Bad News

Last weekend I only admitted one patient to my service, which meant it was a SLOW weekend.  Constantly checked the pager to make sure I wasn't missing calls.

But, what I got was a heartbreaker. 

An older lady, a six-year breast cancer survivor came to our emergency room.  She arrived with chest pain, history of coronary artery bypass grafting.  She had negative blood work for a new heart attack and her EKG didn't look too bad.  So, I admitted her to our cardiac floor.  The ER doctor had done a D-dimer level on her, just to check for the possibility of a pulmonary embolus, a clot in the lung.  It was just barely elevated, so we did a CT scan of her chest.

The report came through and you could have hit me with a cinder block in the chest.  Multiple metastases throughout both lung fields, also probably in her liver.  I'm not her regular physician and her cancer doctor is in the next town over.  I had the duty of sitting down with her, her husband of fifty years and her grown daughter to explain that her cancer had come back.

Now we get to start picking up all the pieces.