My current rotation in Family Medicine has proved to be a bit more benign (in UP Manila speak, not that taxing), so I impulsively went to “volunteer” for night duty at Philippine General Hospital’s Cancer Institute. From 8 PM to 1 AM, I helped out in monitoring patients’ vital signs and carrying out orders (blood extraction for laboratory tests, intravenous line insertion , pushing medications etc). The Cancer Institute is one of the better looking buildings in the PGH complex and for good purpose. Most of the patients are in the advanced stages of the disease and have already experienced the rigors of treatment.
For the curious, interested and oncologist-wannabe, the CI has a wealth of information that’s just waiting to be tapped by those who seek it. One glance at the patient directory would immediately show that the types of cancers that afflict the patients cut across the board. From cases of children with retinoblastoma (a malignancy that affects the eye) to elderly people with cancers of the colon and thyroid, each bed shows a different face that cancer projects.
Sometimes, patients are visibly depressed, irritated and uncooperative. They squirm at the thought of having to be pricked for more blood tests. Unfortunately, repeated extraction and the chemotherapy itself result to the lessening of the likelihood as far as getting patent blood vessels go.
Some patients could be jolly though. One middle-aged woman who was fighting a gynecologic malignancy was in good spirits. Despite having a 200/100 mmHg blood pressure, she claimed to be feeling relatively well. She wasn’t grumpy like the other patients. She has lost all her hair, but her will to live and her gusto to enjoy life couldn’t be doubted.
There were two other patients that left a real lasting impression (enough for me to look up their charts).
- James (not his real name) is one of the patients in the Hospice section. It’s not easy to tell, but he’s only 20 years old. Four years ago, he was diagnosed with Hogdkin’s Lymphoma. A few years later after receiving treatment, it was revealed that he had another malignancy - one that is not related to his existing one. He had osteosarcoma with a focus in his hip. This has caused his leg to swell up due to the blockage of lymphatic drainage (think elephantiasis). He doesn’t have the healthy glow that all of us have. He’s dark, swollen and somewhat disfigured. The disease has definitely changed him and he still doesn’t know that he’s now a terminal case. A person rarely gets two different malignancies of different histology. James is a statistical anomaly.
- Maria (again, not her real name) is one striking patient. A huge, bandaged mass the size of her head is attached to the lower aspect of her right jaw. It has a very offensive smell. You literally have to prepare yourself before entering her room. She has Undifferentiated Carcinoma of the right maxillary bone. In terms of histology (cell studies), it’s better to have differentiated cells instead of undifferentiated ones. The prognosis worsens as the level of undifferentiated cells go.
After the few hours that I spent walking around, counting respiratory rates, heart rates and checking blood pressures, I realized one thing.
I hate seeing sick people. I’m sure a lot of doctors also have a similar feeling, but I guess I really am more emotional than most people I know. I feel for strangers. Come to think of it, these people are on the final days and yet they’re here in PGH helping us learn about their disease so that in the future, medical students like us could better treat and comfort our patients better.
I wish them all the best.
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For my junior year Theology class, I “volunteered” at PCMC. There wasn’t really much to do at the hospice, so we were instructed to do rounds and visit the kids in the rooms. I met this kid who had leukemia. At least I thought he was a kid; turns out, he was 19 and was already in college when he had to be hospitalized. He looked like he was 11. How old did James look like?
I couldn’t do what you do. I guess you could say that I hate seeing sick people so much that I stay as far away as possible. I just don’t know how to handle myself around them. Not one of those people that can keep a smile on my face while people around me are suffering… probably just make them feel creeped out. I’d never want to be the last person a terminally ill person saw because they would end up dying thinking “Well… that was effing awkward…”
Keep up the good work!
Hmm. Makes me wonder what House would do in that situation.
Anyway, nice work.
Helga: He didn’t look human.
Nicest Girl: Well, in the end, it’s great to help people. The question is, is what you’re doing helping them at all? That’s a question I often ask when caring for terminal patients.
Martin: House wouldn’t be there. He only sticks around until the diagnosis is clinched. Cancer patients already a designed management plan. House is just in it for the whole brainstorming part.
Hospital smell is not that offensive or scary, but seeing decrepit bodies might send me to the washroom. But, time well spent, Benj!