I would have graduated from medical school this year. That’s right. Just like you, I’d be getting ready to move to another city and take up residence at an academic medical center to begin my clinical training. Things don’t always work out the way we planned: like Lenny and George in Steinbeck’s, Of Mice and Men. Sometimes, the best-laid plans have a way of going awry no matter how carefully we prepare them.
Cancer. I wasn’t worried. It was just a little mole. Melanoma. Only a few microscopic cells hiding in my lymph nodes. If I was older, I might be concerned. Interferon alpha (a) was the prescribed treatment for an entire year. Recombinant DNA. Ineffective, but brutal: fever, chills, every day, and every night. After the year was up, I went back to being my twenty-something self: working, studying, taking the MCAT.
I don’t have to tell you what happened next. The black vine took root in my lungs. Its tendrils grew, tangled in knots, and I became a statistic. Death came totally unexpectedly. Sure, I knew that pain wasn’t a healthy indicator of recovery, but my fiancé and I kept hoping — waiting for the immunotherapy to work. I’m only twenty-eight. I got this; I can beat it. That’s what everyone kept telling me. You’re going home tomorrow they sang as they walked by my hospital room — except that I didn’t. I went to the morgue. The hard conversation? It never happened. No one ever told me or my family that I was actively dying. No one even asked me my preferences. So before you go out into the world to treat patients, let me persuade you to embrace the only acceptable course of action. If your patients want to know their prognosis, give it to them straight.
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