What to do when....

..all you really want to say is "There is nothing we can do."


There is nothing we can do.


I am sure, in any doctor's life, there will be a few times when this is the one thing that you have to say, yet you know you can't.

For it means, there is no longer any hope, you have come to a dead end and there is nowhere else to go. There are no rays of light, no silver lining, no matter how hard you look.

There is nothing we can do for your mother.
There is nothing we can do for your father.

and the saddest of it all, There is nothing we can do for your child.

I seriously think, malignancies in children is the worst thing in the world. How does one cope with telling parents of a child, someone who's just only about to start his/her journey of life, that your kid may pass away before you do?

A few months ago, a 16 year-old girl came to the clinic with a swollen knee. Subsequently she was referred to another hospital for proper treatment for the cancer.

As doctors, we tend to 'suggest' certain treatment in a matter-of-fact of way and we don't stop to think what we are really telling our patient.

How does one tell a 16 year-old girl that she has to have her leg chopped off? I think about it and consider how I would feel if someone told me that I need to have my arm surgically removed. Devastation doesn't even cut it.

Of course then one may say, where are the parents and what are they doing?

I am not a parent myself so this is something I may never comprehend but apparently when one becomes a parent, all you want to do is to fulfill a child's needs and wants. How do you say to your daughter that her leg has to be removed?

How, indeed.

So of course this unfortunate family decided to seek alternatives.

A friend received her case a few days ago. Apparently the mass is now the size of a football, ulcerating and bleeding. She is pale as sheet and stopped breathing at the A&E but was revived with resuscitation.

No matter how they bandaged her knee, blood was dripping. Her condition had become so bad that her blood could not clot, it was like a leaky pipe. It took the highest concentration of medicine just to maintain the lowest of her blood pressure.

Of course, there is no way she is fit to go through an operation. Even if she is, there is no knowing the state and extension of the growth.

In short, there is nothing we can do for her except make her comfortable. The last I heard her heart stopped beating again in the ward and again she was resuscitated. It looks really bleak; even if she miraculously survives, her brain wouldn't have survived the periods when it was oxygen deprived.

My heart and prayers go to the family.