her sister one last time! I told her that it was out of her control, but I sense that this lack of closure will plague her for quite some time. The doctor and I both said goodbye to here on the way out and gave her hugs. The hug we exchanged was a couple seconds longer than a casual goodbye hug. I felt her desire to be comforted in that moment and I think that physical expression was the best I could offer her. She began crying after this, and felt worried it would never get any easier and my realistic reponse was, to agree with her, that these things are always painful and lingering. Pancreatic caner, what a horrific disease with which to be diagnosed-a death sentence.
Now picture another middle-aged white woman. I walk into the exam room and see this black haired, Italian-looking woman probably in her 50s. Although she is in a motorized wheelchair, she has a sparkle in her eyes and a pleasant smile. Looking at her, I can nearly picture her driving around in a minivan, dropping the kids off at soccer practice, picking up groceries for the family...however over the course of the interaction I realize that this woman barely moves an inch the entire time. Her speech is very slurred, it almost sounded like the type of speech impediment that one might here in a personal with mental retardation but clearly this is not the case. She has her teenage daughter with her, who is sending text messages in the corner like a fiend. I find out later that this patient is suffering from advanced ALS. This disease is ranked up there with pancreatic cancer as one of the most dreaded diagnoses in my eyes.
The next tears shed in the office are from a mid-60s white female. My first impression of her on conversation was that she was just a bit elderly acting...I later began to realize that something was cognitively not right with her. It began with her tangential speech...she went from talking about her medical symptoms to telling me that her sister got a new "kitty cat" without any transition. Then out of no where, she started crying saying how she missed her parents so much since they had died. I got the impression it must have happened recently but she told me that it had been 4 years since it happened. She also told me that lived in a group home, the ARC (Association for Retarded Citizens) so then some of the other things I noticed began to make sense. She was very sweet and somewhat childlike in her personality.
The final story is a man who came in for a general visit, but told us how his teenage son had been set on fire this summer...apparently he and his friends were drinking and/or doing drugs one night and being typical teenage boys with no judgment, somehow a dare of sorts is proposed and the one boy is wet down in WD40 or gasoline and is lite on fire. He ends up having burns over almost 20% of his body and now the family has had to sue, the kid's social life is in an upheaval...crazy store!
So today had the potential to be an emotionally draining day but actually was not any more so than other days...perhaps I am growing a thick skin of sorts...not becoming hard, but just finding a way to cope? I suppose that would be a good thing!
