The Third Chair - life on the other side of the stethescope

My husband was diagnosed with cancer 4 months ago.  With apologies to the Grateful Dead, what a long, strange trip it's been.

Since he is still in the throes of treatment I am not yet ready to process this experience into a thoughtful analysis.  Instead I will share with you a jumble of my impressions of life as the physician spouse of someone dealing with the medical system.  And just my impressions of life caring for someone with cancer.

• I felt guilty when the doctor said, "It looks like cancer" - did I miss something?  How could I have not caught this earlier?  I do feel that I pushed when I felt things were not being followed up when I thought they should.  In retrospect the diagnosis to surgery time was pretty fast, though it felt agonizingly slow when going through it.
• When we interact with health care personnel I feel a need to tell the history, even though I know I should let my husband speak.  He frequently defers to me when I do sit back and try to shut up -- but have I just trained him to do that by my eagerness to speak?
• I feel a little guilty when we are treated very nicely by the hospital staff, like getting a private room.  Part of me wonders if they are just doing that because I am a doctor, part of me knows I wouldn't refuse even if that was the reason we got the good treatment.  I do feel better when I look around and notice other people being treated as well.
• I can't stop being a doctor and just be a spouse.  I make recommendations for treatments - please put dextrose in the IV fluids, please give Reglan.  I question treatment options, especially if it seems no different than what we've already tried.
• And then when I reach the limits of my medical knowledge, and my husband still has that "Please help me" look on his face, I feel guilty and frustrated.  I feel like a failure sometimes when we have to go to the hospital for non-routine treatment because I feel it means I failed at management. Is that the "doctor as god" complex, having a hard time admitting that I can't do it all?
• When he is inpatient I have dichotomous feelings - frustrated by having to wait for other people to act (at home I give the meds when I feel they need to be given), yet safe because if something is not going right there is someone else to turn to (if he vomits the med someone else can figure out what else to give).
• One of the big surprises is how many employees I see in the hospital and clinics that are parents of my patients (did I mention I'm a pediatrician?).  I smiled when the Gastroenterologist came out of the OR to tell me that the PEG placement had gone well and mentioned that "half the endoscopy staff said to treat your husband well because you are their pediatrician."

The one big advantage I have over other people going through difficult medical treatments is that I feel at home.  The geography and language of the hospital are not foreign to me.  I understand the hierarchies - I'm not afraid to ask someone where they fit in the team.  The ebb and flow of shifts, the difference between what can be accomplished during a day shift and a night shift.  This allows me to act as an interpreter for my husband, to try to ease his anxiety.  No, the nurse can't just change that medication from oral to IV, you must wait for the night float resident to answer the page and give a new order.  Yes, they will still take you to the OR for that procedure, even at 6pm.  I know which alarms on an IV I can fix and which I can't.

I am still deep under water with my head down, swimming hard to get through this as I carry my husband along.  But now when I look up, sometimes I can see a bit of light dancing on the surface of the water.  Then I have hope that end of the hard times is near, we will come to the surface and enjoy a large gasp of fresh air that will wash over us with wonder.

1 more round of chemo, 13 more radiation treatments to go.

ALB