the rooms were full. i was moving through the patients as fast as i could. then it was her turn. she had presented the previous week with a 7cm mass in her breast. she worked in the medical field, so she must have at least suspected it couldn't be good. but sometimes we all hope bad things will just go away. they seldom do.
i had told her it looks suspicious of a cancer but we had to wait for histological confirmation. and now i had it. as i walked her to the room, i glanced at the report. it was cancer.
as a surgeon, i treat many people simultaneously, seeing each one for a short time. i therefore must be able to jump between thinking about someone with mild abdominal pain and someone who is facing death and back many times each day. the trivial and the grave alternate through a typical day. this was grave. i consciously slowed down.
i went through her previous examination with her. i repeated that clinically i had been suspicious of cancer. and then i told her the news, as gently as i could. this is never fun, but i think i do it better than most and i'm always encouraged that it is better for her to hear it from me than from someone with little or no empathy.
she asked questions about treatment options. as i answered i could see her mind wandering off. she was probably thinking about her family and the grandchildren whom she would not be able to see grow up. she was being human and i understood. she asked the same questions numerous times and i patiently repeated the answers.
as she sat there with a far off gaze, trying to hear what i was saying and failing dismally, her eyes slowly filled with tears. she was being brave and my heart was breaking for her. i slowed down even more, giving her time, repeating once again how we were going to fight this thing, trying to give her hope.
finally we decided on a course of action and she left. i took a short moment to get my mind back to the day's tasks and moved on.
i moved on, having seen one more breast cancer patient and broken the news once more, but for her, she had just experienced possibly the single most devastating moment in her life.
sometimes our work is very sad.