Mixed Emotions

I find myself already a couple of weeks into my internship now. I meant to devote a special blog to my first night being on call at the hospital, which by the way was pretty crazy and involved me working a 32 hour shift on zero sleep, but that opportunity has passed. In fact, I just finished my second night of being on call with a 30 hour shift. This time was significantly better than the first, though still very busy.

Even more interesting than my experience of being on call, however, is one of the patients I've been taking care of recently. Without revealing personal or identifying information about him, I'll try and give the gist of his story. He is a pretty young guy, somewhere around my age, who has been having progressively more and more problems swallowing for the past several weeks to months. It turns out he has also been feeling sick a lot for the past several months to a year. The swallowing problems have become so bad that he hasn't hardly been able to eat anything for a while and has lost a lot of weight. He had no idea what was going on, and neither did we at first. The more we talked to him, though, the more it sounded to me like it was a neurologic problem that was affecting his swallowing. I wanted to see an MRI of his brain and we ended up ordering one. After a lot of other tests that weren't showing why he was having the problems, the MRI showed that he has a tumor in his brain.

I will say that making that kind of a diagnosis comes with a lot of very mixed feelings - as the guy's doctor, you are happy to finally figure out what the actual problem is, but then you realize that the answer isn't such a great one for the patient. The disappointment in the realization that you have to tell someone that they have a brain tumor quickly overcomes any excitement that comes with solving the case.

This was my first real experience in being the person responsible for relaying some very bad news to my patient. Fortunately I felt I had developed a pretty good rapport with him, which made delivering the news a little easier (and a little harder). Of course, he was completely stunned and in disbelief. Overall, though, I think he handled it very well - a lot better than I'm sure I would have.

The neurosurgeon came to see the patient and is planning an operation soon. We are all hoping for the best. I especially like this guy and feel that in an interesting way we've bonded even more through the experience. I'm trying to stay optimistic - and in the meantime he and his family will be in my prayers.