Today was hard. As much as I love Oncology- and I really do- sometimes it's just hard. Cancer isn't an easy thing. Most patients are not cured. A lot of them can be made to feel better for a while. But, there are some patients who we just really can't do anything for them.
Today was one of those days where it seems like all of the cases we see are those can't-do-anything cases.
My patient, "S", was a 5 year old orange tabby cat. He was so sweet. And his owner loves, loves, loves him. S was dumped by the owner's house as a kitten. One day, while dying of respiratory infection, S jumped up into the owner's lap and declared himself adopted. The receptionist put him in an exam room this morning and told us that she could hear him crying when she left. He cried a couple times while we gathered the history and physical exam. He also cried a little while we talked to him about our diagnostic plan.
The thing is, watching an older man cry just pulls my heart strings. As Kristen (one of my classmates) puts it, I am a co-cryer. His eyes well up and it is just totally reflexive for mine to well up too.
Even starting off in tears, it only got worse from there.
On ultrasound, S had a large mass originating from his pancreas with several other organs involved. On cytology, there was evidence of carcinoma. So, he has a pancreatic carcinoma that has already metastasized.
Even in humans, this is a bad, bad, bad tumor to have. There's no good treatment options.
We broke this news to his owner, who just sobbed. He hung his head, tugged his hair, sobbed and apologized. We told him there was nothing to apologize for.
It was heartbreaking to hear that he hates the month of July because his wife was diagnosed with cancer in July, he was diagnosed with cancer in July, and now his cat was diagnosed with cancer in July. I think we all cried a little.
Showing posts with label sad. Show all posts
Showing posts with label sad. Show all posts
Wednesday, July 13, 2011
Wednesday, June 15, 2011
Equine Internal Medicine- "Spitfire"
I feel so blessed to have been involved in Spitfire's life, as short as it was.
He came in as a 10 day old pony foal who had intermittently had fevers, fast heart rates and fast breathing since he was born. When we asked his owners more, they said that he sometimes dribbles milk out his nose when he's been laying down.
When we were looking at chest radiographs to look for aspiration pneumonia, the radiologist said "Well, if this was a dog, I would say this looks like a persistent right aortic arch (PRAA)." We didn't really do much about it then, but when I brought up the radiologist's comment again in rounds, we decided to pursue it a little further. I got sent over to the small animal hospital to talk to people who might know more about PRAAs, because it isn't something that's really reported in horses (9 times in large animals in general, it turns out.)
It got everyone all twitterpated and very excited. He had a lot of very good prognositic factors. After that, it was a very emotional rollercoaster between doing the surgery or euthanizing him.
In the meantime, Spitfire and I really bonded. I named him Spitfire because he had such a delightful personality. He was full of spunk and silliness. He'd walk right up to people and chew on their pants or lab coat. The emergency/overnight students who did his midnight-2AM treatments called him Chompers. He liked to run and buck around the paddock outside when we turned them out in the morning. He liked to steal stethescopes and carry them around his stall. His mother put up with him with goodnatured grace. Overall, he was just a little spitfire. (His owners ended up naming him something else, but I still like Spitfire better.)
Sadly, the surgical attempt to correct his congenital defect didn't go as planned. It ended up going really poorly and he was euthanized on the table. We all knew it was a real long shot that he'd make it, but that doesn't make it any less sad.
He came in as a 10 day old pony foal who had intermittently had fevers, fast heart rates and fast breathing since he was born. When we asked his owners more, they said that he sometimes dribbles milk out his nose when he's been laying down.
When we were looking at chest radiographs to look for aspiration pneumonia, the radiologist said "Well, if this was a dog, I would say this looks like a persistent right aortic arch (PRAA)." We didn't really do much about it then, but when I brought up the radiologist's comment again in rounds, we decided to pursue it a little further. I got sent over to the small animal hospital to talk to people who might know more about PRAAs, because it isn't something that's really reported in horses (9 times in large animals in general, it turns out.)
It got everyone all twitterpated and very excited. He had a lot of very good prognositic factors. After that, it was a very emotional rollercoaster between doing the surgery or euthanizing him.
In the meantime, Spitfire and I really bonded. I named him Spitfire because he had such a delightful personality. He was full of spunk and silliness. He'd walk right up to people and chew on their pants or lab coat. The emergency/overnight students who did his midnight-2AM treatments called him Chompers. He liked to run and buck around the paddock outside when we turned them out in the morning. He liked to steal stethescopes and carry them around his stall. His mother put up with him with goodnatured grace. Overall, he was just a little spitfire. (His owners ended up naming him something else, but I still like Spitfire better.)
Sadly, the surgical attempt to correct his congenital defect didn't go as planned. It ended up going really poorly and he was euthanized on the table. We all knew it was a real long shot that he'd make it, but that doesn't make it any less sad.
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