I just said Goodbye to my friend. Do not pity me. It was a gift that I could give to him. When I walked into the room, where I have visited with him so many times in his life, he lifted his eyes and whined under his breath. His family did not hear him, but I did. It was then that I knew. I could not let him down.
I have power in these situations. Families look to me to help them know. Usually I explain what I think medically, but remain non-committal because this is the family’s journey. Their hearts have to lead them to the decision when they are ready. But sometimes, only occasionally, will I make a stand. At these times, I must disregard the needs of the humans and only care about the needs of my patient.
In this case, bone cancer had ravaged my friend. He was living with pain, every second of every day. I know this intellectually and I explained it to the family. I had prescribed appropriate pain medication and increased dosing along the way to do what I could. But in the end, the pain won. I saw it in his eyes and I could not let him down.
I told them that there was no wrong answer, but the whole situation was wrong. We had to address the pain, at least his pain. For me and the family, the pain continues. I will miss his sweet face. He was always happy to see me, even today.
And so we all said Goodbye and he slept, with dignity and peace. It hurt us all, but not him. He has always trusted me and I did not let him down. I have honored my friend, my oath and my profession, but oh, how it hurts.
I don’t know whether this reduced me to tears for its subject matter; your empathy; its elegance of expression unimpaired by errors of grammar, spelling, or construction; your sensitivity to readers and “parents,” as well as to your patient, and regret that I am not a dog, because no matter how much my physician cares, he would be risking his license—even his freedom—if he were to hear my plea for anticipatory relief.
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Thank you. It reduced me to tears too. 🙂
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There is no happy ending here except for the pup being allowed to pass on with love and dignity. Thank you for the beautiful post. I was also reduced to tears. Your clients are lucky to have such an empathetic doctor.
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I’m sorry for your loss. These patients are like adopted children. You care for them and help them live the best lives they can. However when it is “time” we (the owners) all look to your guidance because we often need the reassurance that we are making the “right” call at the “right” time.
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