How do you answer?

I was thinking about writing a post about my first week in the ED when I decided it's too soon for that. What I did come across was a bit I wrote one night following a really tough day during my first week of oncology. This patient definitely got to me. It's kinda fun to read about the experience a couple of months out. It's also nice to read about a time when I had a little more responsibility (the biggest knock on my current rotation so far). This is from November 1st:

"Today I was faced with a challenge of which I have had on my mind all night. I have been helping to take care of a younger patient who is fighting his SECOND form of cancer in the last 15 years.  This go around has been tough on him. The chemotherapy has caused a lot of pain and a few different infections. He has had a really tough past few days and as a result was experiencing a lot of pain today. I have spent a lot of time with his wife and him discussing the progress he has made each day, the new complications that have ensued, and even just listening to how they are coping. And then today it happened: he straight out asked me, "tell me I am going to make it, please tell me I am not going to die." We are trained to never make promises. We are warned not to make statements promising a patient about an outcome. Yet here I was, wanting so badly to promise him he would make it. I just sat there looking at he and his wife thinking to myself, "How do you answer that?" The truth is, while I was taught what not to do, I don't know if there is a way to teach what to do."

I never finished so it never got posted. The patient ultimately ended up getting a lot better in the coming days. His long term prognosis is still tenuous, but overall, he made it home in time for his 3 year old's birthday and I consider that an enormous success. This job changes people, I just have to make sure it keeps changing me for the best.

~Vaya con Dios