A Phone Call
- PDF / 142,599 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 80 Downloads / 201 Views
next inbox message read, “The patient wants the M ydoctor to go on the internet and find him a cure. Patient declines scheduling appointment at this time.” That was the note from the nurse coordinator, who had dutifully called Stan after his recent hospital stay for abdominal pain and a laparoscopic biopsy of an abdominal wall mass. The news wasn’t good—he had recurrent colon cancer, and it was metastatic. Stan understood the implications: palliative options, no cure, a terminal diagnosis. His typically dry sense of humor had turned a bit dark in his phone message. I scanned the nurse’s notes once more, then clicked complete. It was an FYI, after all. Our office routinely called patients after a hospitalization, documented any needs, encouraged a one-week follow-up. Stan had declined the visit; he wasn’t in pain, he had no medication or testing needs, and he had no questions for me, his PCP, that wouldn’t be answered by an oncology visit in a few weeks. Stan didn’t need me right now, and I didn’t feel I had much to offer him. We had given our support—well, the nurse had anyway. Stan’s chart disappeared from my inbox. Two weeks passed, including a spring break vacation. I came back to a full inbox. Stan’s name wasn’t there, but somehow his situation lingered in my mind. We had known each other for at least a decade now—consistent office visits, occasional sightings around town at the grocery store or a civic meeting (the joys and dangers of a small town). He had the typical platter of geriatric illnesses: a previous cancer and cure, diabetes in average control, mood disorder with modest control. At age 80, a visit with Stan was mostly a social encounter, some jokes, a philosophic question here and there. “How does one define depression, anyway? Are any of us happy? How would I know?” He had frequent attempts to turn the conversation to me, and at times he was entertaining, at times too personal, at times disarming. On retrospect, he was masterful at building up an emotional armor, and it was hard to penetrate. Of late I was feeling disconnected from my patient panel, providing solid care in the office but perhaps not going the extra step. I had vowed this year to stay a little more in touch with my patients—read with more attention that stack of consults and nursing home reports and PT notes; make a few more phone calls myself rather than leaving them for the
Received June 13, 2019 Accepted August 8, 2019
CMA; make a home visit here and there; randomly check in with a tenuous patient. I should call Stan. Cancer patient, terminal. He needs support. I picked up the phone. The phone call didn’t amount to much, a few minutes. He wasn’t quite sure why I had called. I explored what he knew about his cancer, what his options were, did he have any appointments, how was he handling things (“my wife’s having a hard time”). I offered support, though I am not sure I suggested an office visit. He vaguely mentioned the Death with Dignity Act, and wanting to find a doctor to help him pursue the Act. It wasn’t a brilliant convers
Data Loading...
