Hospital for the Holidays

One of my roles in academic oncology requires that I attend on the inpatient oncology service. So much of oncology has moved to the outpatient clinic that admission is often required only for those with the worst complications of treatment, receiving complicated regimens, and those who are nearing the end of life. I won’t lie. It is often a stressful experience–mostly because these types of doctor-patient relationships are cursory, gained from a review of medical records and the notes of others, not from a long-standing relationship forged after many months, or even years.

While in general attending on the wards is hard, it often is even more so around the holidays. From November and into December, the world celebrates and remembers, and people reflect and give thanks for what we have and for what the year has brought. Outside of the hospital, these months are filled with celebrations, presents, holiday lights, tinsel, presents, and joy. Inside the hospital, however, the experience is often more somber.

As I began my rotation this month, I hoped that my rotation this time would be easier; I wished for patients whose stays would be short and that ready solutions were apparent for their problems. I imagined how wonderful that would be–to have a low census during my own rotation and know that those I met would indeed be home for the holidays.

But illness does not respect holidays or traditions, and for many patients, there will be no respite from cancer. No matter the time or season, our patients get very sick, and some will spend their holidays in the hospital, perhaps for the last time. So I must prepare myself for all those I might meet, whether it be the young man with an aggressive prostate cancer, the young mother dying of breast cancer, or the grandmother with cancer-related pain requiring large doses of medication. And more than prepare myself, I must do what I can to alleviate suffering, maintain hope, and provide guidance.

This is medicine. This is Oncology. And this is art.