A profile in courage

A few weeks before Christmas, I opened a holiday/thank you card that had just arrived from Cheryl, one of the nurse practitioners in my office. Through tear-filled eyes, I read: So, here we sit, staring tragedy in the face. Boy, the day that you had to deliver the news had to be, for you, mind-stopping, even life-changing.

I thought back to a little over a year ago and that fateful August day.

It had started off like any other workday. I'd joined the practice the year before, right after residency. There was one other physician and two nurse practitioners, Cheryl and Jack, a married couple. It was an ideal situation. I felt very lucky to have found such compatible work partners.

Her lab work came back the following morning. Nothing really remarkable, but off just enough to trigger my "Spidey sense"-that intuitive, lingering feeling, that faint whisper that settles in the back of your mind and won't let go until it's been addressed. Over the years, I'd learned to listen to that voice, and I did so that day. I decided Cheryl would have a CT scan that afternoon. I didn't give an explanation, since not everyone believes in Spidey sense. I simply said there was no reason to wait.

About two hours later, I received a phone call from the hospital. The radiologist said, "I have some bad news. The liver is full of metastatic cancer. There are suspicious areas in the colon and pancreas. I can't tell where the primary is."

This hit home on a personal level. My friend and colleague had just been diagnosed with a terminal illness-and I was going to be the one to tell her.

Over the years, I'd certainly had experience delivering bad news. But I'd never had to tell someone close to me that they had a terminal illness.

I called my husband and the first words out of my mouth were, "Please tell me I can do this," as I related what had transpired. My mind filled with jumbled thoughts of Cheryl, or Miz Cheryl, as her loyal patients referred to her. I thought about her cheerful, enthusiastic, and sometimes slightly goofy personality that endeared her to patients and co-workers alike . . . about her love for her 7-year-old son, her gratitude for being blessed with a second marriage, and how proudly she wore her white coat with FNP embroidered on the breast pocket. Last year, to the delight of her patients, both young and old, she'd dressed up as Peter Pan for Halloween, a perfect choice for a little pixie, at just five-foot, one-inch and 100 pounds. Far younger than her 50 years, she loved the holidays and was always decorating the office. She simply loved life.

I felt overwhelmed and completely unprepared for what I had to do. I closed my eyes and said the Serenity Prayer: God grant me the Serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. I took a deep breath, put a smile on my face, opened my office door, and continued seeing patients.

When Cheryl and Jack came back from the hospital, there were still about 15 patients to see. I lied and said, "I haven't heard from the radiologist yet." I knew that I needed to hold things together long enough to take care of the remaining patients.