Taken Root

cambodia2 132He was lying on the couch in my living room, obviously suffering, while the rest of the family ate turkey and mashed potatoes and dressing covered in gravy.

My uncle.

Why had he even come?

The adults whispered about his back pain, how terrible it had been the past two weeks, how none of the meds were working.

He was my favorite uncle.

We would jokingly say mean things to each other every time I saw him. “You’re just a silly kid…” He would roll his eyes. I loved it. I loved harassing him back. There was no other adult that I could joke around with like that. You know how it is when an adult treats you like a human being.

But this time my ten year old self knew that I should not say a single word.

Just stay away. Keep your distance. 

He had to be helped to the car…

That was the last time I saw him alive.

One week later he was dead. From melanoma. His back pain was from the metastatic lesions in his spine.

My mother went to stay with him at the hospital because his wife could not do it. She could not sit there and watch him die. I hated her for it, my aunt. It was her third husband…

He was my favorite uncle, not a third husband.

“Where did the melanoma come from?” everyone asked.

More whispers.

It was a “benign” mole on his leg that had been removed by his family doctor that had not been sent to pathology. It never healed right. It grew. It spread. It ate away at him until there was nothing left.

Medical error.

For a time I hated all doctors, especially family doctors. Stupid, stupid people. They killed him.

And then I became a family doctor myself. Everything goes to pathology. Everything.

I have patients who like to banter at me like he did and every time I engage with them, I think of my uncle. I wonder if he was angry with his doctor. What would he think of me becoming one? Who would he be now if he had had access to treatment like Jimmy Carter?

Who would I be? Might I have missed a melanoma myself? Been careless?

With each new medical breakthrough there is the joy and miracle of lives saved, but it also deepens the tragedy of those lives already lost.

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71 thoughts on “Taken Root

  1. Timely. Dentist found a nicer on my tongue at my cleaning today. It is not painful, I did not know it was there…as a nurse I know what a painless ulcer could mean. How I wish it hurt. Follow up in two weeks and decisions if no change. I….am….terrified.
    It’s probably nothing, probably an overactive imagination, but…my coffee suddenly tastes amazing. And dammit if I’m not going to enjoy this holidays treats. Suddenly everything seems finite. The curtain is pulled back. Exhale…

    Liked by 5 people

  2. Ah those regrets will bring you down every time. You can’t live like that. You have to let go. As long as you have done your best. What more can anyone do? There are worse things than dying. Living with regret is one of them.
    Leslie

    Liked by 1 person

  3. “Each new medical breakthrough…deepens the tragedy…” Sigh. True, but the only way to repair the mistakes of the past is to learn the lessons (everything goes to pathology) and avoid making those mistakes again. Rejoice in being part of the solution.

    Liked by 2 people

    • It struck me as I was writing it how his loss is connected now to so many other lives. I like to think he has managed to save a lot of others over the years. He affected my approach to patients, but also his PCPs approach to future patients, the patients of others that were involved in his care at the end. Who knows who else? It is easy to see the end. It is not so easy to see the futures made possible by that end when we are wrapped up in our own grief.

      Liked by 2 people

      • Absolutely. Your grief, whether consciously or not, certainly affected your decision to go into medicine. When you got there, it affected how you treat your own patients, and they are better off for it. You have made your own mistakes, and learning the lessons from those errors benefits your patients in the future. We all live in this river of experience. Most of us are not the authors of major breakthroughs, but we can all make things better downstream using what we learned upstream. Press on and do Good!

        Liked by 3 people

  4. “With each new medical breakthrough there is the joy and miracle of lives saved, but it also deepens the tragedy of those lives already lost.”

    No. We don’t need to grieve that way. The lives lost and the advances since then go hand in hand. You CAN’T have one without the other.

    Liked by 2 people

  5. The last line of your post got me because it’s so painfully true. There are always those who didn’t quite make it to the finish line of new medicine, the end of a war, the long-awaited rescue. I’m sorry for the loss of your uncle, even after all this time.

    Liked by 1 person

  6. Melanoma scares me to death as a freckled redhead who never had much in the way of sun protection as a kid. It’s scary how that one spreads. Thank you for your dilligence on behalf of your patients (for all things, but especially personal ones like these). ((HUGS))

    Liked by 1 person

  7. Thank you for writing this. I’m so sorry about the loss of your beloved uncle. You are honoring his memory in the wonderful caring attitude you have for your patients.

