“Son, just let me die.”
Those were the first words Mr. O. told me as I introduced myself. As a 75-year-old stage IV lung cancer patient with brain metastasis, Mr. O knew his time on this planet was limited — the last place he wanted to be was in a hospital with a newly minted clinical student. Mr. O’s neighbor had found him unconscious on his porch earlier this morning, and much to his dismay, called the ambulance to take him to the hospital. Upon further testing, it was discovered that Mr. O’s electrolytes were dangerously altered, and he would have to be admitted. Whether he liked it or not, Mr. O was here to stay.
I almost felt guilty examining him as a novice in the field. This man had gone through dozens of chemotherapy treatments with a countless number of specialists, all of which had failed. As he removed his shirt for the cardiac and respiratory exam, his joints and muscles began to ache, and his chronic headache worsened with his slow movements. Somehow, writing 7/10 for pain on my measly scut sheet just did not do justice. His skin, withered from the years of battle against cancer, felt leathery and fragile, yet carried a small semblance of the warmth that once ran through him. He was a dying man on his last leg, and I was in charge of taking care of him.
While we corrected for his metabolic illnesses, more senior members of the caregiving team tried to approach Mr. O with end of life discussions to no avail. Mr. O was fed up with the healthcare system and wanted to just leave. As a last-ditch effort, my attending physician told me to give it a shot. As I approached his bed, Mr. O turned off the TV and looked directly into my eyes with a blank stare. Without saying a word, I removed my white coat and put it on the chair next to me and sat down.
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