One morning in my second year of medical school, while I was studying for my boards, my mom called me to tell me that she was having trouble moving her right hand.
My mom loved to write letters and told me that she couldn’t hold the pen. I could hear the fear in her voice, and so I came right over. When I got there, just like she said, she couldn’t use her right hand.
Now, in medical school, I was doing research for the neurosurgeon who had operated on my brother Eric six years ago. I called him right then to explain the situation, and he said to bring my mom immediately to the emergency department.
When we arrived, my mom underwent extensive testing, including a CT scan of her head.
The scan showed seven tumors in her brain.
My mom was admitted to the hospital that day. She was scared to death, as we all were. I remember going home that evening in disbelief. I couldn’t believe what was happening. I cried myself to sleep that night.
When I awoke the next morning, I was wishing so badly that it had all been a dream, but I knew all too well that it was real and that it was a death sentence for my mother.
The next morning, I went to the hospital early, around 7 AM to visit my mom. Her room was dark, and as I walked in, I could hear her crying.
I asked her what happened, and she said that a doctor walked in earlier to tell her that she had cancer in her brain and that she didn’t have very long to live.
Now I can never know exactly what that doctor said to her that morning, but it is for sure what my mom thought she heard. That one experience has always shaped how I deliver news as a doctor and a neurosurgeon.
I always make my best effort to never deliver bad news to a patient while they are alone, and I always try my hardest to wait until I can have family present.
From that point on, my mom went through two brain surgeries, chemo, and radiation therapy. All her hair fell out, and she would vomit multiple times every day. Her life was miserable.
After about a month, she started talking about things that didn’t make sense, and I knew at that point it wasn’t my mom anymore. She was gone.
From the day she was diagnosed with brain cancer until the day she died was three months. I was standing alone next to my mom when she took her last breath. It was one of the worst moments of my life.
As I look back on that period of time, I have come to realize that more is not always better when it comes to treating people.
And sometimes doing less is the more humane route.
My mother had a horrible existence over those three months. And in retrospect, she would have been better off with hospice-type care and allowed to enjoy what little time she had left than what we put her through.
And I say we, because we as a family put her through those treatments at the doctor’s recommendation. We did it because we couldn’t bear the thought of losing her. How selfish of us, but how human as well.
Throughout my career, and because of my mother, I give patients and their families options. And I don’t always push for the most aggressive measures. Sometimes doing nothing is the more humane and reasonable option than pushing for everything.
Lastly, I see it as my job to help the patient and their families be comfortable with their decision no matter what it may be. There is never an absolute right or wrong answer when it comes to a life-altering problem.
My role as a physician is to educate and counsel the patient and/or family regarding all treatment options available and let them make the final decision.
It should never be what I want to do. It should be what the patient and their family want to do once they understand the treatment options.
Brian Hoeflinger, MD
