by Daphne Lobb
Before admitting the new patient to hospice that day, I found myself quickly assessing, What’s her diagnosis? Mmm, breast cancer?
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She is only fifty-two. Four years younger than me. Reviewing the chart, I asked myself, how much do I want to know, how much do I have to know to do a good job? Do I need to know when she was diagnosed? Or how long has it been from treatment to recurrence? Is this information important to know, to manage her pain well? Do I need to know all the treatment she had---surgery, chemo and radiation, like me? Did she take letrazole, like me?
Stop. Breathe. This is not you. Did I come back to work too soon, only four months after treatment ended? Should I have taken more than eleven months off?
Stop. Breathe. Of course this is tricky not to identify with my patients who have also had breast cancer, who are now dying. Don’t be hard on yourself. My mind says, I need to be thorough, but my heart says, read only what you need to know to take good care of her. What a relief!
Stop. Breathe. This work of being a palliative care physician will never be the same again. Gone are the days of boldly reading a chart—details of chemo treatment, dates of recurrences, pathology, stage, grade—all just medical details of someone else’s life.
Now, two years later, I still always pause after I read ‘breast cancer.’ I still stop and breathe but the pause is shorter now, less full of worry about myself, and more about our shared humanity and understanding.
Daphne Lobb is a palliative care physician in Vancouver who has worked for many years in hospital and home settings. She teaches widely on many issues related to living well with cancer and is committed to helping people find ways to maintain a good quality of life. She is a co-founder of Callanish and has attended every weeklong retreat to date.