KIDS CHANGE EVERYTHING

There is no doubt that having children changes one's perspective on life. However, I was not aware of how much it can also change one's perspective on work.

Today, on rounds in the hospital, we walked into the room of a man my age with metastatic, incurable pancreatic cancer. He was admitted with severe pain despite prior cycles of chemotherapy and a PCA (patient-controlled administration) pain pump. The latter is a device that allows the patient to hit a button to dispense high doses of intravenous narcotics on demand. The Heme-Onc fellow and nurse practitioner on the team who had met him before said his body was a shell of its former self, and it was clear that he had lost a lot of weight. He had lost so much weight, in fact, that it hurt him to lie for prolonged periods on his back or on his side due to the lack of any subcutaneous fat.

This morning he was in visible pain and said that his hospital bed, which had been changed to a more comfortable air mattress the night before, was unbearable. He begged us to send him home after a planned procedure to essentially abolish the abdominal nerves that his cancer was compressing. We explained that we wanted to ensure that he was stable after that procedure and that we did not want to discharge him too soon only to have him get re-admitted several days later. He pleaded with us, at which point his mom, who was also in the room, tried to convince him to stay while also trying to advocate strongly for us to help make her son comfortable.

I could see the powerlessness in her eyes, but, in them, I could also see how she would have been willing to give her own life to save his in a heartbeat... if only that were an option.

This patient's situation. This family's situation made me think of my own son and my own daughter and how sick I would feel if were in that mother's position facing the prospect of having to bury my own son. I have never cried on rounds, but I struggled to hold back tears and quickly excused myself after we were done comforting them.

Kids change everything.

When I got home, I gave Nicholas and Cate big hugs. I was extra patient and extra fun tonight because I was reminded how precious they are and that life is (to quote my former Chairman of Medicine Dan Foster) "until further notice."