I’ve had my goodbye speech prepared for each patient. It was concise and direct to the point, but not devoid of the genuine sense of farewell. This is because I’ve discovered that patients who had no idea that their doctor would be replaced suddenly would become quite perplexed and even annoyed at this new person poring over their charts, and most of them getting worried that this new doctor has no idea what happened to them for years on end.

I’ve written my endorsements in as many charts as I could, barring those who haven’t followed up for many, many months. I’ve written my original plans and recommendations, reiterated the inputs of the consultants I’ve referred the cases to, and suggested algorithms if this event or that happens. Everything was doing well since January, until this week.

When, for some reason, my stablest patients, those whom I am quite proud to endorse because they have completed their treatment successfully and would only need to undergo surveillance, have either started to experience recurrence or horrible treatment-related complications. I never had difficulty doing “disclosure” upon diagnosis with new patients, because obviously the huge sign “CANCER INSTITUTE” emblazoned at the building door already discloses everything, but the difficulty lies in telling them after months and months of chemo and racing for funds that they have recurred, or that the treatment is not working at all, or that they have progressed. Blasted cancer. My concise speech has turned into prolonged explanations on the worsening of the disease, the plans ahead, the expenses, and the expectations, sprinkled with the reassurance that the disease progression was something beyond our control.

Maybe it’s not too late to shift to Allergy.

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