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.
kathrynprimmdvm 