Nov 6, 2008
The only thing that’s going through my mind is “oh my god, he’s 19.” He got a brain tumour, and he’s only 19. The surgeon’s talking about excision and radiotherapy, and I’m trying to compose my facial expression into something less shocked.
The whole family’s there -– mum, dad and son. Their reactions are heart-breakingly middle-class. Sat in the middle, as though being protected, the boy writes down key words “glioblastoma” and “high-grade” deliberately on a small pad of paper. No doubt there’s going to be a lot of wikipedia searching later, trying to make sense of the crashing into their lives. The dad’s pretty steely but he’s no fool; he places his arm around his son’s shoulders. The mum’s the only one shedding tears actually, and she’s restrained about it.
I don’t think the news came as a shock to them. And they all know what the answer’s going to be when the son asks, “I’m training to be a pilot; can I still fly?” No. That’s what he writes down in response. Meticulously, he writes that damning word down.
He acts as though it’s no big deal, like he’s just been told he can’t eat broccoli again. He doesn’t even seem to hear when the surgeon tells him he might still be allowed to drive. A career over before it starts. A life over before it starts. That’s what I saw today. And that’s what got to me. Most of neurology and neurosurgery is a futile fight. You prove to the patient that their taxes haven’t been wasted because you can tell them exactly why they’re getting those pesky symptoms. But most of what you do seems like blowing into the wind.
And as a student, you feel sometimes that you’re not even doing that. I imagine it as being by the side of a road, watching a terrible accident unfold. And not only can you not do anything about it, but the victim can see that you can do nothing about it. I have never wanted to be out of the room during a consultation, but today would definitely have been a good day for the ground to open and swallow me up. Every now and then, one of the family members would make eye contact with me. And I would return their nod or faint smile of acknowledgement, hating myself inside for being there. Because this is a moment of grief, and one deserves the right to experience grief in private. Did they mind me being there? Probably not. Are these situations unavoidable? Almost certainly. But it doesn’t help to be there when all you can you can do is watch.
Link : http://medscape.typepad.com/thedifferential/2008/11/when-all-you-ca.html