All in Green Went My Love Riding
All in green went my love riding
on a great horse of gold
into the silver dawn.
four lean hounds crouched low and smiling
my heart fell dead before.
This spring two of my favorite patients have been simultaneously forced to take intense chemotherapy treatments, replete with side effects ranging from the mildly annoying to the deadly, in an attempt to save their lives. They did nothing to deserve the cancers now fiendishly shaking the hourglass representing their time left alive. Their diseases were not caused by any specific demerit in the scorecard of life - smoking, drinking, lack of exercise, poor diet, periodic irritability and/or unpleasantness [if that is a risk factor for cancer it’s a miracle the blog host is still alive -Ed.]. For whatever reason they just got cancer, and now have come to me, the medical oncologist, for relief. They want to live, therefore they have asked me to kill the tumors within them.
This scenario is not unheard of in the world of cancer treatment. In fact, it is an everyday occurance - mundane, and of little general interest to the intelligent (not to mention good-looking) readers of this small planet in the galaxy called Health Care Blogs. So why do I mention it?
The reason why I squeeze these meager observations from the recesses of my mind is because I simply cannot believe what has happened to my two patients. The chemotherapy I carefully designed and delivered to them both has failed. Unless a salvage treatment is successful in destroying the cancer, all is lost. This is brutal. Even condemned prisoners get to live for years on death row until a final judgement is cast but my patients will never see the next New Year’s Eve unless something miraculous happens. What kind of modern medicine is this when state-of-the-art treatments don’t work when by all rights they should? They say we’re making progress against cancer but every time a patient with it dies I feel the nighttime stars dim, and sense a gray wind clutching the tops of trees and houses until they collapse.
Perhaps in a thousand years there will be a brief lecture given to second-year medical students about the Dark Ages of medicine, back when what used to be called the Internet was in its infancy, and scientists had still not completely deciphered the human genome, and cancer was still allowed to grow into a visible, palpable tumor before even being diagnosed, and the parents of sweet, bubbly infants had no idea what diseases their babies were destined for, and patients were allowed to desecrate their bodies with tobacco and a bizarre diet consisting of fat and refined sugar with little feedback on the consequences.
Wouldn’t today’s doctors like to sit in on that lecture, and chortle with satisfaction? I certainly cannot say whether I will be aware of the advances in medicine that are destined to occur hundreds of years from now - that is one of the limitations of being a mortal. It would be nice, however, to witness the eradication of one or two heinous cancers before my name appears on a granite marquee.
When things don’t go as expected for my patients I often feel like a car mechanic who, when asked to fix the brakes on a stalwart vehicle, does so with enthusiasm only to find out later that the repair job failed and the car went careening off a cliff, with all lives lost.
There is no better motivation to keep searching for the cure, than to see patients with potentially curable cancers wither “like an untimely frost / Upon the sweetest flower of all the field.” Let every child whose path in life leads to a career in cancer research be blessed with brilliance, diligence and divine insight.
I’m sure your job is difficult enough when a patient arrives in your office with a cancer for which your expectation of cure is very limited. I know it’s challenging when we have to admit babies to the NICU who are too immature to have much chance at survival or who have lethal birth defects. One learns to deal with that and to help the families through it.
If I understand you here, these patients should have had brighter prospects. We occasionally have babies we think should surive, and who perhaps have been with us for weeks or months, who develop some unexpected complication. It’s devastating when our interventions don’t succeed.
Perhaps the second line treatments will work. I certainly hope so.
Comment by Judy — May 23, 2005 @ 5:34 pm
Good things happen to bad people.
Only the good die young.
The only required risk factor is not to be a scumbag.
Comment by DrTony — May 23, 2005 @ 8:32 pm
a very cogent post, and i’d like to be sitting in on that lecture one day as well.
Comment by charles — May 24, 2005 @ 5:43 pm
I’m sorry.
Comment by Abby — May 25, 2005 @ 5:23 am
I had a comment. But Abby said it best.
Our cheeful oncologist (teams actually) has had success with our 15 year old son after a long haul of starts and detours. It’s worth it. But, I too, am sorry.
Comment by James — May 25, 2005 @ 3:45 pm
As one who is battling ovarian cancer with not a lot of success, even though diagnosed at stage 2C, I am thankful for those who have made their careers in helping us.
I’m 46, mother of 2 still in school, and all I can say is, Cancer Sucks!
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