I was reminded of this with a recent patient, whom I met in clinic. He had recently been diagnosed with an aggressive form of prostate cancer. and wanted to transfer his care to us
I could not point to anything he had done to increase his risk for this cancer. It was caused by mutations that occurred by chance. He had lost the genetic lottery, but I did not feel that explaining this to him would provide much in the way of comfort. Rather, I tried to focus on what we might do to help him. I explained the odds were long and that he had already had a "Hail Mary" with his first treatment that took place when he was quite ill in the hospital. I was concerned about what more we could do to effectively shrink the cancer. Despite that, I explained that we wanted to be aggressive about reducing the symptoms the cancer was causing. With that, I admitted him to the hospital for further work-up and symptom management.
He and his family seemed relieved to be going back in, but I could also sense that they felt overwhelmed. I cannot imagine what it is like to be in there position. The only experience from my own life that comes close is when my mom was admitted after a surgical procedure. Fortunately, one of my med school friends knew her doctor and put us in touch. Over the course of that weekend, her doctor kept me updated and even listened to my many suggestions. I felt empowered knowing that I was playing a productive role in helping my mom get better.
I now appreciate that families who come off as "demanding" or "difficult" are just trying to advocate for their loved ones. Let that be a reminder that we should all be so lucky to have an advocate like that.
