werner@aecom.UUCP (Craig Werner) (11/01/85)
[Are these excepts being read and liked, or should I stop? -CW]
A Piece of My Mind
Classic Case
JAMA Nov 23/30 1984, 252:2886
"N.W. is a 42-year old white male who received the diagnosis of
squamous cell carcinoma of the lung two years prior to this hospital
admission after presenting to his physician's office with complaints of
blood-tinged sputum and shortness of breath. His physical exams
revealed..."
The speaker rambled on in the cold matter-of-fact banter of modern
medicine as the diseased products of Mr. W's autopsy were projected on the
screen.
"The slide illustrates quite nicely a metastatic nodule in the
right cerebral hemisphere..."
My mind drifted back to the night NW was brought to the hospital.
It was a cold dark night with the autumn drizzle enhancing the eeriness of
the florescent corridor. The tone of my pager sounded his arrival; the
nurse warned me that he didn't look good. The room was dinly lit when I
arrived; his wife and two sons were silently gathered at the foot of the
bed. His eyes were transfixed on the ceiling, bulging, threatening to
explode. Sweat poured off his body as he summoned the remnants of his
waning strength to suck air into his cancer-ridden lungs. I shook him and
shouted, "How do you feel?" (My stupidity amazed me. " How the hell do
you THINK he feels?" I thought to myself.) His gasps persisted as his
empty gaze turned slowly towards me, but he didn't have the strength to
reply.
I bounded into action, reflexly ordering blood tests, cultures,
X-rays, cardiograms, IV fluids, antibiotics, respiratory treatments,
oxygen -- everything the medical armamentarium could offer to make this
poor creature feel more like a human being and less like a frightened fish
washed ashore and left to suffocate on an empty beach. His gasps grew
louder, more agonal, more like the death rattle. I worked on through the
night, racing down the halls with arterial blood samples, methodically
puring over the old charts, the lab results, the graphs, and the
textbooks, realizing more and more that the game was over, and that just
as this arduous night would end, so too would this man's life.
I stood beside him as the sun peeked into the room. The left side
of his body was twitching spasmodically. His respirations grew shallow,
less frequent, and more innefective, and finally stopped altogether. I
turned off the Oxygen, then the IV, and closed the lids over his weary
eyes. His long struggle was finally ended and his new found peace must
surely have been euphoric.
After NW died, I found his family in a smoke filled waiting room,
anxiously drawing thick clouds of smoke into their precious lungs. I
wanted to say I was sorry, that we did all we could, but their cigarettes
destroyed my sympathy. His death had lost its meaning, and I had lost
any hope that we would ever see the light.
Robert J. Havey, MD
River Forest, IL
--
Craig Werner
!philabs!aecom!werner
"... Has Determined That Cigarette Smoking Is Dangerous To Your Health"abc@brl-sem.ARPA (Brint Cooper ) (11/04/85)
DON'T STOP -- KEEP THEM COMING! We buried my wife's father as a result of lung cancer barely 2 years ago. Ten years ago, my little 10 year old son used to beg his grandfather to give up smoking. Now, my 20 year old son carries on his grandfather's torch. Maybe someone can get thru to someone else, etc. Sigh... Brint