The "untucked" patient at night, on the other hand, can be traced to one of two causes:
- The team did not properly "tuck" them in during the course of the day.
- The patient is very sick and "tucking" is therefore impossible.
Looking at her, I was reminded again of why I would never want to do Pediatric Heme/Onc. I know that kiddos bounce back fast, but seeing someone that young face a terminal diagnosis takes a more palpable toll than much else I have seen in the hospital. The next morning, the physician who cares for her during the day, an intern herself, told me that she knew someone needed to have a conversation about the cancer and how bad it looks with the patient, but that she "just couldn't do it." The idealistic, wide-eyed intern I was 9 months ago would have given her the stink eye and yelled at her for being a wimp. Truth be told, it was inappropriate to put off the conversation. I couldn't yell at her today though. I felt like she was recognizing limitations in herself, maturity that she did not yet possess, and it was perhaps too demanding to want her to be as comfortable with the conversation at this stage.
An uncle of mine had a child who was born with a congenital abnormality, which affected the child's development significantly. Sometimes people would ask my uncle how he dealt with it. He never looked at it that way, though. He always said he felt lucky, he felt he had been entrusted this person with extra needs, and it was a privilege, a blessing to be able to take care of this special child.
It's not really the same, but I do sometimes feel that way about oncology. It's not that anyone savors having conversations about death and dying, about bad news and hard fights with poor odds. But it truly is a privilege, it is a blessing. If you're not equal to the opportunity, if you can't see it that way, if you find it daunting to fight the urge to flee from the conversation, perhaps it's best to let someone else do it.