Sadness Revisited

The last two days I have encountered worrisome laboratory findings waiting for me when I logged onto my computer in the morning. Yesterday, there were abnormalities in the bloodwork of one of my prenatal patients. After discussing her case with the OB specialist affiliated with our clinic, I had to send her straight to the hospital for a potential induction of labor even though her baby is only 33 weeks along. One of the sweetest parts of providing prenatal care is how one patient gets wheeled into the labor room but two, hopefully healthy, individuals emerge. However, one of the scariest parts is that both individuals are in danger when crises occur with the pregnancy or delivery. Hopefully, this time all will turn out well for both mom & baby.

Today, I pulled up the labs from my patients yesterday on my way into our weekly staff meeting. At the top, was the blood panel I'd ordered on a 7 yr old boy with a nosebleed. Mom mentioned that he seemed to bruise easily, more easily than his older brothers, so I'd ordered the blood counts to reassure both of us. Unfortunately, this little boy's labs were severely abnormal with low values of infection fighting cells, red blood cells and platelets (they help the blood to clot). As a first year intern, right out of medical school, I'd seen numerous cases of abnormal blood counts like these in children before they were diagnosed with leukemia. We seemed to have at least one case of new leukemia each week, as doctors from rural and far away areas sent their sick patients to be evaluated and treated by the Pediatricians specializing in childhood blood cancers. I felt a sinking feeling in my stomach as I realized all that this patient and his mother had ahead of them. Though I had only seen the boy once, the previous day, I had to call his mom and deliver the bad news. And I had to send them immediately to UNC to be evaluated by the pediatric specialists in hematology/oncology. I tried to remain calm and reassuring on the phone even though I felt a dumptruck load of sadness raining down on me. By the time our staff meeting started, tears were rolling down my face. My colleagues were comforting, of course, but I couldn't hold back the tears. I suddenly felt so overwhelmed with pain and darkness for them, for their impending suffering. Childhood blood cancers are (now) 95% cured. But that road, well known to me from my own leukemia 2 yrs ago, is a tough one. Needless to say, I was never able to recover fully from the difficult start to my day-alternating between feeling so, so sad for them and reliving how hard all of that was for me.

Even now, hours later, I am still resonating in the sadness of what is to come for them. Though I feel especially lucky to have survived my own "major death scare," I feel uncertain and vulnerable. That is the hardest part of "sitting with it" . Tomorrow will be a bit better I do feel certain of that.