Don S. Dizon, MD, FACP, FASCO

Nov 28, 2013

I am sitting in my kitchen having my first cup of coffee. The sun is shining through the windows, and upstairs, my kids are already awake- running from room to room, as if they are trying to catch a butterfly.

I have just completed my obligatory two-week rotation as inpatient oncology attending. I did not know any of these patients before I started; some were in the hospital due to treatment-related complications; others were in because they were overwhelmed by the symptoms due to the cancer itself. They represented all ages, men and women with different cancers including sarcomas, breast, lung, head and neck cancers. It was a strenuous two weeks, but I am fortunate to have a dedicated group of colleagues who care for these patients in the outpatient clinics and an amazing staff of advanced practice providers who worked alongside me.

Still, even as I adjust back to a more "normal" routine, I find I cannot stop thinking about “my” service. I wonder if some of them made it home for the holiday. If so, are they celebrating with family? Friends? Are they well enough to enjoy a traditional holiday feast? If not, I wonder what their day will be like. I hope they do not spend the holiday alone and that it is filled with people who love them.

For these patients, I find myself hoping that this hospitalization is only a setback, a minor inconvenience in their own lives, and one in which they will recover. I hope that they all will have future Thanksgivings to enjoy at home, fueled by the promise of precision therapies and our ever-expanding knowledge of how to treat cancer. Yet, I am keenly aware that for a few, this will likely be their last Thanksgiving due to the tempo of disease progression.

I do not think my inability to walk away from the wards without looking back is unique. On the contrary, I have had countless conversations with colleagues about this and more often than not, we all yearn for follow-up, for closure. I think in medicine, and especially in oncology, the bonds we form as clinicians and patients are ones not only forged through time, but through interactions, especially those that take place in an acute setting.

As I have been reminded of several times this year (and as clichéd as it may sound), no one is guaranteed a future, cancer or no cancer, remission or living with advanced disease. So, I will give thanks for today, for my family, for the sun shining outside. And I will keep in my thoughts those I have met only recently.

I hope  they know what an honor it was to care for them.



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Robert L. Coleman, MD

Dec, 03 2013 9:59 AM

Don, thanks again for your thoughts. I can't tell you how many times this concept has crossed my mind. I feel for each of our patients, we intersect their journey for a bit of time...sometimes along side, sometime carrying.  But at the times they go back to their daily routine, away from the acute care setting, i often wonder how they day will be, how will it be spent, how will their disease interrupt what they considered routine and have i helped or hindered this.  we are fortunatel to cross paths with so many amazing people with far reaching capacity for adaptation.  But I do hope this consideration goes into the care we give. thanks again my friend

Don S. Dizon, MD, FACP

Dec, 03 2013 1:16 PM

Dear Rob: Thanks for your post; it is exactly the sentiments I wished to share. Even as Thanksgiving passed and service became more and more a distant memory i felt compelled to check on "my patients" who stayed in the hospital, even as I became free to resume a more normal schedule. Words like "routine" and "normal" certainly take on a new meaning after the experience of inpatient attending. it happens every time and certainly, leaving the experience behind remains a challenge, no matter how long I have been in practice. Hope we cross paths again soon. D

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