Student MD: “Could you tell me what you are most concerned about now, Mr. M?”
Mr. M: “I don’t want to be dependent.”
Student MD: “Could you tell me more about that?”
Mr. M: “With this getting worse…I’m worried I won’t be able to control my urine and stool…it’s so embarrassing.”
Student MD: “I see…I can understand your concern. I’ll make sure to talk to the team about what best can be done with medications and arrangements at home to keep as best control possible of your bodily functions. We’ll talk again about that and clarify that before you leave the hospital. Can you tell me what else is on your mind in terms of your condition and the future?”
Mr. M: “Well…to tell you the truth, I’ve really had enough, enough of the chemo and x-rays and tests and being in the hospital. I’m sick of being sick. Dr. X (my oncologist) basically said that there wasn’t much treatment left anyway. I just want to be home and be comfortable. I just don’t know how to tell my wife and kids. I’m worried they’ll think I’m giving up and I don’t know if they can take that…”
Student MD: “That must be incredibly hard to feel that kind of responsibility and worry about your family. I’ve heard your wife say how hard you have fought this disease. I’ve also heard her say how much she wants you to be comfortable. I also know that even without getting chemo, there are a lot of effective treatments to treat your pain and other symptoms to give the best quality of life possible for the time you have left. Do you think it might be helpful to have the team talk with you and your family together about all this, about what treatment we should focus on and how you are feeling?”