caged animal

    The patient had breast cancer.  Like my brother, she discovered it because "my back hurt."  Metastasis in the spine, you see.  How many people go in with back pain and expect to walk out with cancer?  By then, it's already Stage IV.  She's a very sweet lady and far too young.  Very amicable and pleasant, especially given the topic of our conversation.  But about 25 minutes into the visit, she starts to become restless.  She moves the bed up.  She moves the bed down.  Her answers get shorter.  Shifts to the right.  Pauses.  Shifts to the left.  Leans forward with a grimace shooting across her face.
     I know this look all too well.  It's the look of a caged animal.  It's the look my brother had far too many times.  It's a pain spike.  She's trying to get comfortable but can't.  When they hit, they hit FAST and they hit HARD.  And then the patient pops the oral pain killer but it takes a good 45 minutes to kick in.  And that ends up being the longest 45 minutes of their life.  I'm relating this all to her hoping to validate how she feels, that by talking about it, it might lessen the intensity just a smidge.  And she nods her head in agreement.  And she seems a bit surprised that someone else is on intimate terms with pain spikes such as she experiences. 
    I don't wear the grief of my brother and the struggles of my dad on my sleeve.  After all, a patient surely doesn't want to hear about my problems.  Plus, we're trained to be professional and all that.  But I also don't shy away from it.  Empathy is a hard thing to do.  When appropriate (and it's an ever shifting art of determining when it's appropriate), I communicate my own experiences with cancer to help bridge that gap between doctor and patient.  That at some small level, they are not alone in their pain.