Now I'm not one to be serious all the time. In fact, I tend not to be serious most of the time, which is probably not the best quality for a future doctor. (Warning, I may go the entire way here without saying some moronic joke. Apologies.). Pehaps it is just because I am not used to seeing certain things inherent to this profession, perhaps I am not desensitized to the mess that is the human race, but I must say that what I saw yesterday was more than a little disturbing.
Since our bone marrow transplant selective teacher just had a baby, he didn't really have time to plan anything for us (actually I give the guy props for even showing up. I'm sure his wife was thrilled.). As a result, he just took us on rounds with him. I learned that rounds are basically an opportunity for doctors to take fellows, residents, interns, students around to talk about their patients, then visit the patients, then pimp the shit out of the inferiors (see Big Pimpin
if you want to know how much fun that could be). Since he knew we didn't know jack shit, he didn't bother with that last part and we just talked about his patients and got to meet all of them.
For the most part, this was pretty uneventful and educational - I thought there was an interesting contrast of the patients on the verge of death congratulating our doc on bringing new life into the world. OK I'm done trying to be deep.
We get to the last room and he introduces this one with a "basically she's on her way out". Sad indeed, but nothing we hadn't seen before. We walk in and she's crying. She asks all these questions about what treatment plans she has and our doc tries to explain to her that there isn't much of anything to do, other than hope that there is some experimental drug trial she can participate in. She even said at one point "Well what am I supposed to do, wait for death?" They don't teach you how to deal with that shit so well. In all, her story seemed sad but unremarkable: acute myeloid leukemia, multiple chemo rounds, etc. We walked out of the room, and one of the students asked why there was no bone marrow transplant attempted. The doctor said "Weeeeeeeeeeeeell, the only HLA match [think donor match] is her brother, who's a schizophrenic. And his wife has power of attorney over him, and she adamantly refuses to let him undergo a bone marrow transplant donor." Basically, this wife refuses to let a guy who's already nuts (and probably wouldn't even remember this procedure so well anyways) save his sister's life. The doctor tried to talk her out of this ridiculous stance, but she would not budge (to give an idea of his powers of persuasion, he managed to reconcile the patient with another sister who hadn't spoken to her in 20 years over some financial scrap).
She literally had control of this patient's destiny, her life, her chance to continue and live with her three daughters. Instead, she sentenced this poor woman to death. Now, I don't know what the history is between them, the brother, whatever. To put it bluntly, it doesn't fucking matter. It is absolutely disturbing to know that stuff like this goes on, and it literally made me sick to my stomach when I was told this. I feel so bad for this patient, and I can't imagine what it might be like to know that your life could be spared (there is a decent 5 year recovery percentage for this specific AML) but you have no chance to access it. To this wife I say this: karma. You better fucking watch out, because it's coming to get you, and it never fails.
OK hopefully I'll be a little less serious next time.