    Amen to sending everything to pathology. I was fortunate with my melanoma for it to be in a spot on my arm that was readily visible when I started wearing short sleeves again in the spring. I have a lot of moles and dark spots and tan easily, but this one was the “ugly duckling” that didn’t look like the others. Fortunately my family doctor removed it in its entirety and sent it to pathology. The report said it was in a very early stage, but I still had to have a big chunk taken out of my arm just to be sure (5mm. in each direction.) I have an ugly scar there, but my dermatologist says it is much better than the alternative. I see her every year for a skin check. She has mapped my moles and compares measurements at each visit. I always sweat it a little during those checks, but I figure if something new comes up at least it will be caught before it can spread.

    Liked by 2 people

  8. I’m in the boat with Trailer Trash (that phrase made me giggle). Mine was found at a stage 0, which, if you’re going to have cancer is the one to have. It was removed within 2 weeks, and I get frequent checkups.

    Preventive medicine works.

    As for your uncle, losing people is so hard. So devastating. It impacts the whole rest of your life and how you live it. I think becoming a doctor was a great way to honor your uncle — because you can’t bring him back, you can just hope to help others avoid the same fate. So bravo!

    Liked by 2 people

  9. I like the way you say Everything goes to pathology. I really, really like that. There’s always a panic when specimens are sent, and we patients think, “OMG what does she think it is,” but it’s always so nice to get the relief call that “Everything came back normal.”
    But when it’s bad news…Ugh.
    I’m sorry about your favorite uncle. Many childhoods bear the wounds of lost loved ones who made them feel special. He must have been a great guy, I’m sorry for your loss.

    Liked by 1 person

  10. I love the picture for this post. And what a wonderful message to everyone. I have had two pre-cancer spots removed and see a dermatologist. But I still love being in the sun on THE River. I try to use strong protection now. But I am another red haired freckled kid who spent hours and hours in the water and outdoors. Melanoma scares the crap out of me. thanks for the reminder and good message. Your Uncle would be very proud and you honor him every time you have someone go get checked out.

    Liked by 1 person

  11. My favorite uncle died of lung cancer when I was very young, maybe only in kindergarten. While he was lying in the hospital, knowing the end was near, he called and asked to speak to me. For whatever reason (maybe it was the tone in my mother’s voice), I was too scared to pick up the phone. He died, and I never got to see him again. I’ve felt guilty about that ever since.

    Liked by 1 person

  12. Medicine is not a perfect math equation. Too many unknowns for everything. I almost died from a ruptured appendix because they didn’t know what it was. Luckily they finally decided to open me up and look. An appendix! How could you miss that? But I didn’t have classic symptoms. I think most doctors do the best they can.
    Still, so hard to lose a favorite person. His spirit does live on in yours though. (K)

    Liked by 1 person

  13. I was so happy to hear of Jimmy Carter’s prognosis. Wow. We have come such a long way since your uncle’s misfortune. Sorry for such an early exposure to loss. I understand that one.

    I, too, was one of those pale, freckled kids who worshipped the sun, peeled frequently, and deals with all kinds of skin issues now, many genetic. I’ve been told by dermatologists that they are harmless. Still. Wise to send all issues to pathology. Good for you, Doc.

    Liked by 1 person

  14. I couldn’t comment on this the first time round but I can’t shake it.

    “With each new medical breakthrough there is the joy and miracle of lives saved, but it also deepens the tragedy of those lives already lost.” This applies to 2 of my family members. One lost to HIV and the other to cancer.

    In respect of doctors missing things – I don’t know that the cancer could have been beaten but I do know that the doctors focused so much on her leg injury and blamed all her symptoms on it until a lump literally grew on her throat and she started spitting blood. Then they realised she had cancer. The size of the tumour in her body was unbelievable. It was everywhere and attached to everything. She died 3 months after the correct diagnosis. Maybe…

    Liked by 1 person

      • It’s OK. It was a hard lesson but it’s in the past now. Now I get a second and third opinion on everything. This has already paid off at least once. A piece of glass cut my foot quite deeply recently and the ER doctor insisted it was just a cut and put in 6 stitches. I asked her repeatedly and specifically to please check my tendon. “Don’t be dramatic,” she said. I knew that pain was not just a cut. I almost never feel intense pain. Due to a birth injury the right side of my doesn’t feel pain unless it’s severe. She discharged me immediately. I got up off that bed and i nearly fainted and she said, gosh. Do you want a wheel chair for effect? She was smiling though. She genuinely thought i was faking it. I limped home and took myself to another doctor the next day. I was right, my tendon had been severed cleanly and my toes were, by then, hanging limply. 2 surgeries later I have partial movement in my toes. I’m grateful.

        Liked by 1 person

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