Goodbye, Mr. B

Today was a somewhat bad day. I mean, I've had quite a few bad days in my years on this planet. But, this one was up there in terms of pure badness.

It started as the usual. Not too busy. Rounds. Paperwork. Returning some calls. Waving to some of my chemo patients.

Mr. B. A wonderful man. A wonderful family. A "country boy", as his daughter calls him. Tough. Salt of the earth. Decent.

You name the cliche, he fits the bill. Truly a good guy.

But a smoker. Big time smoker. Did I mention how much I fucking hate smoking?

I met him a couple months ago... well, "met" isn't quite the description, since he was intubated and sedated. He had just been diagnosed with a new lung cancer. A huge tumor sitting right near his pulmonary artery, filling his right mainstem bronchus. He couldn't breathe. So, in went the plastic into his lungs.

Some scraping, roto-rootering, some lasering and a lot of antibiotics later, we had a diagnosis of squamous cell cancer and a lung that started to aerate.

I didn't expect him to make it. Didn't give it a thought.

Then I met his daughter, S. S is a special person. Young. Married. Pretty. But, there are so many people like that. Caring. Nice. Loving. Also commonplace.

But, there was something different. An innocence. Something in her face, a gentleness when she and her husband looked at me as I explained his condition. Something that made me want to give my right arm to do something for Mr. B.

Patients don't realize sometimes that we play favorites. I try to be objective. But, in the end, we (I) do favor some people. It's hard to know why. It's like falling in love. Who knows?

I fell in love with this family. With her look of hope, her tears, her husband's caring and tenderness.

My project.

Well, today, he died.

Sitting in a chemo chair, he started to cough blood, then vomit blood, then POUR out blood... in a span of 5 minutes, he "bled out". His tumor ate into the pulmonary artery that so tenuously sat near. With each heartbeat, jets of blood poured out into his lungs and then out of his mouth and onto the floor.

In the middle of the infusion room.

I've seen chaos. Many times.

This was one of the worst.

Between his daughter's sobbing, the other patients' horror and the look on his face as his life literally poured out of him... well, I don't know what to say except that it was horrible.

Horrible.

Is there justice in the world?

God?

I don't know sometimes.

I hate fucking smoking.

Dying is one thing.

Cancer is one thing.

But, this, in front of others, the fear in all of us. His daughter, S.

I'll never forget her crying if I live a hundred years.

And, in the midst of primal screaming, grief, pandemonium, the crashing of the paramedics, the blood everywhere... she had the decency to turn to us, to me and thank me for everything we did.... THANK US?!

All we did was watch him die.

I've never felt so helpless as a physician.

As I sit here, I am a bit numb, writing this. It is a bit unreal.

Goodbye, Mr. B. I'm so, so sorry. I'm sorry we failed you and your family. I'm sorry that this disease is so cruel and merciless and swift in its decisions.

I don't know if there is anything after this short life of ours... I wish sometimes. But, if there is, I hope you are there and I hope someday you and your daughter meet again.

I was honored to be your doctor.

Love, Dr. P