The Seventh Dwarf

I was sitting in a consultation room having just taken a brief history from a new patient. New to us, anyway. Not new to him – he had been referred to our team with his fourth recurrence of a particularly fickle malignancy. He’d been treated further afield, but this time decided he didn’t want the travel. Cynically, I wondered if his specialists had flicked us a literal hospital pass.

He needs a name. Let’s call him Mr Sherrin.

He was our last patient of the day. I took a good history. Talked with his wife. Had a look at the problem. It was pretty bad. Ugly, obvious, fast-growing, metastases all over the place. Disfiguring.

I handed over to the consultant. He and the registrar came back to the consult room and we all had another look and a feel and the consultant talked about treatment options. Cures are off the table, this is palliation. The treatment might slow things down or make them worse.

Mr Sherrin is not young but he’s not old either. Mrs Sherrin is visibly anxious but Mr Sherrin is quite calm. He wants to give it all he’s got. There is no hesitation as he opts for treatment.

I was watching the consultant, talking, feeling the lumps, asking questions of the Sherrins and the consultant. I wondered, for the umpteenth time, how oncologists deal with the daily load of poor prognoses. Who drinks? Who swims? Who prays? Who kicks the cat? Who washes their hands at the end of the day and leaves all the work in the sink?

Somewhere in amongst all this, Mr Sherrin and I had a long moment of eye contact. We knew what we knew. As that moment passed, I felt a rising tide of grumpiness.

Cue lightbulb.

I’m not welling up and I genuinely, honestly, don’t feel sad. I feel grumpy. Not about anything, or toward anyone.

I’m not angry with death, and I’m not afraid of it or uncomfortable around it. I know, and I feel, that I’m not part of the life and death stories around me any more than a flight attendant is part of a traveler’s holiday.

Something in the way I’m emotionally and intellectually processing what I’ve learned and experienced on this rotation is producing a consistent response, because that grumpiness has been here pretty much every night for a month.

I guess I shall stomp off somewhere soon and get my head read. Come up with a better plan. Life is not a Disney movie, but Grumpy is no way to be.

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