By Thomas E. Creighton
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Extra resources for Molecular Properties
The initial treatment had failed, an experimental drug was being offered with “less than 25 percent chance of success,” and he was having ongoing pain that medicine poorly controlled. Stopping chemotherapy had not been considered. The adult children lived at least three hours away by plane. Prior to this call, he had no primary physician in his hometown. On my first visit to his home, we concentrated on pain control, and I prescribed ibuprofen, a mild but often effective drug when given regularly several times a day.
We should take advantage of that accessibility. The physician needs to explore the patient’s values. Failing that, one may inadvertently provide unwanted care or find unexplained conflict with the patient’s wishes. There is more to comfort than pain control. Even when it seems we can do no more, we can do a great deal. ” Even if someone’s body cannot be healed, there is still the opportunity to find comfort in resolving conflicts and healing relationships. Part of our responsibility as members of the healing professions is to facilitate that process.
The gastroenterologist and the surgeon were managing her case, each taking care of only part of her. She had no primary physician and no close family. I reviewed her hospital chart, interviewed and examined her, and made recommendations regarding the management of the diabetes—not a difficult task. In addition, I wondered if anyone had asked her, “What’s this like for you? ” So I asked. The experience was overwhelming, she said, a nightmare. Given the seriousness of the diagnosis and the hopelessness of the outcome, she would prefer that treatment cease; all she wanted was comfort.