What’s For Lunch?

These days, Thursdays are my busiest day of the week.  It’s the day I see all of my on treatment patients.  Currently there are thirty one of them—a busy load for a radiation oncologist.  Nonetheless, I have instructed my therapists that they must leave me time for lunch, and so they schedule the patients so that during a brief period during the noon hour, my nurse and I can retreat to the quiet of our offices and grab a bite to eat.  Food having always been of major importance to me—it’s the high point of my day on a busy day like today. Since we have no cafeteria or vendors in our building, I usually bring something easy, like a salad, or perhaps some cottage cheese and tomatoes.  I don’t usually hit the Milky Ways and peanut M and M’s until late at night, but that’s for a different story.  When I do break for lunch, I can usually be found at my computer, catching up with emails, surfing Facebook, and yes, checking to see if anyone is actually reading this blog.

So there I was minding my own business, the door to my office wide open to compensate for the fact that maintenance has never succeeded in making the room cool enough to ward off my hot flashes, when a man walks into my office and says, “Is there a doctor around here?”  I have not met this man before, but I assume he is one of the patients belonging to one of my colleagues who have been covering one day a week since my partner went out sick.  I look around hopefully for my nurse who is nowhere in sight, and then own up.  “Yes sir, I am the doctor here. I am Dr. Fielding.  May I help you?”  He said, “Yes, I need you to look at my rectum.  I think there’s something there.”  I am hoping that he has lung cancer, since I do not want to look at his rectum, or his anus during lunch.  I say, “Sir, since we haven’t met, what are we treating you for?”  He said, definitively, “Rectal cancer.”  I see now that, as they say, the only way out is through.

So I ceremoniously put down my fork, pick up my napkin and dab at my lips, and say, “Follow me.”  In we go to the exam room next door, where he drops his drawers and I have a look.  It’s a hemorrhoid, plain and simple, and swollen from the irritation caused by the radiation.  I say, “Sir, it’s not the cancer.  It’s a hemorrhoid. I can prescribe some medicine for it.”  There is an audible sigh of relief.  He follows me back into my office, where the sad tomatoes and mozzarella are looking a bit waterlogged by their balsalmic vinegar.  I write the prescription and he thanks me profusely and goes on his way, and I go back to my lunch.  A day in the life….

Reflecting on this later, I thought to myself, “Well, at least he wasn’t an asshole when he asked me to look at his asshole during lunch.”  Always happy to be of service!

I Am Easily Charmed

There has been some confusion around the office due to the fact that my partner became suddenly ill, and it was important that the patients on treatment be seen once a week.  In addition to my own patients, I had seen all of his three weeks ago while he was on vacation, so I had a working knowledge of most of them, their cancers and the problems they were having during treatment.  Still, there were new patients to be seen, simulated and treated and it seemed that the most logical division of labor was for me to see the new patients, and the substitute doctor to see the old patients, many of whom were close to the end of their treatments.  It seemed that way anyway.

So when my partner’s nurse asked me to see a prostate cancer patient belonging to my partner this morning, I asked, “Didn’t Dr. Substitute see him yesterday, as she was supposed to?”  Our nurse answered, “She tried, but he wanted to see you.  He remembered you from three weeks ago. He is at the end of treatment.”  I said, “Okay, just this one time, but I will NOT see him in follow up.  He can return to his urologist for follow up as long as his PSA normalizes.”  A moment later, I was in with the patient, a kindly elderly man who described not his side effects and symptoms, but the fact that yesterday he went to the San Diego Fair with his two daughters, and what a delight it was that he got to spend time with his adult daughters alone without his wife.  Apparently this is a yearly ritual. We spoke about the art exhibits, the rose growing competition, and of course, the fried food.  I thought to myself, “Maybe Dad would like to go to the Fair.” I exited the room twenty minutes later, proclaiming to the nurse, “Okay, I will see him ONE time in follow up.  Just ONE TIME!”  She smiled.

At the end of the day there was another.  Just started on treatment, this prostate cancer patient had missed his on treatment visit yesterday because Dr. Substitute had to leave.  The nurse warned, “He’s a bit chatty.”  I entered the room, whereupon he declared, “No cancer patient is truly cured.  I just hope I outlive my cancer.”  This was a challenge indeed.  Despite the fact that I was quite certain my partner had already had this conversation with the patient, I felt the urge—no, the COMPULSION—to tell this patient of the multitude who indeed I had cured over a thirty year career.  It was a long conversation.  We both enjoyed it, heartily.  I added another patient to my roster.

What is it with these prostate cancer patients?  We have a mutual admiration society.  And I hear that the word on the golf course is, I give the best “finger wave” in the business.  Just sayin’…..