Dr. Rao

I read this Monday; it was Jan Brody's column in the Health in Fitness section of the Post-Dispatch. Unfortunately, the letter that ran with the column isn't printed on the web, which is too bad, because it was one of the more moving things I've read in some time.

A grieving husband wrote the letter to his late wife's oncologist. The gentleman explained that he wasn't impugning the doctor's medical ability, but felt it was inappropriate and sad that the doctor essentially turned away from his wife when it became apparent that she was going to die soon.

I've had some firsthand experience with this; nearly three years ago, my father died of colon cancer. We'd been living with the cancer for so long that it became an everyday part of our lives. When an ambulance took Dad to the hospital before dawn that final Monday morning, I couldn't accept that he wouldn't be going home in a few days - despite the fact that he'd been growing weaker daily, was hallucinating and lived his days in ever-growing pain. We delude ourselves into thinking that those who are dear to us will never, never leave.

The sad truth hit me later that night when mom called to tell me that Dr. Rao, the surgeon who removed the colon a year ago came by to visit Dad in the ER that afternoon, after I had left. Dr. Rao was kind of a cocky prick. He walked with a swagger and had a cocksure glint in his eye that made me want to smack him. I didn't like him when I met him, but he fixed Dad up, so I did respect him.

Dad's regular oncologist was nowhere to be found. She finally returned a call after several hours; the residents acted much the same. Dad was clearly terminal, yet they would basically look in very briefly, tell us how he was doing (in doctorese, which is slightly less decipherable than Russian, yet more decipherable than the bookshelf instructions I read recently), and leave. However, Dr. Rao heard Dad was in the ER, awaiting transfer to Barnes, and he went to visit. He sat with Dad for an hour, hugged him, and gently told him that it was okay to die; that at some point, fighting for a few more days of life filled with nothing but medicine, doctors and pain really isn't much of a life; that there was no dishonor in giving up.

I hope that, Heaven forbid, if I'm ever in that situation, I have a doctor that will do the same thing. Oncologists and other doctors fight battles they constantly lose; the few clear wins become that much sweeter. And it's human nature to pull away, to put a little distance between yourself and the pain. I'm sure that for many oncologists, a small piece of them dies along with each lost patient. But the sad truth is that these patients who are facing death need their doctor's guidance and strength more than ever during the final stages of their illness, even if it's just to hold their hands and stand with them until the end - especially if that doctor has been with the patient from the beginning.

I don't know what Dad went through the last week of his life. All I know is that I sat beside his bed and watched him grow weaker and more dim from the blinding pain and the pain killers, and that when he finally passed, in one small way, I was relieved; he was no longer suffering.

Not a day goes by that I don't think of Dad; I miss his booming laugh and arguing politics and history with him, but he lived a full, rich and good life. I'm also happy that a surgeon took a few minutes out of his very tight schedule to meet with him, offer him comfort and let him see that he could die with dignity, surrounded by his loved ones.

More doctors need to take a page from Dr. Rao's book.