A New Perspective (10/27/2001)

I have a new perspective on patients.  This week I have spent hours at the bedside of my mother in Emory Hospital in Atlanta.  She just had surgery for pancreatic cancer.

I know too much!  For a general surgeon, there are few diagnosis that are so difficult to treat and have such a dismal prognosis.  When I first received the news of her diagnosis, found during what was supposed to be an operation for a benign process, my heart sank.  My earliest childhood memory, burned forever into my mind at age three, was the image of red and blue tubes protruding from the abdomen of my mom’s father after his operation for pancreatic cancer.  He died shortly thereafter.

 

When I first heard about Mom’s symptoms in April, my surgeon’s training said, “rule out pancreatic cancer!”  As her workup continued, the tests were negative for pancreatic cancer, but my suspicion was still there, as it was for the doctors involved in her care.  I anticipated each new test, and was relieved with the continued “good news,” but yet I had my doubts.  Pancreatic cancer is like that: sometimes difficult at times to diagnose, at times even until the end.

 

Becky and I had discussed the possibilities and plans for the worst case scenario.  When I did not receive the expected voice mail on my cell phone the day of surgery telling me that all went well, I went to bed for a troubled sleep.  At first light, I checked my phone.  There it was, my sister’s voice, giving me the news I somehow expected but hoped wouldn’t be.

 

Quickly we made arrangements for a trip to the States to be with my mom.  Becky and the kids stayed in Honduras for now.   During the preparation to leave, I discovered that my emails of the past month, which I had thought were making there way to the intended recipients, were lost in cyberspace.  Ignorance was bliss!  It was too late to investigate or correct the problem.  I had hoped to share news of my mother’s illness with our friends and supporters via email to encourage prayer.

 

At Emory, I was quickly confident that Mom was in the best hands possible: one of the best of the best medical facilities in the world.  The care provided was excellent.

 

It was hard being a patient family member.  I spent two overnights with Mom, and several days, feeding her ice chips, rubbing her back, emptying her potty chair, and waiting for the doctors to make rounds.  From the doctor side, what seemed to be a passing discussion of possibilities or promise of a medication change was totally different from the patient viewpoint.  Mom was hurting!  Why did it take so long to bring the medicine?  Why did the resident have to mention an NG tube?  The fear of another insult, another discomfort amidst the misery of being poked and prodded and tethered to bed by countless tubes and drains sent Mom into quiet anxiety.  “How much more?  Was it worth it?” she questioned.

 

And then, the wait for the pathology report.  For me, the future hung on that one written document.  It would tell me if this would be Mom’s last Christmas with us, or if she had a chance.  The doctor said it would be out today!  We waited, all day!  I struggled with my emotions, trying not to discourage my parents by showing my fears.  I left the room for just a few minutes, and returned to find out that I had missed the doctor and his entourage of residents!  He made no mention of the path report!  We would need to wait another day!  I had never experienced this part of being a patient before.  The expectations, the fears, the questions, the waiting!

 

Then, the unexpected:  the junior resident showed up with a copy of the path report for me to read, “Hot off the press!”  This would have deserved a significant reprimand in my residency days.  It was the attending surgeon’s job to “break the news.”  I have broken the bad news many times, never enjoying it, but always attempting to minister in the midst of turmoil.  This perceptive resident saw my struggle and ministered to me, at his own risk.  My family determined to appear “uninformed” when the attending surgeon finally showed up the next day to give us the news.

 

As I read the report, my mind was in a whirl.  The margins were clear.  The tumor was small.  Only one lymph node was involved, and that by direct extension, not by lymphatic metastasis.  I had to read it again, and once again as I tried to understand the meaning.  Mom and Dad looked on, waiting for me to tell them what it meant.  In short, it was good news in a bad situation.  Mom was fortunate to have her cancer caught early.  It gave her a fighting chance of 20% to live another five years!  Not good odds, but to me, it was welcome news!  The usual odds for pancreatic cancer are 50% chance of living 18 months, 5% at 5 years.

 

Then, what about chemotherapy and radiation?  In the usual advanced case, they would offer little to survival.  But for Mom’s select subset, Emory was participating in a study that used both, which, in the Emory experience, was offering a possible 40% chance of 5-year survival.  That’s approaching 50-50!  Those are odds that are more acceptable and less discouraging!

 

So, as we wait for Mom to recover, and contemplate the future, I begin to formulate plans, options, “what ifs.”  I return to Honduras tomorrow morning and share the news with Becky.  Then we wait: wait for mom to feel well enough for a visit from the whole family, wait to see how she responds to chemotherapy and radiation, wait to see if the tumor recurs.

 

And during all this, what of God?  What of our faith?  God is all knowing and all wise.  And He is all powerful.  He is also present with us through all circumstances.  And He exercises all these qualities in love.  We have the confidence that no matter what happens, even though it is difficult to understand from our finite point of view, that this will turn out for the good of Mom, and Dad, and my sister, and all our families, for we do love God!  And even death, which appears to be our enemy, will be swallowed up in victory.  For whenever it happens, for Mom, or for any of us who know Christ, we will be in the presence of our Lord and Savior, Jesus Christ, where there will be no more suffering, no more tears, no more death, only life forever, as life was initially intended to be, in perfect fellowship with our Creator and God.

 

Dave Drozek

 

with Thoughts from Honduras