The Last Fraction: straddling the lines of friend, caretaker and rad tech
It was a normal day in the radiotherapy center, the patients were awaiting their treatments as others were being prepared. The daily QA was done and we were ready to start effecting treatments. I was preparing my first patient and I could overhear the oncologist who was welcoming a new patient with an orientation regarding the 25 fractions of the treatment that he would be receiving starting the following week. Out of line of direct sight, I realized that the patient’s voice was extremely familiar. To tell the truth, I was somewhat relieved that he didn’t see me, as I did not want to deal with the awful reality of having to treat someone I knew.
Someone I knew… An emotional understatement. My suspicions were miserably validated; the Oncologist confirmed that the patient was who I suspected him to be. My closest and dearest classmate from my days at university. Our friendship started at the very beginning of our studies, we both had been very serious in our scholarly pursuits and had both been awarded the two available nominations for a PHD program in Belgium. Miracle of miracles, my best friend and I were both chosen as the most promising and our adventure together would continue for the next several years in a new and very promising environment.
As it often happens, we get older and we lose touch with some of the people who are near and dear to us due to daily priorities, love, family, job, etc… Now, he was suffering from esophageal cancer and I was part of his treatment team.
After a long weekend, I returned to the clinic. I was scared to meet him, but at the same time I wanted to comfort him as much as possible. Having the same background as myself, there was little point in telling him that he was in good hands and that everything would be OK. He knew as well as I did that the probability of a meaningful recovery was extremely remote.
He was the scheduled first patient for treatment. The door opened, I saw him in a wheelchair and walked towards him, he looked at me pronouncing my name, and asked me: “What are you doing here?” I replied in the same way. Funny how people act stupid in uncomfortable situations and also funny how people are more comfortable suffering anonymously. Smiling, I gave him my best script: “You will be fine and leave after you get well”. He looked me in the eyes and said “don’t lie on me, it is an esophagus tumor, I will lose my voice soon, I will be vomiting, they will intubate me and soon, I will not burden anyone”. Naturally, the discussion moved to reminiscing of our days together at university and in Belgium, the good and bad times we shared together, our favorite hangouts, old friends and not another word about the reality of the moment.
After only one week, he was moved from ambulatory to interned patient. He didn’t beat the odds and the Cancer was continuing to ravage him. He was wheeled down to us in order to receive the last of his 25 fractions. I approached him, trying not to react to his diminished state and with a smile on his face, he told me “I don’t want to be treated today, keep me in my wheelchair”. I took a seat next to him, held his hand and recounted our many memories about our time in Brussels, liege, Bruges… every weekend we spent together with all the guys from our group. After 2 hours of discussion, he said we finished the treatment for today, I feel better now, I will return tomorrow.”
He didn’t.
In retrospect; this was the best and most effective last fraction that I ever delivered. It was void of radiation but full of honesty, dignity and humanity. The real reasons I chose this profession, which I love.
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