The sense of loss extends beyond the death of a patient

At the end of the year, I find myself thinking about patients usually—and especially those that have passed away. I wonder how their families are coping, how their children are, and whether each day has gotten easier. I think about how my patients died—and whether or not I did enough to ensure that they did not suffer.

It’s an odd thing about oncology—we come into our patients’ lives at such a critical time: when someone faces a cancer diagnosis, and the possibility that they might die of that disease. We get to know them beyond their cancer—we get to know who they are, what they do/did for a living, about their medical history, and about their family. We get to know that family, their friends, and share in each triumph (like the birth of a new grandchild, or graduation of a child) and each sorrow (death of a spouse or parent). Yet, when those patients die, our contact with these “others” goes away too. It’s at the end of the year I realize this the most: that I’ve met some really great people through my patients, and I wonder how they are and discover in some small way, that I miss them as much as I do my own patients.

Some of my research I began at Brown focuses on the concept of the social network. No—not on social networks envisioned by technology, but on the relationships people form, within family, friends, church, and community. I’ve wondered how these relationships affect decisions, particularly at the end of life, and how we as doctors make assumptions often in the routine care of our patients. How often have you thought: “That man bringing in Mrs. X each week for paclitaxel must be her son—he seems so devoted”? Only to learn that that man is a friend from church with no relationship to her.

I wonder how unique my experience is—this “sense of loss” that extends beyond the death of a patient, but also of the social networks you were lucky enough to be a part of for as long as that patient was under your care. I bet I’m not the only one.

So—for all of my patients, alive and dead, and those who provide(d) the support to help make life a little easier, I want you to know that you are in my thoughts. As the song goes …

“Should old acquaintance be forgot, and never brought to mind,

Should old acquaintance be forgot, and old lang syne.

For auld lang syne, my dear, for auld lang syne,
we’ll take a cup of kindness yet, for auld lang syne.”

Don S. Dizon is an oncologist who blogs at ASCO Connection, where this post originally appeared.

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