Saturday, October 3, 2009

Full circles

Patients die almost every day in our inpatient unit. Some of them have been my patients but, up until these last few weeks, they have been patients handed down from the previous fellow or one of the attendings. Suddenly, two of my "full circles" just died; patients I had known from their diagnoses till their deaths.

One lady had breast cancer and didn't want conventional chemotherapy. I don't know what to say about her choice. Hopefully, it wouldn't have made a difference. When I first saw her, she didn't look sick, except a big belly from cancerous fluid. She had 4 very good months and two not so good. She wanted to go to hospice but died before we could get that far. When she died, it struck me how much more striking the death of a "full circle" patient is.

The other one was an old man who I only saw a few times. He had a lymphoma that killed him surprisingly fast. I was telling him one week that he looked strong and that he would probably do okay with the chemo and would, perhaps, be cured. He didn't and wasn't. He changed so much from the time of diagnosis until before his death that it was hard to imagine it was the same person.

Speaking of full circles, we have been here almost a year. The long days are long gone. A few months ago, our long runs in the woods would finish in daylight at 11. Now, it's getting dark at 7. In a few months, it will get dark at 3.

My running season is almost over and it's time to build a base for next year. I came out of Transalpine in great shape but there is no time to start building up to a big race or a PR attempt. I actually look forward to getting into a training rhythm, hopefully as good as last winter.

I had a good season. My 16:15 5000m in the rain and wind was probably the high point. I know I could have PRd if I had had competition and no wind. I won a lot of races but got no PRs, despite hitting some very good form in the spring. The summer and fall were dedicated to "for fun" races, most notably Voyageur and Transalpine. I wasn't really injured all year. If next year is as good, I'll be more than happy.

We are planning the race schedule for next year.


Danni said...

That must be so tough. I hope you have a good system for "self-care" so that the sad side of your profession doesn't get you down.

SteveQ said...

Having dealt with so many deaths, I've found that one is either remarkably lucky or remarkably unlucky if their last year or two isn't awful. You reminded me of how I had to have someone tell me which patient was my grandmother and how I kept people from visiting my mother in the last weeks, saying "you don't want to remember her like this."

On the opposite end of the spectrum, when I worked at the University of Minnesota hospital, I'd see swollen, jaundiced lethargic kids, then forget about them only to see them again six months later, after liver transplants, being chased down the halls by nurses, laughing as they ran.

Be sure to remember those rare happy endings!

I haven't even decided whether next year I'll be racing short or long, seriously or for fun, close to home or as destination races.