Bad news at the wrong time from the wrong person.
The waiting game begins again. It was different this time. The last time she was in for surgery, five years ago, we knew what we were dealing with, and so the time post-surgery was focused on healing her body so she could go home. This time, while we were focused on the healing of her body, we were also dealing with the fact we didn’t know what we were dealing with, and how much of a problem it was going to pose for Joanie.
I had been hoping against hope it wasn’t metastatic cancer, but I think I knew in my bones that’s what it was. However, no one had told us yet exactly what she was facing, so I hung on to that hope.
When I got to the hospital Friday morning, I stopped at the nurse’s station and asked how she did overnight. I was told she did well, and there hadn’t been any problems. I went to the door of her room, and found her awake, and in fair spirits. She was still dealing with pain, and her ribs were sore from being spread during the surgery. When she saw me she gave me a weak smile, and asked me how my night had been. I told her it probably had been better than hers. Then she looked at me and asked me, “How does my hair look ?” I smiled at hearing that question again, and told her it looked great. Whether she believed me or not, I didn’t know, nor did I care.
Her nurse for part of this day came in to change her bedding, and get her cleaned up a bit, and I went out for a smoke and to pick up some coffee from the lobby coffee cart. Later that morning, her room began to take on a familiar look as the flowers began to arrive from many of her friends. She took calls from her brother Dick in San Francisco, Mikey Hoeven and her sister Ann, and seemed to be handling it all in stride, until shortly before noon, she told me she was going to take a nap. I went for lunch.
That afternoon, her sister Ginny stopped by to check in on her, and she also got a visit from Dr. Maddaus. He stopped in to brief her on the surgery. He told her basically the same thing he had told me yesterday, but this was the first time Joanie had heard that he had taken lymph nodes for biopsies while they were removing the two lobes of her right lung. She liked Maddaus, and didn’t ask him any questions, and even thanked him for taking good care of her. He told her she was going to do well, and, as soon as the chest tube stops putting out drainage she could think about going home.
He made no mention that afternoon about the pathology report regarding what kind of cancer it was, or if the lymph nodes were positive for cancer. I assumed it was because the reports weren’t back yet.
It was late Friday afternoon, and as I was outside having a smoke, you could see it was shift change time. I even saw a couple of the nurses from 7C on their way out, and one who was on her way in. The weekend had begun, and with it came the slowdown in time. I went to Sally’s for a beer and burger as I had done many times before, and then back to spend the rest of the evening with my patient, Joanie.
She was still feeling the effects of drugs and the surgery, and would drop off without warning, and come too without warning. She would just look at me when she came too, as if to see that I was still there, and drop off again. That would go on for a few hours, until she would tell me it was okay to go. As I reflected on it, it was a familiar scene, one that had been played out more times than we cared to think about.
Saturday came, and when I got to her room, I heard the same question, “How does my hair look?”I began to see this as a theme to this episode of her hospital stays, and I made note of it. I told her, as I always did, it looked fine.
There were more flowers today, and more calls from her friends, and then my sisters, Jane from Fargo, and Joni from Avon showed up. It think this was about the fourth time they had made the trip down. They had a chance to see and visit with Joanie, and wear her out a little bit before we headed downtown for lunch. It was always a welcome respite from the reality of the hospital, and every caregiver needs a break now and then, even if it is a brief one.
When I got to Joanie’s room on Sunday morning before eight o’clock, she was awake, but seemed a little loggy. The phone rang at eight, and it was her friend Mary Pat Woodmansee from Bismarck. Her face seemed to become brighter as she talked with her, and I thought it was a good way to start out the day. After she hung up, the first thing she asked me was, “How’s my hair look today–bad?” This time I laughed, and she asked me why I was laughing, and I told her she didn’t even realize how many times she has asked me that question since Thursday. She just smiled and shrugged.
Ginny and Ed stopped by later in the morning, and she was glad to see them. She seemed to get some energy from certain people, and they were among those she did. While they were there, we were visited by one of the residents who was working with Dr. Maddaus, and I just figured it was part of his training to stop by and check up on patients whose surgery he had been involved with. Then, as he sat there in the room, he dropped a bomb that set me off. He began telling Joanie that it looked like they were dealing with metastatic cervical cancer, something neither Dr. Maddaus or Dr. Carson had said a word about. When I heard him saying that, I found a way of ending the conversation, and after he was gone, as I walked out with Ed and Ginny, they were both surprised at what they’d heard. I was not only surprised, I was pissed.
I don’t think Joanie realized what he was saying. She asked me if I knew what he was talking about, and I told her I hadn’t heard a thing from either Maddaus or Carson, but the next time I see Maddaus, I would ask him about it.
I would have that opportunity the next day, when Maddaus along with the resident stopped in Joanie’s room to check on her. When they were done, as they were leaving, I asked to speak to Maddaus alone, and when alone, I said, “I think this resident will make a fine doctor someday, but I didn’t think it was appropriate for him to be talking to Joanie about what is going on with her when he is not her doctor, and any news about her situation should be coming from either you or Dr. Carson.” I was proud of myself, I told him what I was feeling, and did so in a manner that was cool and calm, but left no doubt that I was not happy with what had happened. He told me he understood, and appreciated my comments, and it was left at that. We didn’t see that resident again for the rest of the time we were there, and Joanie never knew anything about my conversation with Maddaus. Also my respect for Maddaus was not diminished in the least. His care of Joanie was nothing less than highly professional, and the relaxed, confidence he presented in his relationship with her as a patient could be used as a model for doctor-patient relationships everywhere.
I chalked up the episode to my belief if she was going to hear bad news, and there had been plenty of those times, it should be coming from the one person she has confidence in, and that is her doctor, not anyone else.