I Made the Cardinal Mistake of Falling in Love with my Patient
Ever since I could remember, I wanted to be a pediatric oncologist. After three years of pediatrics residency, I had made it to the first day of my oncology fellowship.
As we got to the wards, I could feel my heart beating out of my chest. I sheepishly introduced myself to the patients and their families after my supervising doctor shuffled in and out of patient rooms.
As we approached one of the last rooms on the unit, I saw colorful animated characters dancing on the door of the room.
We knocked and entered, and I saw Super Mario characters on the pillow and bedsheet, a giant Yoshi stuffed animal sitting on the bed and a six year old boy with a buzz cut kickboxing with an inflatable punching bag.
He saw us enter and immediately hugged my supervising doctor. My supervisor held out his hands and Antonio punched them while giggling. My supervisor held out his arms to lift Antonio and Antonio spread his arms and then, all of a sudden, his smile turned into a frown. He asked to be put down and told his mother, who was standing to the side of his bed, that both sides of his chest hurt. His mother helped him to his bed and tucked him in.
As the brutal year known as the first year of fellowship progressed, Antonio and his mother became my refuge. During morning rounds, I’d sense immediate relief when I approached his room. I found myself making an extra cup of chai for Antonio every morning as I poured my own. I heard myself advocating for him in group meetings with the other physicians at the hospital.
There were days he’d dress up as Super Mario or Woody from Toy Story but there were also days he’d be sleeping all day because he had no energy. His battle with cancer unfolded in front of my eyes. We tried chemotherapy after chemotherapy but nothing seemed to work. Every scan would show progression of his disease and none of the world’s experts had anything left to say.
I searched the medical literature myself because maybe there was something out there that could help him. Every article I read revealed that our team tried every thing for Antonio. Unfortunately, none of it was enough.
The last time I spoke to him, he asked me for glitter slime that was purple and blue. I obliged, he smiled and went back to sleep in the arms of his parents.
Two days later, I visited his room to find his mother sitting on the side of his bed crying and patting Antonio’s head. Next to her was the hospital music therapist softly singing Jesus Loves Me. I heard his mother say, “Look Antonio, look who it is, it’s Dr. Payal.” As his mother pleaded with Antonio, tears rolled from my eyes into my N95 mask. My sniffling grew louder and I just stood there, without anything to say.
In medical school, I learned about the disease Antonio had, and the prognosis it carried. I learned how to do a physical exam on a pediatrics patient and how to break bad news with an actor who was pretending to be a patient. During a summer oncology rotation, I learned the treatments offered to Antonio and memorized their side effects. I learned to not accept dinners from pharmaceutical companies that cost over a certain amount and how unethical it would be to fall in love with a patient from my practice.
What I didn’t learn, however, was how to protect myself and stay sane. In Samuel Shem’s famous novel, the House of God, the Fat Man always cautions the medical trainees lower down on the totem pole that “they can always hurt you more.” The Fat Man was right.
When Antonio died, I felt as if I had lost a family member. I felt nauseous for days as we approached his room on the unit. I found myself crying after rounds and reaching out to his family to offer any support. I swapped my chai for coffee because it made me sad to think of Antonio passing before starting every day.
It’s been nearly a year, and I still think of Antonio when I see a little, spunky boy, who looks like him on the street. I think of him and his mother when I see the way my sister smothers my nephew in affection. I think of him when I tell people about the patients I treat and how resilient they are.
