Beat: favorite patient has pancreatic cancer

[Skipbidder]

Depressing story follows:

I've been drinking a lot today. My favorite patient has pancreatic cancer.

This guy was almost dead two years ago. Bad emphysema, requiring home oxygen. Intubated while in the intensive care unit. Angina (heart pain) frequently. His wife had died recently. Claudication (pain in his legs on walking a certain distance) but not a candidate for a revascularization procedure because he can't handle the dye load because he's got only one kidney (other removed from cancer). He told me that he was ready to pack it in. He told me that he wasn't able to do anything that he liked anymore and asked what the hell was worth living for. I found out that among his physical activities, he missed golfing the most. I told him that I thought I could get him back to golfing again. I got him down from 2 packs a day to 3-4 cigs per month. (His pulmonologist vehemently disagrees with me, but I told him that this was okay.) Then, got him off the home oxygen. Got him a pacemaker. Got him on the right cardiac meds. He was no longer needing nitroglycerin. Got him eating better. He golfed last summer and fall (with a cart). Woohoo, I'm a [censored] great doctor.

Last week, he came in bright yellow. I now have the confirmation that he pancreatic cancer. The 5 year survival is something like 5% for all comers (and with his comorbidities, his will be less than this).

I've had plenty of patients die before, but this is the hardest by far (even though he's still alive). I really, really like him, and I feel like [censored] for getting his hopes up. I painted a pretty grim picture for him yesterday, but I'm still not sure that he understands.

Carry on.