Had an odd patent encounter yesterday.
I had seen this patient ( Mr C) over the last week at the hospital while on call. It had been a prolonged course due to his several medical problems of pneumonia, lung disease, and kidney failure. I had assisted in stabilizing his cardiac conditions and the intention was to follow up as an outpatient. I had signed off the case as he was to be discharged within a day or so. His daughter called me the day after discharge informing about his breathing being suddenly labored and his heart rate had increased. We arranged a telephone visit, as is vogue in this new era of healthcare.
We called him up at home and his daughter came on the line. They both went on to the speaker phone together and we began our encounter.
Me: How you feeling sir ?
Mr C: Ok, as good as I can hope for, I guess
Me: Your daughter mentioned your heart rate was up and you are more short of breath. Did you get the prescription I called in for you yesterday?
Mr C: Yes it helped thanks
( we discussed more medical stuff for a few minutes)
Me: so when am I seeing you again?
Mr C: I dont think we will
Mr C: I am going to hospice
Me: wait what? Why?
Mr C: They diagnosed me with metastatic cancer of the prostate. It has spread to the brain, liver, bone.
ME: ( shit I thought I dont recall this when I saw him last week) But I just saw you a few days ago, when did this happen:?
Mr C: The doctors found it the day before my discharge. Nothing they could do at this stage
Me ( shocked) How long did they say you have?
Daughter: They are putting him in hospice for the next few months
Mr C: I think I have a few weeks
Me: (silence…. what do I say, what do I do to give him comfort… my mind races)
Mr C: Doc, its been a good run. I am 84, I have had a good life. Thank you for all you have done for me. The care. The time you have spent with me. The funny conversations
Me: ( feeling ashamed that he is doing my job and comforting me instead)
Mr C: Guess I am not setting up a follow up visit huh? ( he said with a chuckle probably sensing my awkwardness and uncertainty of the moment )
Me: I am sorry to hear of this news. And you are right, you have had a good life. Is there anything I can do to help ?
Mr C: No. You did all that you could. The rest is up to me.
ME ( gulp) Listen I will refill the cardiac meds for the next 6 months, hope you make it at least that long, lets be optimistic( I laughed nervously, trying to do my doctoring of giving hope)
Mr C ( he laughed, a short belly laugh) Yeah right !
Me: I wish you well my friend, blessings to you on your path. See you on the other side
Mr C: Indeed doc. Thanks again. I appreciate you.
We hung up the phone. The sterility of a non face to face encounter dissipated. I sat in silence for the next several minutes, in some disbelief, and shock at the suddenness of the encounter, his diagnosis and his soon unexpected demise. I thought of my own mortality.
I looked out the window at the bare trees. I could die today or tomorrow or the next day. I do not know when. What could end my life? Disease, an accident, old age, a meteor?…. who really knows.
There is so much uncertainty in the world at the moment given all the global events, which simply reflects the same flux in life as well. It is wise to take each day’s experience to its fullest, without judgment or hesitation.
To explore the magic of each moment with each person we encounter is perhaps the essence of life itself. It is the best thing we can do, as tomorrow is not certain.
So my doctor prescription:
Go enjoy life each day. Give your loved ones hugs
Dispense # 90
I love you