SLOW PAINFULL EXIT TO THE OTHER SIDE
I feel sad and helpless. Right now there is a elderly chinese man in my ward who is suffering. He was diagnosed with lung cancer about 6 months ago in a private hospital. He has smoked practically all his life. By the time he was diagnosed with the ailment, he was already in Stage 4. The histopath was 'poorly differentiated adenocarcinoma'.
He was administered 2 doses of chemotherapy after which he felt a lot better and decided to forgo chemotherapy and sought traditional herbal remedy. He came back to us in January this year when he started to be forgetful. A scan revealed that the tumor has spread to his brain, adrenals and also the mediastinum (the area in the chest wall where the heart and other major vessels were located). He was offered chemotherapy but he declined. He was given some steroids to 'shrink' the tumor and he was better.
He was readmitted over the weekend after becoming increasingly breathless. Another xray showed the tumor has grown very large, almost covering 2/3 of his right lung! More steroids did not help. He requested for chemotherapy! By now his functional status is grade 4 (very bad).
Coming in on a weekend is bad news as we could not trace his notes. He didn't have any card or letter on him. All I could do was give him steroids and put him on oxygen 24 hours a day.
I feel sad because here is a man literally suffocating and in his last stretch of life and I could not do anything. I am trying to get the oncologist to give him some palliative radiotherapy to ease his breathlessness but I don't think it's going to be of much help. He is too far gone.
I got to know that he is divorced. He has an only son, in his late teens who has been by his bedside since yesterday. His wife is in Australia and according to his son "she couldn't care less". He has a sister in USA who may not make it back in time to see him.
The man drifts in and out of drowsiness and confusion; sometimes scolding the son, sometimes pleading, breathless all the time. He could not lie flat at all. He can't sleep. He is literally suffocating.
It sickens me to know that the traditional therapist that he has been to has strongly advised him against having any more chemotherapy. Instead he was fed concoctions after concoctions (which probably contain loads of steroids anyway) adn he got no better. I am thinking, perhaps things could have been a lot different had he continued with his chemotherapy earlier. Perhaps not. For stage 4 lung cancer, the end is probably guaranteed. Medical science has no cure as yet for this stage.
It was hard for me to take the son aside and tell him that his father is dying. It's hard for me to look at the patient in the eye and tell him we are doing the best we can. Can he see the helplessness in my eyes? Does he know that there is no more hope?
I don't feel good. Once again I am reminded that human life is finite. Life is short. It's a terrible way to go. It reminds me again that in my short life, I want to try and make the most of it; to leave this place a little better, or make someone's life a little easier. It reminds me also of God's sovereignity. In the end He has the final say.
However, I am also reminded that, just as Gandalf whispered, with a little twinkle in his eye, to little Pippin (or was it some other hobbit?) just before the assault by the dark forces on the stronghold, in Lord of the Rings: The Two Towers (or was it the third part? I forgot), death is but the door way to something better. And that is strangely comforting.
I feel sad and helpless. Right now there is a elderly chinese man in my ward who is suffering. He was diagnosed with lung cancer about 6 months ago in a private hospital. He has smoked practically all his life. By the time he was diagnosed with the ailment, he was already in Stage 4. The histopath was 'poorly differentiated adenocarcinoma'.
He was administered 2 doses of chemotherapy after which he felt a lot better and decided to forgo chemotherapy and sought traditional herbal remedy. He came back to us in January this year when he started to be forgetful. A scan revealed that the tumor has spread to his brain, adrenals and also the mediastinum (the area in the chest wall where the heart and other major vessels were located). He was offered chemotherapy but he declined. He was given some steroids to 'shrink' the tumor and he was better.
He was readmitted over the weekend after becoming increasingly breathless. Another xray showed the tumor has grown very large, almost covering 2/3 of his right lung! More steroids did not help. He requested for chemotherapy! By now his functional status is grade 4 (very bad).
Coming in on a weekend is bad news as we could not trace his notes. He didn't have any card or letter on him. All I could do was give him steroids and put him on oxygen 24 hours a day.
I feel sad because here is a man literally suffocating and in his last stretch of life and I could not do anything. I am trying to get the oncologist to give him some palliative radiotherapy to ease his breathlessness but I don't think it's going to be of much help. He is too far gone.
I got to know that he is divorced. He has an only son, in his late teens who has been by his bedside since yesterday. His wife is in Australia and according to his son "she couldn't care less". He has a sister in USA who may not make it back in time to see him.
The man drifts in and out of drowsiness and confusion; sometimes scolding the son, sometimes pleading, breathless all the time. He could not lie flat at all. He can't sleep. He is literally suffocating.
It sickens me to know that the traditional therapist that he has been to has strongly advised him against having any more chemotherapy. Instead he was fed concoctions after concoctions (which probably contain loads of steroids anyway) adn he got no better. I am thinking, perhaps things could have been a lot different had he continued with his chemotherapy earlier. Perhaps not. For stage 4 lung cancer, the end is probably guaranteed. Medical science has no cure as yet for this stage.
It was hard for me to take the son aside and tell him that his father is dying. It's hard for me to look at the patient in the eye and tell him we are doing the best we can. Can he see the helplessness in my eyes? Does he know that there is no more hope?
I don't feel good. Once again I am reminded that human life is finite. Life is short. It's a terrible way to go. It reminds me again that in my short life, I want to try and make the most of it; to leave this place a little better, or make someone's life a little easier. It reminds me also of God's sovereignity. In the end He has the final say.
However, I am also reminded that, just as Gandalf whispered, with a little twinkle in his eye, to little Pippin (or was it some other hobbit?) just before the assault by the dark forces on the stronghold, in Lord of the Rings: The Two Towers (or was it the third part? I forgot), death is but the door way to something better. And that is strangely comforting.
posted by Jimbo @ 3/14/2006 12:25:00 PM
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