Tuesday, December 28, 2004

The Angry Husband

"When I go I'm taking that doctor with me."

Thus spoke a retired police officer one afternoon to his surgeon, who probably considered this blunt statement as merely a catharsis of anger, not a serious threat. The surgeon certainly didn't see any need to ring the authorities or even call the intended victim - in fact it was not until the following week, when he happened to run into "that doctor" in the parking lot did he mention the gentleman's unique promise, sporting a rather sardonic smile as he talked. The poor designee promptly dropped his tranquil demeanor and began to pepper his friend with urgent questions regarding the officer's mental status. The doctor in question, now laden with twenty fresh pounds of nausea, began to eye the space around him like a young wildebeest in the lion's den.

The doctor in question was me.

As I remembered the case I realized my predicament had formed from an unfortunate merging of misunderstanding with misfortune. The officer's wife had been my patient and had fought a difficult cancer for weeks, achieving the most precious of goals - a complete remission. Despite her gruff disposition (a trait both spouses had mastered), the necessary treatments were agreed upon and delivered, and now the storm of cancer had abated. All was well again in the world. Peace reigned throughout the body.

The officer's dear wife, alas, was destined for only a brief armistice. Within a month she developed a change in her laboratory values - a subtle sign to me of possible turmoil within. I tried to keep up hope since she certainly felt well, but as summer approached I became more suspicious that her disease might still be alive. If this were true her life would be lost, for no further treatment could eliminate the invader if it survives the initial killing blow.

I approached this potential crisis with the optimism of the young doctor, yet with the trepidation felt when inexperience clashes with rancor, and basically did nothing that would upset the patient. My counseling was rudimentary and any words of comfort I gave did little to assuage the anger boiling within both patient and spouse, who were convinced that cure was a certainty. I counseled caution - to wait it out and see if the tests stabilized, or the patient developed symptoms of concern.

Then as all doctors who are not employed by either royalty or state leaders do, I left for my summer vacation. When I returned, my partner informed me that the patient indeed had relapsed and died a few days after...and that the family "took it hard".

Upon hearing this I suddenly gained the most unwanted form of wisdom ever found within a medical career: the gift of 20-20 hindsight. I now realized all the warning signs my patient displayed and what I should have done about it but did not, out of fear of facing her ire. I choked in a crucial time because I was scared to have to wade once again into the muck that was her cancer, knowing full well that she was doomed.

I neglected my duty out of a little fear, and now had to live with a greater one.

Walking quickly to my car each day I learned to scan my surroundings, looking like a cheap actor in a self-defense instructional tape. As the weeks went by eventually I convinced myself that the threat was simply a venting, and forgot about the angry husband.

About one year later I ran into that same surgeon and was impelled to ask him if he had heard from the officer recently. His reply left me standing in stunned silence: "Oh, he died of gastric cancer a few months ago."

This ends the story of The Angry Husband. To this day I am uncertain as to what message is contained within it - but whether I am enlightened or not, like Moses before the burning bush I kneel in respect of this formidable opponent...this pestilence that strikes with random fury. May all oncologists prove themselves worthy when the day of reckoning comes.

12 Comments:

At 8:09 PM, Blogger angela marie said...

I have the feeling that the anger of this husband was directed at you...that time. If he was the kind of person he was, he probably was angry some of the time with others in his life. When things weren't going 'his way'.

You always have those in the 'anger' stage of grief when they come to the clinic, but they are easily separated from the people angry with life. Those people ALWAYS feel ripped off. They make you nervous and make you document EVERY WORD, for fear they will use it against you.

Luckily, most of the people who start off with anger pass through it and move on. They find that we laugh in oncology too. We are trying very hard to make them feel well again.

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"...the most unwanted form of wisdom ever found within a medical career: the gift of 20-20 hindsight."

Amen.

 
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