“Mom’s real tired, she don’t want to eat, and she’s lost some weight”.
how much weight?
“About 45 pounds”.
“Over about the last 4 months, and she’s always been skinny. She says sometimes she don’t want to eat ’cause her stomach hurts.”
I know it’s cancer, I assume they don’t know, and I wonder how they’ll take it. The patient is beyond caring, a thin late-middle aged woman who’s only here because she was too weak to enforce her stubborn will on her daughters.
I order the tests. Chest Xray is unremarkable, labs show some anemia. The abdominal CT looks like a grave to me: a liver riddled with dark spots that can only mean one thing.
We need to talk about your mom’s tests. There’s no good way to say this: your mom has cancer, it’s pretty advanced, and I don’t think she has much time left.
“We figured that was it, but she wouldn’t come in to see no doctor”.
They knew, but had to know, and I understand that desire to have an answer, to be able to predict the future because the now is explained.
I think about this sometimes. Many people bring me their problems: some I can help, many I cannot, and occasionally I give terrible news. Life and medicine can be very painful, on both sides of the gown.
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