My patient's chart was brief. A diagnosis of colon cancer that might have been cured had he not disappeared from medical care to return, nearly a year later, with cancer so advanced that it had torn through his intestines.
Colleagues at the hospital had called him to schedule appointments, to get follow-up and to start chemotherapy, but he never responded. Now he was back, but there was nothing the surgeons could fix, and so he would remain in the intensive care unit until his death.
When he arrived in our unit one night last winter, his cheeks were gaunt, his body wasted and abdomen protruding. He was also angry. As I remember the events of that night, as soon as the doctors in training and I gathered at his bedside to explain his prognosis, he lashed out. There was nothing wrong with him, he insisted. All he wanted was for us to treat his pain so that he could go home. He had things to do: a game to watch on television later that night.
As a critical care doctor, I am familiar with denial in its many permutations. I know how it feels to sit at a bedside and in windowless conference rooms, talking with families who cannot or will not let themselves acknowledge what is unfolding in front of them. We learn language to show that we are on their side, while also making it clear that things are not going to be OK. "I wish that the antibiotics were helping, but I worry that your loved one is dying," we say...
https://www.nytimes.com/2021/10/06/opinion/doctor-patient-death-truth.html?smid=em-share
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