As far as I was aware, from the notes and from what the consultant said, he'd been told his diagnosis last week. He seemed a bit more upset and agitated, but was in a lot more pain. I thought, considering everything, he was taking this bad news pretty well...
Then today I was involved in a conversation with the palliative care team, his nurse on the ward, the FY1 and I. Turns out he'd only been partially told.
I felt sick.
He'd been told that there was shadowing in his imaging, and that this was being further investigated. So really he had no idea. The doctor never explicitly used the word "cancer". The consultant was adamant that the patient knew what he implied. The rest of us weren't so sure.
It was left down to the palliative care team to go over to him and break the news properly, making sure he understood everything.
I've always thought it's important to say things as they are. Words like cancer and death are scary, but it's only fair that the patient knows what's happening. Or at least that's my opinion.
I know that when my Mum was dying in hospital it was a long time before we were told she had cancer and was dying. In fact it was only a couple of weeks before she died. I have no doubt that the team caring for her were aware long before us. Probably like my team they were waiting for histology and a proper management plan. Surely though, for someone with obvious mets, it's important to at least tell them that they have cancer.
I can't help but think that if we had a bit more knowledge about my Mum having cancer that she might have had the chance to die in a hospice, which is a lot nicer than a hospital. I also think it would have been a lot kinder on my Dad and I if we'd been told more and prepared a little more for things.
I just wish I was a bit more influential in the team so that I could help this family a little with what is clearly going to be a difficult time.
I don't think histology or the finer points of management matter that much to patients or relatives. What matters is knowing a realistic prognosis and the major options for the future. Home, hospital or hospice care? Saying goodbye to loved ones. Getting affairs in order. Sorting out finances and wills.
I'd like to know what other people think, or situations other people have been in? What would you do if you were the consultant?!