I work in a cancer hospital. I need to know why you can't just tell people they're dying? How can a specialty with so much certain death just spread so much fucking hope?
Yesterday I messaged my patients onc team to come participate in goals of care in the MICU at the request of our attending. Onc attending messages me back - "yeah, this lady is definitely not making it out of here. If we can come we'll come, but if not let your team know hospice is reasonable." Cool. Fast forward to the actual meeting. Oncology enters. Same guy who just told me this lady is dying looks the family directly in the eyes and tells them he has "some pretty good chemo options if she can make it to the outpatient clinic." Who would withdraw after news like that? Why not say hey she's maxed on the vent, CRRT, 3 pressors and is septic and fungemic. Maybe getting to clinic is a pipe dream.
Out in the hall I said hey, didn't you just tell me earlier this lady wasn't making it to clinic? Him - "well we can't ever say there's zero chance. And the family clearly wants aggressive treatment"
Whyyyyyyyyyyyyyy?! This is a daily occurrence. For sure not the first time the note says the exact opposite of the unicorns and rainbows I see spread in real life.
Catastrophic brain bleed? It's ok the kappa light chains are looking SO much better. Let's just get over the hump
92 yrs old? Hasn't walked since 1997? Let try some palliative chemo.
All the organs have peaced out? It's ok because their cell counts recovered. Let just trach/peg/put on the ltach shelf and call it a win.
I only see these people in passing, and obviously I can't just say what the actual fuck in a professional setting. So real talk with you reddit oncologists - what the actual fuck is happening here? What am I missing, because I'm tired of doing shit to people and not for people.
Edit - I'm not a physician. I just the bedside torturer with a front row seat to the horror show. Sorry if that wasn't clear.
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