Thursday, June 2, 2011

The tough part of my job

Overall I really love my job, but there are parts of it that I really don't enjoy. On Sunday morning I was on call at the hospital and I was called down to the ER to admit a patient to the hospital. She was a 42 year old lady who aside from being a little overweight was otherwise pretty healthy. She had been seen by her Primary Care Doctor a couple of months ago and felt overall very well. In the next two months she started to develop some digestive problems that weren't terribly worrisome to her as she's had some similar problems in the past that cleared up. These waxed and waned a little, but in the last 3 weeks she's also developed nausea and vomiting and had trouble keeping anything down. She has seen the Gastrointestinal Doctors and they took a look from the top and bottom and didn't find anything. She was set up for a CT scan of her belly set up on Tuesday, but the nausea got so bad that she came in early to get one in the ER on Sunday. She ended up being told by the ER doctor that she had a mass in her pancreas and liver as well as other places and then handed off to me. All cancer is bad, but pancreatic cancer it is almost always a death sentence and almost certainly with metastases like she has. So I have to walk into this room where I have to explain to this previously healthy 42-year old woman, her fiance, and 3 of her siblings that she will most likely have weeks to months to live. Pretty much the worst thing I've had to do as a doctor