This job is a little surreal. Where else do you get to say this to a complete stranger:
"Yeah, hi, my name is Runningdoctor; we met briefly up on the floor before your discharge...
Okay, I know you met so many of us, so it's no surprise you don't remember me. I was the last one to see you up there. Remember how we ordered that MRI of your head? The results are back and it looks bad. It looks like the cancer spread to your brain...
No, it's not good. It's probably why you have been feeling so confused and haven't been able to talk...
I have talked to the radiation oncologist and he'll call you in for a talk about radiation, probably Monday next week...
You can't really do much, other than wait. I wish I didn't have to tell you over the phone, but this couldn't wait. Have a good day."
I don't remember anything about this guy. I met him for five minutes last week and now he'll remember the day I called him for the rest of his short life. I imagine him standing there with the phone in his hand, facing a Wednesday afternoon of knowing he has brain mets.
I think a lot of about death these days. It seems so obvious, but we all really have to die at some point. We only get one shor life and that's it. I have gotten a pretty solid version of "the talk" down, ie. when I have to tell people they are dying. For some reason, I have become the guy up on the floor who gets to tell people they are dying.
There was a big guy with tattoos, who scared the nurses and everyone else. He was so mad at the world for having gotten lung cancer that people avoided him. He had a kind of cancer called small cell lung cancer, which is typically very bad. One day I told him I thought we should discharge him, and that there were some tests we could do as an outpatient. He made it clear that he didn't want to leave, until we knew "what was going on". He had mets everywhere and was dying but apparently didn't know it. So I thought, hell, let's see what happens if I tell how bad it looks.
So I told him, and the room came unglued. But in a good way. No one had told the guy that when you have cancer everywhere, you generally die very fast. He was scared out of his mind of what was next. More chemo? More radiation? More of being 52 and walking around in your underwear in the hospital? More pointless rectal temperatures?
I told him nothing was next. That he should go home and enjoy it while he could. He cried for a long time; I think he was relieved more than anything. Okay, I cried a little, too.
But about "the talk". People always never get the fact that they are dying. So I tell them something like this:
"It's terrible. There is nothing we can do (then I explain the details of their disease). It wasn't your fault that you got this; you just got unlucky. It's like being run over by a truck, only your running over involved chemotherapy, and it took longer. I think you have fought against this long enough. You are losing the fight."
It's a strange job.
I have thought about mortality a lot. What if I died right now? What would my regrets be? My spinal reflex answer is always "I can't believe I lived the last half year of my life without my kids". On the other hand, little gripes mean absolutely nothing.
My running is good, thanks. I have lost weight; saw 64.3kg on the scale the other morning, which is a modern-day record. Been doing some speed work in preparation for a race tomorrow. It's the regional masters championship; I'm running the 5000 (the Girl is running the 1500). I have to get under 16:30 or this would be a complete disaster. 16:20 would make me happy. 16:15 would make me thrilled. I feel fast; if someone goes out in 16 minute pace, I will stick to him like glue and see what happens. I can't wait.