When to Be the Doctor, When to Be the Patient

This past week has been surreal for me. Cast for the first time in my life on the receiving end of bad news rather than the delivering end, it's opened my eyes again on the nature of the "doctor-patient" relationship and the boundaries, emotional and physical, of our knowledge and our profession.

Someone really special and dear to me learned this past week that her mother, a healthy, health-conscious, vivacious 64 year old woman with no medical problems had a potentially fatal disease: hepatocellular liver cancer. This is usually something that occurs in patients with known liver disease, hepatitis or cirrhosis.

Devastating. You know, as many times as I've given bad news, I've never sat with someone I knew and loved and received some bad news, or, for that matter, received my own bad news. I've seen the hollow devastated looks on patients' faces. Seeing it on my friend was something totally different.

When my friend, Elephant Number 5, died last year, it was different. She was in the "fighting" phase. I wasn't there for the diagnosis. She was already pushing forward, had battled the disease for years when I met her, and was resigned to this being the end of her life.

This is different. Shock. Flabbergasted. Compounded by the fact that my friend is ALSO an oncologist. A doc. She knows the score. She knows that this is probably fatal. I don't think I'll ever get the sound of her sobs and crying out of my head. I've always thought that things would be easier because I'm a doctor, but that's just a pile of crap.

What's more painful is watching someone you care about run around like crazy, just crushed and frantic, and you just don't know what to do. You just listen and cry and hold hands and listen more and buy food and listen. I've had to try to put away my "medical" hat and just be a friend. There are enough experts working on this case. We're trying not to be that stereotype of the doctor who is a nightmare patient or family member, just torching the medical staff with questions and second-guessing. But it's hard... sometimes, the medical staff sucks...

For months, my friend's mom had nausea. We kept telling her that maybe she needed a scan. Hell, we're oncologists. All we ever see is cancer. We kept wondering why a scan hadn't been performed. And now that it shows this, we just keep wondering and banging our heads and second-guessing everything.

I know that this is what we all go through in our lives as we face illness and death. It's scary. No amount of education or status or training takes that fear away. We all have this one precious life on earth and it is sacred. And it hurts. It really does.

I don't think I'll forget that the next time I talk to a patient. I'll look for that fear and hope in their eyes. Hopefully, they won't see it in mine also.