What Dr. C Saw
And What I Missed
Here’s a little something most in the non-cancer world might not know: the moment you find out your diagnosis becomes its own small stage play, complete with lighting, props, background characters, a carefully crafted script, and two main characters: the DELIVERER OF THE NEWS and the patient.
To be clear, just days earlier this patient (which is to say, me) was happily not a patient. I was a person. I was someone who didn’t provide her birthdate multiple times a day to anyone who asked (did we all know that the medical world is PRACTICALLY OBSESSED with our birthdates, and yet not one member from this community has ever sent as much as a happy birthday card?). I actually had all kinds of other interesting titles, like co-worker, mom, friend, and romantic interest (that’s another blog!).
In any case, the day you learn your diagnosis your title shifts. Patient becomes top billing in the pecking order, and all other affiliates immediately become in service to this new moniker.
You remember everything about that moment.
Faithful readers might remember that the day I learned I had Stage IV cancer, I was in a room at Stanford Hospital on a Monday, but I had expected to learn the results of my biopsy the following day. I was admitted to the hospital the night before, in part because my fever had spiked again (north of 102 is never not awful), and also because anyone who had read my chart probably knew the odds were strong that my biopsy news would be grim.
Still, oddly, that Monday morning I didn’t feel all that sick.
So it was that around 10:00am, a hospitalist named Dr C entered my room. He introduced himself, and pulled out what looked like a small stick from his lab coat pocket. But it wasn’t a stick at all. Within seconds, his stick magically unfolded into a small stool, or more like a saucer perched on three small pegs.
I knew immediately what this little device was. I had seen it just a week before when I was at the US Open at Pebble Beach. I had gone to watch the best in golf with some friends, and noticed that all kinds of clever fans had perched alongside putting greens with these handy collapsible stools in order to save their backs, and to savor the views of the best putters on the planet. I wondered then – and then also with Dr C – where these little contraptions were sold. I also marveled at our world for a minute: how remarkable that it may have taken 2,000 years for someone to invent a tiny little chair you could fold into your pocket. It was like wheels on a suitcase – so obvious, and yet how many generations of souls survived without an easier way to lug their luggage, and for a quick seat with no chair in sight?
Anyhow, there was Dr C, unfolding his tiny stool. Why was he in my room at all? And did he buy his collapsible chair at the Pebble Beach gift shop? I wondered if he played golf. Did he golf all the time? Did he get into medicine only as a way to play more golf? Did he think he was impressing me with his cute little seating contraption? I wondered if he took his miniature chair with him everywhere. Did he annoy his colleagues in the break room with that lame chair? Maybe he had a couple of kiddos who played soccer on the weekends and they practically begged him every Saturday morning, “Dad please. Don’t bring your minuscule chair.”
This was all going through my head while Dr. C got right to the point. “Well I’m afraid I have tough news. You have Stage IV metastatic colon cancer. The cancer has spread from your colon to your liver, where you have a 15 cm mass. It’s a tough diagnosis. Kind of like a kick in the shins. I’m sorry.”
What happened next was a blur of chaotic questions and evasive answers, but mostly what I remember is how preoccupied I was with Dr. C’s slightly adorable collapsible chair, that magically appeared out of his lab coat pocket.
He left. I sobbed.
And because he delivered awful news, in the stage play that swallowed me whole, Dr. C was a haphazard cameo. A character with few lines, and a pathetic prop.
But as it turns out, Dr. C prepared beautifully for his walk on part. And I missed it completely, and just recently realized it.
Just days ago, while mindlessly scrolling through my twitter feed, I discovered a thread from a doctor, whose own mother was in the hospital, battling something serious. This doctor decided to write some smart advice as a physician to other physicians, but from the point of a view of a daughter of a patient.
She had a smart set of reminders: explain in plain English plans for discharge, both to the patient and their caregiver; speak loudly because we’re all wearing masks in the hospital these days; describe in better detail how medications you take home will work.
Oh and she wrote this – invest in something called the Rounding with a Purpose Stool.
A collapsible little chair, where you can sit and look into the eyes of your patient when you deliver important news.
She concluded her thread by simply saying, “Take time to listen.” While sitting on the little stool. At eye level. With your patient.
Oh Dr. C. Did you have that little stool in the trunk of your car? And did you read my chart and hustle all the way back to your car before entering my room? Or was it in your locker where you stow your workout clothes? Or did you maybe it borrow it from another doctor?
All I know is that you had it with you. On purpose. Because you knew that you were the one summoned to tell me the most awful news, and you knew how important it would be to look into my eyes, rather than stand there and hover over my bed, with a terrible hierarchy of height that wouldn’t at all be true.
Because there’s nothing more vulnerable than learning that you’re sick, especially when you feel well. And if you’re the one delivering that news, there’s nothing more important than bringing as much empathy, compassion, and humanity as you can offer.
I suspect Dr. C knew then – and knows now – that someday he’ll be on the receiving end of similar news. And that even though he’s a doctor, he doesn’t hold any kind of hierarchical power in this gorgeous adventure called life. And because of that, he knew his most important job that day – that impossible Monday, July 1, 2019 – was to simply (and profoundly) be a good soul, sitting at eye level. Sharing the most sacred space of all: the space that says, come, it’s time, be here, draw closer to the fragility of life, and be brave.
I see you.