Parting is Such Sweet Sorrow
I had just popped out of an exam room, bursting with the fierce energy that radiates from mind and body when working in perfect harmony (also known as having a good day at the office) when I caught my nurse placing a chart quietly on my desk. She backed out of the room like gentle Rosencrantz and Guildenstern taking their leave from the evil Claudius. Not considering myself as particularly wicked, I wondered what gave rise to her timidity. I glanced down. The chart, which bore the name of a beloved patient of ours had the word “Expired” and today’s date written across the front.
Somewhere deep inside me I heard the sound of a tree falling. Its crash shook me as I stood there, leaving me more exposed to the fury of the skies. I placed the chart on the top of a pile of tan folders and went on to my next appointment.
Later that day I experienced a flashback: I recalled attending a dinner party during my fellowship given by a retired Tennessee family practictioner. He had enjoyed a long and prosperous career and fascinated the table that evening with tales of medicine “back in the day”, when he would deliver country babies at night by the light of his car’s headlamps since many families had no electricity. He told us that on the day of his retirement he received a citation from the town signed not only by his long-time patients but by his patient’s children and their children, all of whom had grown up under his gentle care. He had ministered to some folks for nearly fifty years.
Fifty years! What a contrast to the career of medical oncologists. Unlike family doctors who get to watch many of their healthy patients grow to be old and healthy, oncologists seem to be constantly running a crisis center. We scramble throughout the day putting out the fires of suffering, taking calls from emergency rooms holding more patients in search of relief, monitoring a dozen situations in our treatment rooms, always bracing for the next catastrophe. While we toil the silent killer inside our patients rages against the deadly molecules assaulting it. Both patient and cancer struggle to survive the assassin’s strike.
Then after a period of time, it is over. The day comes when most of our patients, to put it bluntly, really don’t need us anymore for they are either in remission or dead. Even those incurable cancers that we are trying to turn into a chronic, livable disease, that require months and months of intense care, will someday take the lives of our patients. Even those who have been cured of their disease and must be followed for long-term complications will eventually return to their primary care physicians, reveling in the thought that they are finally free from our scrutiny.
Can we blame them? Wouldn’t we be thrilled to forget our anniversary date of being diagnosed with cancer, it had been so long in the past? I’m sure many patients when asked who their oncologist was would love to reply with a smile “You know, I can’t remember his name.” Rather than complain, oncologists should consider this their highest honor.
Please forgive us though if we stand at the window of our office and watch new mothers carrying in their babies, or elderly couples helping each other down the entrance ramp, and sigh with the thought of that day when we will no longer be needed. Don’t think that we are discouraged - if nothing else, oncologists understand the nature of our profession. We realize that after decades of service, the only citation coming to us is the one that hangs in our memory and in the memories of all those lives we tried to help during a time of anguish. Why does this please us? Because we know that if we remain true to our calling only two words need be written on this commendation:
“Well done.”
