SHORTSTORIES

MY MOST MEMORABLE PATIENT I have seen lots of cancer patients, and I still sometimes remember them as clearly as yesterday.

One that I will never forget was a 44-year old woman I saw during my respiratory medicine rotations.

She had breast cancer and had undergone a mastectomy of her left breast, but the cancer was locally advanced and despite surgery and thirty-some rounds of radiotherapy and two or three rounds of chemotherapy, she was admitted to our ward.

Her tumor had infiltrated the pleura of her left lung, and with two chest tubes, it was my duty every morning to check how much effusion (fluid from her affected pleura) had accumulated overnight.

We wished that it would subside so we could perform pleurodesis, which is like gluing both pleura together, and it would increase her livelihood and decrease her pain, and we could then remove the chest tubes.

So, she was my regular patient. I started my rounds with her, and then I was very inexperienced and did everything by the book. I took the vitals, checked the effusion, auscultated her chest, and asked about how she had slept the previous night.

I felt uneasy to uncover her chest because she acted like she felt ashamed of her chest, and the flat space that once had been her left breast. And so I slid my stethoscope to listen. Sometimes it would hit one of the chest tubes and she would let a faint cry of pain, but that was all.

So, we had bonded quite a bit.

One day I asked her, almost absent-mindedly, about her family. With the enthusiasm of a mother that talks about her kids, her pale face brightened and told me about her boys. One was 14 and one was 11. She was telling about their schooling and how good was the elder one at drawing. I asked, in our morning small talk, while scribbling some notes into her file about overnight blood test, “Do your kids play soccer?”

It was the moment.

She answered: “Yes, and I would be the goalkeeper.”

I think it was during this little moment that she once again saw all of her family together, and realized she wouldn’t be much longer with them. She knew her prognosis, she knew all our efforts were palliative, but she knew it as a scientist knows a distant physical fact. But it hadn’t penetrated her yet as reality.

And at that moment, it did.

She spoke no more, and I didn’t ask more. A little pool of tears formed at the corner of her eyes, and a huge drop rolled her pretty face. And I quietly left the room.

Among thousands of patients and all their stories, this has stuck with me. I can still remember her face, the empty flat left chest, the sad eyes of her young husband whom I saw when she was discharged, and the elder son, the one good at drawing, who was quietly giving his mom a pep talk that doctors are gonna get you better. Teenagers hate doctors, and yet this little guy had faith in us. We, who had failed them. We had been defeated by the monster. The effusions never ceased, and we couldn’t do pleurodesis, and she passed away a couple of weeks later. But as I stood watching the trio leave the ward as she was discharged, the son pushing the mom’s wheelchair, a part of my soul left me and remained with them at that very moment forever.