Case continued:
You see speak with Mr. M’s oncologist later in the day and she tells you she spoke with Mr. M and told him that there were no good options left for chemotherapy for his cancer and she recommended to him that focus of his care should be comfort and advised a referral to home hospice.
The next day on pre-rounds you are surprised to see Mr. M in a very different state than the day before. He is agitated and tearful and tells you that his pain is not better then it was when he first came in to the hospital. A careful physical exam shows that his vital signs are normal and his abdomen is soft, just minimally tender in the Left upper quadrant and his rectal exam shows small amount of soft stool.
Student MD: “Good morning Mr. M how are you today”?
Mr. M: “Well, not very good, listen I am still in pain, the pain is the same as it was when I came here yesterday, in fact it is worse! Nothing is working, this place is awful, no one is doing anything for me, here.”