the man in room 15 presented with a three-month history of hoarse voice, lethargy, anorexia and weight loss. CT chest showed a left hilar mass and mediastinal lymphadenopathy. Bone scan revealed widespread metastases. CT brain, abdomen and pelvis lit up liver mets, adrenal mets, bone mets, pleural effusions, the works. We are waiting for his CT-guided lung biopsy results to come back from the lab. But he is a sitting duck. We all think he is fucked. I'm sure he can tell from our voice and our eyes.
I hae been telling him to eat, to get out of bed and mobilise, in order to maintain his weight and muscle bulk, so he can remain fit for chemotherapy. It's war, I tell him, and you must be fit. You've got to buff up so you can fight it. But what is it all for?
I have seen his family. Met his anxious wife and daughter. They have no idea what he is in for. Will I be seeing them in day oncology in two weeks' time? Will they be like all the others, giving up their own lives to extend his? Will it all be worth it?
The woman in room 18's blood films came back confirming her neutrophilia. Toxic granules and band forms. She has a serious bacterial infection and we are giving her ciprofloxacin. She was asymptomatic so we sent her home. But we haven't found a bug. Perhaps we should bring her back in and scan her head to toe. An abscess, a fistula, anything. Her grandchildren were clueless and a little intimidated by all the goings-on of an acute medical ward. Will they lose their grandmother because the doctors couldn't find bacteria?
The pathologists' middle son got married the other weekend. His eldest has just become a father, and his youngest is graduating from physiotherapy school this year. I was going home on my afternnon off, and he was strolling back to work afater lunch at home, so we were both having great afternoons.
They have all delivered their genes successfully to the next generation. I have only my patients.