Indexing Title: CLEYSONs Medical Anecdotal Report [04-7]

MAR Title:  To face death

Date of Medical Observation: October, 2004

 Narration:

    This is a case of a 49-year-old female who was diagnosed to have stage IIIB breast cancer left, s/p modified radical mastectomy, left. She is not your typical female. Feminine hardly describes my patient. She surely fits a different category altogether. She is what in layman terms called tomboy or t-bird, some of the bizarre terms used for lesbians. Weighing around 90 kilos, sporting a hair cut short enough for ROTC training.

    She resembles a man, in built, in looks and attire.

    The first time I met her, she seemed to be a happy-go-lucky person, with a sunny personality and of considerable strength of character. Perhaps it was because of her appearance, there was a masculine air about her, expressed by the way she looked and the manner with which she carried herself. She struck me as someone very strong, someone who will face difficulties in life head on and not back out.

    The first time we told her about her condition, she looked a little bit off but easily regain her composure. She was keen on asking questions pertaining to her operation, indicating her interest on what was about to happen to her. She was zealous in completing the materials needed for the operation. She even joked around a few minutes prior to the OR while she was lying on the operating table waiting to be anesthetized. Perhaps this was her way of dealing with the fear of having to undergo surgery.

    It was after her operation that a change in her demeanor became noticeable. Up until that time, I was convinced that she was a very strong person, far stronger than what was expected of her gender, but she disclaimed my previous opinion of her. In such a short span of time when news of how terminal her prognosis was, she took on a character vastly different from what she unwittingly projected all along. Her fear of her uncertain fate was like a tangible entity floating along the vicinity of her bed. Her questions were asked not purely because of interest on what’s going on in her body, but more of its impact on her life from that point on. She confided that her initial reaction from the news was that she cried foul and unfair.

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements)

    It is through this patient that I am reminded of a person’s death. Faced with the uncertainty of the future, we tend to forget ourselves and bask on the emotions that threaten to drown us. We lose our masks and we drop the pretenses of being somebody we are not, we become vulnerable to fear and uncertainty of what the future holds for us.

    It is through this patient that I realize once more that despite appearance; inside each and every one of us is a human being scared to face death.

     This case reminded me of the hardships of patients having a terminal disease; the physical, mental, emotional and spiritual impact to them. As a physician, we should be compassionate in dealing with these patients.  We should support them and help them so that they will live their remaining life in comfort and in peace.