After today, I can make one solid educational point: an inadvisable way to end your work day is to spend the last three hours of it explaining to a sixteen year-old and his family that, despite aggressive chemo and other supportive treatment, he probably only has one or two days left to live. Having a teenager push away an oxygen mask to ask you how long he has left is pretty much the worst thing possible; it was all I could do to not break down sobbing during my conversations with the family. By the time I got home, I felt dull all the way down to my very core, a feeling which is only now starting to subside.

I know that we do a lot more good for kids than we do harm, and I also know that this is all going to get easier; right now, though, I’d trade both of those things for a chance at giving my patient a little more time.


The reason it will get easier is because of the saves that you make and the truly awful deaths you able to turn into bearable ones.

And that’s why we don’t grant the wishes of residents and fellows - because you’d trade all the good you’d do today for the single patient in front of you. Don’t worry, you’ll get your share of wishes granted. But later, after the wisdon comes. Say, in about 30 or 40 years.

Still waiting for mine.

• Posted by: alwin on Sep 10, 2003, 10:58 PM

I don’t know if it’s one of those parts of life that can be explained, but it is unfortunately part of life, and I’m glad people going through it have you to be there for them. You do important work, and that’s something few of us can really, truly say.

• Posted by: Anil on Sep 11, 2003, 12:47 AM

Kudos to you, Mr.Q, and Alwin.

You’re good people.

• Posted by: curt on Sep 11, 2003, 1:31 AM

I’m afraid all I can add are yet more unintelligible answers to insoluble problems. Meanwhile, thank you for being there and brave.

• Posted by: victor on Sep 11, 2003, 12:18 PM

Just the fact that you are there and fighting for your patients comes though, even if you don’t realize it. I have been there on the patient’s family side and know when the end is coming, a doctor who cares makes all the difference in the world.

It is still a hard time, including for you, but know that you make a difference.

• Posted by: Scott on Sep 11, 2003, 12:48 PM

The world would be a lot worse without people like you, who struggle to make it a better place, and still have hope. You’re a good man, and you have nothing to blame yourself for.

• Posted by: Xavier on Sep 12, 2003, 11:56 AM

You put my “end of day bureaucratic woes” in perspective. Next time I walk into my house totally exhausted by organizational life I will think of you.

I hope you do get many wishes!

• Posted by: Jeff on Sep 16, 2003, 11:00 AM
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