One day in clinic, recently, I reviewed my daily schedule with the oncology fellows who were working with me that day. With the exception of the new patients on my schedule, I recognized all of the names on my list. I opened the electronic chart of the first patient to skim the problem list, a handy spot where I keep a summary of all the treatments received for the cancer diagnosis.
“Mrs. Jordan* is just here for routine follow up. She completed therapy about three years ago, and she’s done great so far,” I said. I went on to tell them that her son was a physician, but that he never came with her to her appointments. He had emailed, once, just to touch base; but it was clear that his mother valued her independence and wanted be in charge of her own health care. She was in her 80s and very clear about her expectations of me and, I’m certain, of her son.
Using the computer mouse, I pointed to another patient on the list.
“Ms. Finley is coming today to discuss her CT scan from last week,” I said.
I planned to discuss chemotherapy with Ms. Finley, and I was sure she would agree based on the scan results that showed progression of her cancer. I mentioned the regimens I was considering to the fellows, as well as my rationale for my top two choices. I fielded questions about chemotherapy selection in platinum-resistant ovarian cancer versus platinum-sensitive disease.
“She’s retired from teaching,” I told the fellows. “She usually comes with her daughter, who’s a pharmacist.” Keeping busy through volunteer work has been very important to Ms. Finley, and it’s helped to reduce her anxiety about her disease. I hoped she was still doing it. If she had stopped volunteering, it could be an indication of her level of symptoms.