Last night as I was working in the emergency department I was talking with one of the other residents who told me the story of his nephew who is dying with ependimoma. He told me how he had been through intensive radiation therapy for six weeks that involved therapy every single day during that time. The cancer was in remission for a year or so until that fateful MRI when the cancer was seen to have spread all over the brain and spinal cord. Now it's a matter of just a few months. He said that his nephew's family were able to take him to Disneyworld with the Make a Wish program and he was tucked in at night by a different Disney character each night.
His nephew is three years old. He was two when he was originally diagnosed. Just my Sam's age.
As he told me the story I got pretty emotional imagining my perfect son dying through a horrible long term illness (or even overnight in a terrible accident). The thought is devastating in a way that no other thought is.
Then I imagined myself next year as the physician directing the radiation therapy for this little boy. What would I do and how should I act? Would I allow myself to show my emotions and have a good cry with the family or should I be sympathetic but detached in hopes of allowing the family their grief but keeping the credibility perceived in a non-emotional assessment of the therapy's progress? I never had the experience of being involved in therapy quite like this during my oncology fellowship or my rotation last year. It will be interesting to see what it ends up being like.