28 July 2010


although i attempted to be optimistic on gyn-onc, it eventually got the best of me: between the hours, the scutwork, and the overwhelming sadness. during the two weeks i was on, three of our patients died (including one i took care of every day). additionally, i helped operate on a number of women with late stage ovarian cancer who had prognoses of maybe 6 months. i laughed with them. i cried with them. ultimately, there was nothing i (or any of us) could do for them medically.

i will never forget the morning ms. p died. it was like any other day, but it was somehow so different. i went in to round on her at about 4:30am (as i normally did), and she was lying on her side, awake.
"how did you sleep?" i asked her, apologizing as i always did for the early hour.
"not well." she looked different. she was breathing fast. "help me sit up a little, will ya?" she reached for my arm. i helped her sit up in bed as i counted her respiratory rate. it was too fast. we both half-glanced at the infomercial blaring on the tv. it seemed so irrelevant and intrusive.
"any pain?" i placed my stethoscope on her chest.
"nah, sweetie. just trouble breathin'." she was sitting up in bed now, but every muscle in her body looked uncomfortably drawn.
"try to rest, ms. p. i'll be back with one of your doctors."

my resident went to see her. she was a 50yr old lady with known metastatic cancer; our plan was to continue to follow her symptoms and offer any comfort care we could.

around 7am, i went to the operating room to help with a case. we'd been operating for about an hour when we received a call to the OR - ms. p had died. just like that. gone. i was scrubbed in to the operation and my entire job as a medical student consisted of cutting suture and retracting... i was so distracted for the next 10min i had to be reminded to cut.

sigh. her time was coming sooner or later... it was just hard for me in my small understanding of mortality to experience sooner. but here i am. and there she is -- in a better place.


April said...

:( I'm sorry. Days like that are hard.

But hopefully OB side will be much more joyful and fun most of the time (although you can be assured of incredibly sucky hours!)

A Musing MD said...

I agree with April. I had Gyn-Onc the first two weeks of the clerkship, and I was so sad (not to mention exhausted!). But once I was able to physically bring a human being into the world, I forgot about the miserable days that I'd had on Gyn-Onc. Hopefully, you'll have the same experience!