Thursday, June 16, 2011


I have a patient with metastatic cancer. She's in her 40s. She just got married, after knowing her diagnosis and poor prognosis. Her husband always accompanies her to her visits. He is very attentive and pushes to make sure she's comfortable.

Her chemo is only sort of working. Her numbers are going in the wrong direction but the tumor itself seems to have shrunk. She's got liver metastases that are not getting smaller; rather they are getting very painful. I think the liver cells are starting to die.

The husband is really hard to understand, he has a very thick southern accent. She usually has to translate for me. My patient has no hair, is in constant pain, and has no source of income. She is usually in thrift-shop clothes, but dressed like she's going to church. No jeans and T-shirts, always in the nicest clothes she has. Her husband wears a trucker hat (probably because he's actually a trucker), jeans with dirt stains, and socks that used to be white. But they are proud, and they are always smiling.

And they are clearly in love, he spends more time doting of her than she cares to admit, and he makes sure all of her concerns are heard at each visit. She actually apologized to me this past visit, because it was an unscheduled acute appointment. To watch them together is to see two people who are living in the "now." They are not worried about how much time she has. They want her to continue to laugh. They want her to be pain-free enough to go to Memphis for a honeymoon. I have learned a lot from my patients, and I have learned a lot about the importance of Today from this one. It's good to plan, but it's not good to lose sight of what's going on today.