"Mrs. Adams, I wish I didn’t have to tell you this. You have pancreatic cancer."
The disbelief registered on her face. ”That can’t be right…. I feel fine. This must be a mistake….”
Even though I was talking to a simulated patient, the emotions seemed real. This week we have been practicing delivering bad news. It has been a real downer. One patient started sobbing. Another angrily demanded repeat tests. One just couldn’t understand that no cure really meant no cure.
We have some of the best simulated patients (though I may be a bit biased). From kids to adults to the extremely elderly the acting has been top notch. Maybe that is why this has felt so real. Too real.
I am glad for the opportunity to practice in a setting where I can get constructive feedback. But no matter how fake I know the scenario is, I can’t help but feel this is the real thing. As our lectures have moved into palliative care, hospice and DNRs I have began to think a lot about how I want to go. That has only been compounded by the fact that a classmate of mine recently wound up in the hospital with an unknown mass right next to his pancreas.
As death has swirled around in my head there is only one thing I can think: I am happy to be here. I am glad to be on this adventure. And if I were to meet an untimely demise, at least I spent my life in pursuit of a dream. I can live, and die, with that.
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- letsexplode said: have you heard of the podcast Radiolab? They have an episode called “The Bitter End” where they discuss end of life care and the differences in opinions between doctors and patients. Also the New Yorker article “Letting Go” by Atul Gawande.
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